Furthermore, children who previously met criteria for PDD-NOS under the DSM-IV might now be diagnosed with SPCD. One study found the new SPCD diagnosis encompasses those individuals who possess subthreshold autistic traits and do not qualify for a diagnosis of ASD, but who still have substantial needs ( 15). It has yet to be determined how the new diagnosis of SPCD will impact the prevalence of ASD. Nevertheless, the number of people who would be diagnosed under the DSM-IV, but not under the new DSM-5 appears to be declining over time, likely due to increased awareness and better documentation of behaviors ( 4). Overall, most studies suggest that the DSM-5 provides increased specificity and decreased sensitivity compared to the DSM-IV ( 5, 13) so while those diagnosed with ASD are more likely to have the condition, there is a higher number of children whose ASD diagnosis is missed, particularly older children, adolescents, adults, or those with a former diagnosis of Asperger’s disorder or PDD-NOS ( 14). Often those who did not meet the requirements were previously classified as high functioning Asperger’s syndrome and PDD-NOS ( 11, 12). However, a systematic review suggests only 50% to 75% of individuals maintain diagnoses ( 9) and other studies have also suggested a decreased rate of diagnosis of individuals with ASD under the DSM-5 criteria ( 10). One study found that with parental report of ASD symptoms alone, the DSM-5 criteria identified 91% of children with clinical DSM-IV PDD diagnoses ( 8). There are varying reports estimating the extent of and effects of this change. However, studies estimating the potential impact of moving from the DSM-IV to the DSM-5 have predicted a decrease in ASD prevalence ( 4, 5) and there has been concern that children with a previous PDD-NOS diagnosis would not meet criteria for ASD diagnosis ( 5- 7). This new definition is intended to be more accurate and works toward diagnosing ASD at an earlier age ( 3). Additionally, severity level descriptors were added to help categorize the level of support needed by an individual with ASD. A separate social (pragmatic) communication disorder (SPCD) was established for those with disabilities in social communication, but lacking repetitive, restricted behaviors. Rett syndrome is no longer included under ASD in DSM-5 as it is considered a discrete neurological disorder.

In DSM-5, the concept of a “spectrum” ASD diagnosis was created, combining the DSM-IV’s separate pervasive developmental disorder (PDD) diagnoses: autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS), into one. Table 1 Changes in ASD criteria from the DSM-IV to DSM-5 Interviews with Outstanding Guest Editors.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process.

Dsm 5 asd dx