DSM-5 Considerations

With the new DSM-5* due for release in May of this year, there has been much debate about the wisdom of the American Psychiatric Association's decision to drop Asperger's Disorder as a separate diagnosis. Instead it will be folded into a new diagnostic definition of Autism Spectrum Disorder. 

Media reports have ranged from outrage (New York Times 'New Definition of Autism will exclude many' Jan 2012) to more calm assessment of the facts (New York Times 'Report Sees Less Impact' Oct 2012). Clinical psychologists in Australia are also divided in whether they see the changes as being a logical response to the scientific evidence gathered over the last twenty years, or a pre-emptive lumping together of neurologically different conditions (Medical Observer 'Are there differences in Aspergers we are missing?' Nov 2012).

The Australian Psychology journal has just published a paper 'Towards the DSM-5 Criteria for Autism: Clinical, Cultural and Research Implications'. The paper's seven authors describe the main differences between DSM-IV, when Asperger's Disorder first appeared in 1994, and DSM-5, and the implications of Asperger's removal. In the paper's abstract they conclude:

'. . . that the new criteria appear to better reflect current understanding of ASD than the current DSM-IV criteria. As expected with any major change in classification systems, there are also significant risks, which will have to be carefully monitored and addressed by both policy makers and the scientific community to ensure that best clinical practice and research are facilitated and advanced.'

You can read the full paper here.
Australian's Olga Tennison Autism Research Centre (OTARC) at La Trobe University Melbourne is the leading autism research organisation in our country. Last October they held a seminar 'Towards a New Definition of Autism' which explained the history of autism and Aspergers in the DSM. Due to overwhelming demand for places they have since held a webinar on 13 Feb 2013 to cover the same material. And now they have kindly made the full webinar available on their website, so you can personally view the slides and listen to our local experts explain the ongoing process of developing and refining the autism definition. 

I highly recommend you view the webinar yourself, rather than relying on sometimes sensational media reporting on this issue. Understanding DSM-5 is essential for parents and individuals with Aspergers to fully understand the complex issues behind this decision.

Another reliable Australian source of information about Autism and Aspergers is Monash University's School of Psychology and Psychiatry. They've produced a range of resources available for free download. Click here to go to the Fact Sheets section of their website.

*DSM-5 is the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders, and will be published in May 2013. See www.dsm5.org for more.


Previous posts I've written on DSM-5:

Dr Swedo explains autism changes in DSM-5

June 2012

Dr Gerri Dawson, Chief Science Officer at Autism Speaks has written an easy to read summary of a talk given by Dr Sue Swedo, chair of the committee recommending changes to autism criteria for DSM-5,  at the 2012 International Meeting on Autism Research in Toronto.

According to this report, Dr Swedo has again confirmed that the American Psychiatric Association is NOT attempting to reduce the number of people diagnosed with an autism spectrum disorder.  Rather they are trying to ensure all individuals are accurately diagnosed by strengthening the criteria and removing clincian's bias.  By collapsing all subtypes into the one autism spectrum disorder it will improve the consistency of diagnoses. Currently this is an issue as what one doctor calls high functioning autism will be classifed as Asperger syndrome by another, depending on the recall of whether the person had a language delay or not.  

Asperger syndrome will not disappear, rather it will become a specifier or type within the autism spectrum diagnosis.  Scientific research into Asperger syndrome will continue.  And the addition of sensory sensitivites into the DSM-5 criteria is also to be welcomed.  

I do encourage you to read the full article here 


DSM-5 Field Trials - Initial Report

May 2012

Autism Speaks, America's autism activisim and research organisation, has just released a report into their initial findings from the DSM-5 Field Trials.  Determined to discover if the proposed new criteria for autism spectrum conditions (especially the removal of Asperger Syndrome as a separate diagnosis) would disadvantage those who currently have a diagnosis and therefore receive funding for services, the study has found that DSM-5 does NOT reduce the number of children who receive a diagnosis.

I recommend you read the full report here at the Autism Speaks website