A Comparison of DSM-IV Pervasive Developmental Disorder and DSM-5 Autism Spectrum Disorder Prevalence in an Epidemiologic Sample

Abstract

Objective Changes in autism diagnostic criteria found in DSM5 may affect Autism Spectrum Disorder (ASD) prevalence, research findings, diagnostic processes and eligibility for clinical and other services. Utilizing our published, total-population Korean prevalence data, we compute DSM5 ASD and Social Communication Disorder (SCD) prevalence and compare them to DSMIV Pervasive Developmental Disorder (PDD) prevalence estimates. We also describe individuals previously diagnosed with DSMIV PDD when diagnoses change with DSM-5 criteria. Method The target population was all 7-12-year-old children in a South Korean community (N= 55,266), those in regular and special education schools and a disability registry. We utilized the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of screen-positive children were offered comprehensive assessments using standardized diagnostic procedures, including the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule. Best estimate clinical diagnoses were made using DSMIV PDD and DSM5 ASD and SCD criteria. Results DSM5 ASD estimated prevalence is 2.20% (CI: 1.77-3.64). Combined DSM-5 ASD and SCD prevalence is virtually same as DSM-IV PDD prevalence (2.64%). Most children with Autistic Disorder (99%), Asperger Disorder (92%), and PDD NOS (63%) met DSM-5 ASD criteria, whereas 1%, 8% and 32%, respectively, met SCD criteria. All remaining children (2% ) had other psychopathology, principally Attention Deficit Hyperactivity Disorder and anxiety disorder. Conclusion Our findings suggest that most individuals with a prior DSMIV PDD meet DSM5 diagnostic criteria for ASD and SCD. PDD, ASD or SCD, extant diagnostic criteria identify a large, clinically meaningful group of individuals and families who require evidence-based services.

Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using DSM-IV-TR and DSM-5 Criteria

“…Within DSM-5, individuals who have impairments in social communication but who lack restricted, repetitive behaviors or interests may be diagnosed with Social Communication Disorder. Kim et al (2014) found that 32 % of children who meet DSM-IV-TR criteria for PDD-NOS may meet the criteria for Social Communication Disorder. However, given that Social Communication Disorder is newly recognized within DSM-5, it might not be recognized by insurers or schools, potentially limiting access to treatment for children with clinically significant impairment.…”

Behavioral and Neuroanatomical Phenotypes in Mouse Models of Autism

“…The high prevalence of autism, currently estimated at >1 % [3], underscores the need to discover the biological substrates of this unique but heterogeneous disorder, including neuroanatomical abnormalities.…”

Mismatch between diagnostic reports and special educational needs classification in a public educational system

“…Considering the proportion of students with SEN in relation to the total number of students enrolled in the schools, it is possible to conclude that there is underdiagnosis of SEN cases, and consequently under-reporting of these cases to the education department. Taking autism spectrum disorder as an example, where the estimated prevalence is between 0.6 and 1% 13,14 , in this study only 0.05% of students were classified with this diagnosis.…”