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.