When a new diagnostic definition of autism spectrum disorders (ASD) went into effect in May 2013, many were concerned that fewer individuals would be diagnosed with ASD, and therefore not qualify for special services. But a new Yale study published in the Journal of the American Academy of Child and Adolescent Psychiatry suggests that those children who do not meet the new ASD standards will receive a different diagnosis under the new guidelines.
The study of Korean children by Young-Shin Kim and her colleagues at Yale found that children who will no longer be diagnosed with ASD under the fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5), will now be included in a new category of social communication disorder (SCD).
Children with SCD exhibit symptoms such as severe social and communication deficits, but they don’t have the restrictive and repetitive behaviors typically found in ASD.
Differences between the manual’s criteria for DSM IV Pervasive Development Disorder (PDD) and DSM-5 ASD have led to debates — in both the scientific and lay communities — over whether these changes in diagnostic criteria will affect the prevalence of ASD; change the way individuals will be diagnosed with ASD; and, possibly, the eligibility of individuals for clinical and other services.
This new study found that only about 17% of children would show a change in diagnosis under the new DSM-5 criteria. More than 75% of these children have a diagnosis of PDD-not otherwise specific (PDD-NOS).
The study also showed that most individuals with a prior diagnosis of PDD-NOS meet the APA’s diagnostic criteria for ASD and SCD. When ASD and SCD are combined, virtually everyone with a PDD diagnosis remains on the new spectrum.
“Treatments for ASD and SCD remain the same or similar, so it is important for children (and their families) moving to a new diagnosis of SCD to continue receiving the interventions they received with the DSM IV’s previous PDD diagnosis,” said Kim.