Changes in Diagnosing Autism Spectrum Disorders

You may have heard in the news recently that changes are coming to the world of mental health with the publication of the DSM-V. What does this mean? First, it is important to understand what the DSM-V is. As with any field, whether it be medicine, education, or psychology, to someone not trained in that area, it can seem like a different language is spoken, and it is often a confusing alphabet soup! DSM stands for Diagnostic and Statistical Manual of Mental Disorders and it is developed by the American Psychiatric Association. DSM-V means we are currently on the 5th edition, which was released in May 2013. The first DSM was published in 1952 and has undergone several revisions as we have learned more through research.

One of the most talked about changes in the current DSM-V is the new category of Autism Spectrum Disorders or ASD. This change removes the separate categories such as Autism, Asperger’s Disorder (or Syndrome) and Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS). This means that if your child has been diagnosed with Asperger’s Disorder previously, that diagnosis is now encompassed under ASD. This is a controversial change in diagnosis, with hot debate occurring on both sides. On one hand, the change aknowledges the “umbrella” nature of these disorders. In other words, all have similar characterstics, but exist on a continuum, with different presentations and severity of the characteristics. On the other hand, concerns have been raised that removing the specific diagnoses under the ASD umbrella also reduces understanding of a chid’s specific symptoms. For example, children diagnosed with Asperger’s Disorder are often considered higher functioning than children with severe autism. Children with autism may engage in stereotypical behaviors such as hand flapping or rocking and perhaps even be nonverbal, while children with Asperger’s Syndrome may perform quite well academically, communicate with others, but fixate on a topic or interest, have difficult sharing this fixation with others, and speak in a pedantic or “bookish” voice. By including all the diagnoses under one label, interpretation of the diagnosis may become muddled.

Regardless of the lable, the point that remains paramount is that we need to treat the person, not the diagnosis. Even if Asperger’s Disorder was still a category under DSM-V, two children with this diagnosis may present very different symptoms. Additionally, they are very different people, each with their own personalities, likes, dislikes, wants, and needs. There will likely always be changes in diagnosing autism spectrum disorders and other disorders as more research is conducted and more understanding is obtained. Diagnoses and lables help us to understand challenges one faces and how to intervene to help maximize success in life. However, the focus needs to remain on discovering and developing each person’s strengths in order to minimize challenges.