An Update on the DSM-5 and ASD

May 17, 2012 

The Autism Society knows individuals are concerned about the potential impacts of the proposed criteria for autism spectrum disorders in the DSM-5, set to be published next spring. The American Psychiatric Association (APA) has recently opened the third session for public comment ending on June 15. So far, more than 6,000 comments have been received by the APA workgroups related to ASD. 

The Diagnostic and Statistical Manual of Mental Disorders (DSM), a publication of the APA, provides a common language for physicians intended to facilitate accurate diagnosis of brain disorders and guide appropriate interventions. According to the APA, revising the definition of autism spectrum disorder is an attempt to further establish defining characteristics so all diagnosticians are able to diagnose with more reliability and validity from person to person and place to place. The specific diagnoses that are considered Pervasive Developmental Disorders are all quite complex. According to many clinicians, the problem with the definition of autism in the DSM-IV is that it is too long and too complicated, generating diagnoses of co-morbid conditions. For example, in some instances an individual may be diagnosed with obsessive compulsive disorder or anxiety disorder, while in some people these symptoms are observed and used to diagnose a person with ASD.  These inconsistencies can increase true understanding of a disorder, impact research efforts and lead to treatment non-specificity.

The Autism Society is particularly focused on preserving services for those who need them. Many have called on the APA to investigate whether individuals on the spectrum would lose services based on a re-evaluation under the new criteria. The issue of service availability (and loss of or reduced services) is one that should not be based solely on a DSM-5 classification.  Any public entity providing services or funding for such services should base support decisions on a needs basis and not solely on a classification or diagnosis.  

The Autism Society strongly encourages you to enter this discussion by sending your comments to the APA by June 15 has provided some helpful guidance on how to provide comment:  To begin, you have to. Once you have filed out the form, they will send you a temporary password so you can log in. Then you must go to the specific section that you would like to comment on (in our case, the ASD section). This provides the proposed revision, the rationale and the current criteria from DSM-IV. When you have logged in, a field at the bottom of the webpage is provided for you to submit your comments. Some have experienced difficulty getting their comments in that field to be saved. If this is the case, submit your comments to the APA viaemail. 

The Autism Society works to provide you with details so you may examine all the information with a critical eye and examine (and comment on) potential consequences to DSM-5 revisions based upon data. We know this is a highly emotional issue for our community. Understanding the purpose for revisions and the implications is a critical component to advancing how people living with autism are treated. The on the proposed revisions and issued a  on the matter with the autism. We will continue to keep you updated with additional information and ways you can get involved in this process.