Annual Research Review: Re‐thinking the classification of autism spectrum disorders

Abstract

Background The nosology of autism spectrum disorders (ASD) is at a critical point in history as the field seeks to better define dimensions of social-communication deficits and restricted/repetitive behaviors on an individual level for both clinical and neurobiological purposes. These different dimensions also suggest an increasing need for quantitative measures that accurately map their differences, independent of developmental factors such as age, language level and IQ. Method Psychometric measures, clinical observation as well as genetic, neurobiological and physiological research from toddlers, children and adults with ASD are reviewed. Results The question of how to conceptualize ASDs along dimensions versus categories is discussed within the nosology of autism and the proposed changes to the DSM-5 and ICD-11. Differences across development are incorporated into the new classification frameworks. Conclusions It is crucial to balance the needs of clinical practice in ASD diagnostic systems, with neurobiologically based theories that address the associations between social-communication and restricted/repetitive dimensions in individuals. Clarifying terminology, improving description of the core features of ASD and other dimensions that interact with them and providing more valid and reliable ways to quantify them, both for research and clinical purposes, will move forward both practice and science.

Developmental pathways of language and social communication problems in 9–11 year olds: Unpicking the heterogeneity

“…Communication Disorder (SPCD) (Lord & Jones, 2012). Third, about half the children with social communication problems, prior to the introduction of the DSM-5, had received a clinical diagnosis of autism (44% of SCI-LI group and 50% of the SCI group).…”

Predicting symptom severity in autism spectrum disorder based on cortical thickness measures in agglomerative data

“…Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impairments in social interaction and communication, restricted interests, and repetitive patterns of behaviour (Lord and Jones, 2012;Wing, 1997;Gillberg, 1993). The definition admits substantial behavioural heterogeneity (Georgiades et al, 2013); ASD is, in fact, a family of developmental disorders with unique, but related, phenotypes, with a variety of genetic associations (Devlin and Scherer, 2012).…”

Misdiagnosis of High Function Autism Spectrum Disorders in Adults: An Italian Case Series

“…But only a correct and prompt recognition of these disorders will allow appropriate support for these patients and their families [17]. The effect of inadequate identification and assessment of patients with ASD leads to inadequate or even damaging care [22].…”

“…The individual being evaluated is given just one module, depending on his or her expressive language level and chronological age. Module 4 is used with fluent adolescents and adults [17].…”