The move to a single diagnosis of autism spectrum disorder would eliminate Asperger’s disorder and pervasive developmental disorder-not otherwise specified as separate diagnoses. They are included in DSM-IV. The possible elimination of Asperger’s has proven controversial, as evidenced by an article in the New York Times yesterday suggesting that the proposed change would narrow the definition and exclude people in need of a diagnosis and treatment. But in fact, adults or children diagnosed with Asperger’s according to DSM-IV criteria would meet criteria for autism spectrum disorder, with “specifiers” that help clinicians identify patients who have individual differences.
Swedo explained that a major reason for the proposed change is that much research has indicated that there is little concordance among experts treating autism in how the DSM-IV criteria are applied: in other words, a child diagnosed with Asperger’s in one clinic would as likely be diagnosed with autism in another. “The improvement we are proposing for DSM-5 is to have specifiers in place that allow us to identify for other clinicians the differences presented by individual patients.” Final decisions on DSM-5’s content are still months away.
A comprehensive article on proposed changes to the chapter on neurodevelopmental disorders will appear in the February 3 issue of Psychiatric News.