What the new criteria is trying to achieve is a vast improvement over the current situation. As the details have not all been released yet I will withhold judgment on if it succeeds in its goals. The success of it will be determined by the still unreleased severity criteria. What should be noted is that the severity criteria are for the different aspects. The idea is that your particular problems could be defined in more detail.
I particularly like that the social and communication difficulties are combined.
Rationale for DSM-V 299.0 Autism Spectrum Disorder:
Quote:
Differentiation of autism spectrum disorder from typical development and other "nonspectrum" disorders is done reliably and with validity; while distinctions among disorders have been found to be inconsistent over time, variable across sites and often associated with severity, language level or intelligence rather than features of the disorder.
In my own research I have been facing the difficulty posed by the above and I have been finding it much more useful and consistent when the ASDs are seen as a whole or as the proposal rationale says:
Quote:
Because autism is defined by a common set of behaviors, it is best represented as a single diagnostic category that is adapted to the individual’s clinical presentation by inclusion of clinical specifiers (e.g., severity, verbal abilities and others) and associated features (e.g., known genetic disorders, epilepsy, intellectual disability and others.) A single spectrum disorder is a better reflection of the state of knowledge about pathology and clinical presentation; previously, the criteria were equivalent to trying to “cleave meatloaf at the joints”.
Also, the cleaner structure is good:
Quote:
Three domains become two:
1) Social/communication deficits
2) Fixated interests and repetitive behaviors
Deficits in communication and social behaviors are inseparable and more accurately considered as a single set of symptoms with contextual and environmental specificities
-Delays in language are not unique nor universal in ASD and are more accurately considered as a factor that influences the clinical symptoms of ASD, rather than defining the ASD diagnosis
-Requiring both criteria to be completely fulfilled improves specificity of diagnosis without impairing sensitivity
-Providing examples for subdomains for a range of chronological ages and language levels increases sensitivity across severity levels from mild to more severe, while maintaining specificity with just two domains
-Decision based on literature review, expert consultations, and workgroup discussions; confirmed by the results of secondary analyses of data from CPEA and STAART, University of Michigan, Simons Simplex Collection databases
The release of DSM-V has been moved to 2013 to align more closely with the ICD-11 development so you can expect whatever happens in DSM to feed into ICD for those of us in parts of the world that do not use DSM
13 Feb 2010, 8:57 pm
