The New Autism Diagnosis a la DSM-V

As the American Psychiatric Association is gearing up for the DSM-V to replace the DSM-IV-TR this year, the category of Autistic Spectrum Disorder(ASD) is being revised.  The change would eliminate the categories under ASD, which include Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Syndrome and Pervasive Developmental Disorder NOS (PDD-NOS).  Instead, a child would be diagnosed with Autism Spectrum Disorder only.

Additionally, the criteria have changed.  In the DSM-IV-TR,  there were 3 categories from which at least one symptom from each, and a total of 6 (or more) needed to be present.  The 3 categories were: social interaction, impairment in communication, and restricted, repetitive and stereotyped patterns of behavior, interests and activities.  For the revised diagnosis, the 3 categories have been collapsed into 2:  social communication and social interaction and restricted, repetitive patterns of behavior, interests and activities.

The criteria that stated that onset took place prior to age 3 now states that “symptoms must be present in early childhood, but may not become fully manifest until social demands exceed limited capacities.”  The final criteria states “symptoms together limit and impair everyday functioning” in place of “the disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.

Finally, a clinician would specify level of severity for social communication and restricted interests and repetitive boundaries using Level 1 (requiring support), Level 2 (requiring substantial support) or Level 3 (requiring very substantial support).

The rationale for these changes is that the single diagnostic category represents the common set of behaviors seen in children with Autism.  The level of severity would allow for a clearer picture of the child clinical presentation.

So, I’m curious to hear your thoughts about these proposed changes.  Are you pro or con? Why?
"The various psycho-educational testing Dr. Liz conducted on our son gave us critical clues about where his learning strengths and weaknesses lie so that his needs could be better addressed at home and school. Moreover, because of their warm, kindhearted personalities, both Dr. Liz and her associate, Stephanie, formed an immediate bond with my son. He eagerly looks forward to his weekly therapy sessions. We are so lucky Dr. Liz came into our family's lives when she did! For stressed-out families trying to help their children as best they can, she is a calming voice of reason!"
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"Dr. Matheis has a remarkable ability to understand the unique needs of her patients and address them constructively. She builds strong, meaningful relationships with patients and their families, encouraging trust and collaboration. When working with my son who struggles with autism-related anxiety, she created an environment in which he was able to calm down and open up to her in ways I had not seen before. She was able to reach him and helped him work through his crisis/problem. Most importantly, she empowered him to move forward."
- N.L.
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"Dr. Matheis has an amazing ability to read kids and connect with them. She has been an invaluable resource for our family over the past several years and has helped us with everything from educational consulting, to uncovering diagnoses as well as family therapy. Working with Dr. Matheis never feels clinical and most importantly, our children love and trust her. We can not thank you enough Dr. Liz!"
- Anonymous
"My teenage son had been seeing Dr. Matheis through his senior year of high school, as he was only diagnosed with ADHD at 16 years old.  Dr. Matheis came highly recommended from our pediatrician and she has done wonders for our son as well as our family, navigating new ways for him to deal with his diagnosis without the use of medication.  She taught him ways to organize himself and even when something did not work for him, she patiently continued teaching him new ways to keep himself on track.  She has also helped us as parents to understand how his mind works so that we did not continue to blame his lack of focus on him, rather on his unique way of thinking.  Thank you Dr. Matheis!!!!"
- LG
"Dr. Liz is the best! Our family was directed to her by our Pediatrician to assist with figuring out severe mood changes, severe anxiety, strange new fears and food aversion that had come onto one of our children literally overnight. After just a couple of visits, she suggested that the issues may actually be rooted in a physical issue and suggested we immediately take our child to be swabbed for strep, because Dr. Liz suspected PANDAS (a pediatric autoimmune disorder brought on by strep). The same Pediatrician that suggested Dr. Liz would not do the swab (they do not believe in PANDAS and we no longer go there) but I took my child to my doctor who did the swab and it was positive for strep. When our child went on antibiotics, within 24 hours all symptoms went away and our child was back :-) Dr. Liz then recommended a PANDAS specialist who helped us and our child is in complete remission and is happy and healthy. We are incredibly grateful to Dr. Liz for her knowledge of all things, even the most remote and unusual and for helping us so much! Thank you!"
- Anonymous
"The various psycho-educational testing Dr. Liz conducted on our son gave us critical clues about where his learning strengths and weaknesses lie so that his needs could be better addressed at home and school. Moreover, because of their warm, kindhearted personalities, both Dr. Liz and her associate, Stephanie, formed an immediate bond with my son. He eagerly looks forward to his weekly therapy sessions. We are so lucky Dr. Liz came into our family's lives when she did! For stressed-out families trying to help their children as best they can, she is a calming voice of reason!"
- Anonymous
"Thank you, Dr. Liz. Although we have told you countless times, it will never feel enough. You have listened when J could barely speak and continued to listen when he was sad, angry and confused. You've challenged him and directed us in our roles as parents. You've helped J face his fears while the list evolved and changed, and yet you've stayed committed to 'the course.' We pray that your children realize that time away from them is spent helping children learn and that vulnerability is a sign of strength and bravery."
- June I
"My son was admitted to an Ivy League school when only 2 years ago, you assessed him and saw his struggles, his Dyslexia. We are grateful that he no longer has to carry that deep feeling of inadequacy or shame that must have kept him so self conscious and from reaching his potential. He has the PERFECT program for him. He has A's in high math and economics. He became a Merit Scholar, a Boys State legislature, the HEAD captain of the football team and help a job ALL while studying and managing his classes and disability. I am PROUD of you, a young doctor, who knows and sees the vulnerability of children and helps them recognize "it's NO big deal" God bless."
- Anonymous

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