Group items tagged

also compared SEA-indicated evaluation procedures across SEAs to evaluation procedures noted in IDEA-2004

The federal definition of autism preceded the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) [8], and it is essentially unchanged since 1990.

The federal definition is generally compatible with both the category of Pervasive Developmental Disorder (PDD) as described in DSM-IV and Autism Spectrum Disorder as described in DSM-5 [9], but it does not match any specific variety of PDD (see below). Within public school systems, students who have been clinically diagnosed with either a DSM-IV PDD or with DSM-5 Autism Spectrum Disorder are likely to be identified under the federal category of autism for the purpose of receiving special education services

In contrast to the IDEA-2004 definition, criteria for autism are more specific in the DSM-IV clinical diagnostic criteria

DSM-IV was superseded by DSM-5 [9]. The disorders comprising PDD in DSM-IV are largely addressed in DSM-5 by the Autism Spectrum Disorders category, which—unlike DSM-IV’s PDD—has no subcategories.

identification criteria still include substantial social problems (social initiations and responses, nonverbal social communication, and social relationships) and restricted, repetitive behaviors or interests (deviant speech or movements, rituals and resistance to change, preoccupations, and sensory reactivity). State education agencies (SEAs) have not yet incorporated DSM-5 information into their policies, procedures, and practices related to students with autism, and the DSM-5 definition was not involved in the present study.

State education agency (SEA) definitions of a disability do not have to match the federal definition but must substantially address its elements or lose federal financial support for special education.

No doubt the prevalence of ASD naturally varies somewhat with geography [4] but probably not by such a large factor, greater than tenfold in adjacent states. Conceivably, some state-by-state variation might be attributable to the content of SEA definitions of autism and perhaps the evaluation procedures required to accurately measure the concepts presented in definitions.

In a study of SEA definitions of autism, MacFarlane and Kanaya [10] found substantial variation in the eligibility criteria used by different states. By their analysis, 35% of SEAs based autism eligibility solely on the federal definition of autism, while 65% used diverse other criteria including symptoms of autism from the DSM-IV-TR

levels are not consistent with the diagnostic criteria.

Key areas, including sensory aspects, are not mentioned within the severity levels.

The minimum criteria for level 1 severity “Needs support” are considerably higher than the minimum criteria for a diagnosis

DSM is an American publication. Most diagnoses in the UK are based on the International Classification of Diseases (ICD), published by the World Health organisation, or other criteria, such as those developed by Professor Christopher Gillberg. 

Creating a direct link between a clinical decision over diagnosis and a recommendation for support could affect clinical impartiality. In the UK we are aware of situations where clinical professionals have felt under pressure from their employers to under-assess needs in order to ration limited resources.

Dr Lorna Wing and Dr Judith Gould have submitted a paper to the American Psychiatric Association, jointly written with Professor Christopher Gillberg. This article has been published in the journal Research in Developmental Disabilities. It calls for a stronger focus on social imagination, diagnosis in infancy and adulthood, and on the possible under-diagnosis of girls and women with autism

They recommend that sub-group names for particular autism spectrum disorders are kept in the new diagnostic criteria, including a description of Asperger syndrome, to make it very clear that this continues to be a part of the autism spectrum. 

APA propose creating a new diagnosis of social communication disorder. This would be given where someone exhibits the social communication and interaction aspects of an autism spectrum disorder diagnosis, but does not show restricted, repetitive patterns of behaviour, interests or activities. 

linking of a clinical diagnosis to recommendations of support may create expectations for people on the autism spectrum that services will be provided when this will not always be the case (at least in the UK), due to high eligibility thresholds or because decisions about such support may be taken by professionals who have no relation to the diagnostic process. 

The current ICD (ICD-10) is virtually the same as DSM. The next version of the International Classification of Diseases (ICD-11) is due to be published in 2015. They will consider the changes made to DSM-5, but their descriptions are often slightly different. For example, the diagnostic names in ICD-10 are different to those in DSM-4. 

Diagnoses should always be based on a clinical decision about whether someone has an impairment which has a disabling effect on their daily life. Diagnoses will be given where symptoms cause an impairment to everyday functioning.

Overall, we believe that the changes to the diagnostic criteria are helpful. They are clearer and simpler than the previous DSM-4 criteria. 

The diagnostic manuals are updated every so often to reflect the latest research. The last change to the DSM was in 2000, and before that in 1994.

How long have autism and Asperger syndrome been in the DSM? Autism was first included as a separate category in DSM-3 in 1980 when it was called 'infantile autism'. This was later changed to 'autistic disorder' in 1987. 'Asperger’s disorder' (syndrome) was added into the next version, DSM-4, in 1994.

14 percent would switch to a diagnosis of SCD

Deficits in developing, maintaining, and understand relationships,

Deficits in nonverbal communicative behaviors used for social interaction

Highly restricted, fixated interests that are abnormal in intensity or focus

Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment

The American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition (DSM-5)  provides standardized criteria to help diagnose ASD.