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New DSM Brings Change, Assurances For Those With Autism

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For the first time in more than a decade, a new version of the Diagnostic and Statistical Manual of Mental Disorders will be unveiled this weekend and with it comes major change to the way autism is diagnosed.

The American Psychiatric Association is releasing the fifth edition of the DSM at its annual meeting beginning Saturday in San Francisco. The new version marks the first major update since 1994 of the so-called psychiatric bible which is relied on by everyone from mental health professionals to researchers and insurers to determine what symptoms merit a diagnosis.

Among the most controversial changes to the manual is its updated definition of autism. The psychiatric association decided to eliminate the diagnosis of Asperger’s syndrome and instead fold it as well as childhood disintegrative disorder and pervasive developmental disorder, not otherwise specified into the broader category of “autism spectrum disorder,” with clinicians indicating a level of severity.

Changes were also made to the way autism will be diagnosed, which led to concern that some with the developmental disorder could lose the label entirely and, with it, needed services.

In an effort to quell such worries, the new DSM includes a note specifying that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder,” according to an advance copy of the autism entry provided to Disability Scoop.

Nonetheless, even as the new edition is going to press, pushback continues. A new book from Allen Frances, a psychiatrist who led the task force responsible for the previous version of the manual, is critical of the DSM-5.

And, just weeks ago, Thomas Insel, director of the National Institute of Mental Health wrote of the DSM that “patients with mental disorders deserve better.” Insel said that his agency would be moving away from the manual’s classification system and looking to more scientifically verifiable standards for research going forward.

Subsequently, Insel appeared to soften his tone, issuing a joint statement with the American Psychiatric Association indicating that the DSM in addition to the World Health Organization’s International Classification of Diseases offer “the best information currently available for clinical diagnosis of mental disorders.”

Those behind the DSM revision say that it is research-based and the product of a transparent process. There were three open-comment periods while the manual was under development, which drew more than 13,000 responses, officials from the psychiatric association said.

“The changes to the manual will help clinicians more precisely identify mental disorders and improve diagnosis while maintaining the continuity of care,” said David J. Kupfer, chair of the DSM-5 Task Force.

Beyond the autism updates, the new manual will include a far less controversial change to its listing for “mental retardation,” replacing the term with the more commonly accepted “intellectual disability.” Additionally, plans called for the diagnosis to be adjusted to put less emphasis on IQ score and allow more consideration for clinical assessment.

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Comments (7 Responses)

  1. Cheryl Jorgensen says:

    I just don’t understand why autism is considered a “mental disorder.” Feels like the DSM and the clinical world is still in the 19th century.

  2. A.Harris says:

    Cheryl,
    Even though it shouldn’t be considered a stigma of any sort to carry the diagnosis a person on the spectrum is still outside of the typical parameters for what is considered normal mental functioning. “Disorder” is descriptive not derogatory in this case.

  3. heather hudson says:

    Autism is not a mental disorder it is a Neurobiological disorder. My son Lyric is 10 years old at an age 3-5 yr old age level all around. He was diagnosed at age 4 years 10 mos old with Autism spectrum disorder [severe degree]yet High functioning and also was non verbal from 14 mos to age 5 and a half years old. When born my son covered alot of his milestones and quite quickly at that but lost all speech,stopped eating sleeping,walking at 14 mos old. At the time he was diagnosed with severe high functioning Autism he was assessed and observed etc.. for months beforehand and in the end was at an infant to age 2 year old age level all around. I get frustrated that because dr.s said he is high functioning and he now is so verbal people always say oh he has Asberger-but I was told my son is right on the spectrum and those that were diagnosed with Asbergers have never lost speech-so please clarify with all these changes to the dsm is my son still concidered high functiong yet moderate degree autism [asd] also to note he displays serious and severe behavioural and aggression,meltdowns thus the severe category at the time,plus he wa severely delayed in every way speech,behaviour,developement etc..yet was diagnosed HFA because he was/is teachable learnable-too many labels new DSM-Is my son ASD plain and simple or still ASD with HFA and Moderate degree due to his behaviour,aggression severe meltdowns??? Any and all advice would be greatly appreciated please e-mail me at heatherhudson5@gmail.com,thanks!

  4. Jay says:

    Mental by Webster’s definition is: of or relating to the mind; specifically : of or relating to the total emotional and intellectual response of an individual to external reality.
    Disorder by Webster’s definition is:to disturb the regular or normal functions of.
    Autism by Webster’s definition is:: a developmental disorder that appears by age three and that is variable in expression but is recognized and diagnosed by impairment of the ability to form normal social relationships, by impairment of the ability to communicate with others, and by stereotyped behavior patterns especially as exhibited by a preoccupation with repetitive activities of restricted focus rather than with flexible and imaginative ones.

    Where do these abnormalities stem from? The brain. Brain equates to mental. Right? Is this type of behavior normal by society’s standard? No. That is why it is a “mental disorder”. Educate yourself before posting a naïve comment.

  5. L. Anderson says:

    As a teacher of students with Autism spectrum disorder and a son with Asperger’s, I am dismayed by this turn of events. My son was in the Navy, and doing well. His diagnosis of asperger’s was not a problem, but now that the DSM has moved it into autism, he was discharged. They do not accept people with Autism.

  6. Karen Walsh Keely says:

    Fetal Valporate Syndrome !!!! Why and when is doctor’s going to start looking at that. Everyone knowes it’s also related to austim. I am one woman in Ireland trying tobring this out. But no one wants to know.

  7. Patti Lehigh says:

    My son with a diagnosis of Asperger’s Syndrome (originally PDD-NOS), has already been primarily denied services through Vocational Rehab. They cited it was mostly due to the new DSM-5. They also advised us not to seek Social Security because they will most likely deny him for the same reasons. He is not self-sufficient, and I cannot guarantee that at 17 he will ever acquire the necessary skills to be independent. I am scared that if something happens to me, he will end up on the street.

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