Brief Report: An Exploratory Study Comparing Diagnostic Outcomes for Autism Spectrum Disorders Under DSM-IV-TR with the Proposed DSM-5 Revision

Abstract

The proposed revision for Autism spectrum disorders (ASDs) in the Diagnostic and Statistical Manual of Mental Disorders--Fifth Edition (DSM-5) represents a shift from the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition, Text Revision (DSM-IV-TR). As the proposed DSM-5 criteria require a higher minimum number of symptoms to be present compared to DSM-IV-TR, there have been some concerns about the impact that this will have on diagnostic outcomes. Therefore, the current study aimed to compare diagnostic outcomes using both DSM-IV-TR and DSM-5 criteria for 132 children. Of the 111 participants who received an ASD diagnosis under DSM-IV-TR, 26 did not meet DSM-5 criteria. The majority of these had received a DSM-IV-TR PDD-NOS diagnosis. Implications of the results and the proposed DSM-5 changes to the ASD criteria are discussed.

Application of the Final DSM-5 Criteria for Young Children with Autism Spectrum Disorder

“…For example, Matson et al [4] reported that 48% of toddlers with PDDs did not meet the new criterion, ASD. Several studies have also shown that a considerable percentage (8.8%~53.8%) of children with PDDs diagnoses did not meet ASD [2][3][4][5][6][7][8][9][10][11] (Table 3). Table 3: Characteristics of the previous studies *Reduction means the number (or rate) of cases who lost the ASD diagnosis in the draft or in relaxed rules.…”

“…Gibbs et al [7] and Taheri et al [8] demonstrated another relaxed rule which required 1/4 of the RRB dimension, resulting that more than 70% of PDDs met the ASD criteria.…”

“…Before the final version of DSM-5 was released in May 2013, several investigations with the proposed draft had been done [2][3][4][5][6][7][8][9][10][11]. These preliminary studies showed that a considerable percentage (8.8%~53.8%) of children with PDDs diagnoses did not meet the new criterion of ASD.…”

“…The results made families anxious whether their affected children not meeting the new criteria might therefore lose necessary services. Therefore, a relaxed rule for ASD was argued for [2,7,8,11]. In the draft, whereas the strict rule which requires all three factors of the SC dimension and two out of four factors of the RRB dimension was employed, several researchers have proposed original relaxed rules.…”

Características e Especificidades da Comunicação Social na Perturbação do Espectro do Autismo

“…A publicação da DSM-5 propõe uma abordagem diagnóstica de PEA consideravelmente diferente daquela que é proposta pela DSM-IV. Alguns autores têm-se debruçado sobre a nova proposta dos critérios de classificação da PEA (BARTON et al, 2013;GIBBS et al, 2012), em particular a proposta de deixar de se considerarem as perturbações globais (ou pervasivas) do desenvolvimento sendo assumido de forma explícita o conceito de -espetro de autismo. A tríade clínica de incapacidades que define as PEA na DSM-IV é reduzida para dois critérios na DSM-5, ficando os déficits de interação social e os déficits da comunicação englobados num único critério, a designar como "déficits na comunicação social".…”