There is considerable confusion and anxiety surrounding the new diagnostic criteria for Autism. It is helpful to understand what the new criteria are, and how it affects those who are already diagnosed with autism, and people who will be diagnosed in the future.
Autism Spectrum Disorder DSM 5
Must meet criteria A, B, C, and D:
A. Social communication and social interaction ‐ meet all three
1. Deficits in social‐emotional reciprocity
2. Deficits in nonverbal communication
3. Deficits in relationships
B. Restricted, repetitive behavior, interests, activities ‐ meet two
1. Stereotyped, repetitive speech, movements, or object use
2. Excessive adherence to routines, rituals, resistance to change
3. Highly restricted, fixated interests, abnormal in intensity or focus
4. Hyper or hypo‐reactivity to sensory input or unusual sensory interest
C. Symptoms must be present in early childhood
D. Symptoms together limit and impair everyday functioning
In order to be diagnosed with autism, and individual must meet all three criteria in A. They must exhibit deficits in social-emotional reciprocity, nonverbal communication and have restricted behaviors. In addition, they must have at least two of the criteria in B. Repetitive tendencies, adherence to routines, intense interests, or atypical sensory reactions. In addition, these symptoms must have been present since early childhood (although some may not appear until school age) and the symptoms must be problematic in a person’s life.
Asperger’s and High Functioning Autism (HFA) are no longer diagnoses of autism. Instead, the entire diagnosis is called the Autism Spectrum Disorder. Classification of levels of impairment are now done by determining what level of support the person will need to function. For example, a person who will need one-on-one supervision for life will be considered severely impaired. On the other hand, a person who was previously considered to have Asperger’s, but who is able to participate in school with support from an aide might be diagnosed as moderately impaired. Someone who had the diagnosis of High Functioning Autism (HFA) but who is living and working independently might be qualified as mildly impaired.
People who were previously diagnosed with Autism under the DSM 4 will keep their diagnosis. It is only children and adults who are evaluated after DSM 5 who are subject to the new diagnostic criteria. Notice that it is no longer called Autism, but is now Autism Spectrum Disorder. ASD used to be a description, but it is now a label.
This is a tremendous change for the community. In the end, however, the goal is to provide appropriate and adequate services so that all people can achieve their potential. Hopefully, the DSM IV will take us in that direction.