DSM-V and Changes to the Autism Diagnosis

By W. David Lohr, MD


Many people have questions and concerns how the new DSM-5 diagnostic criteria will effect individuals with autism. To help families understand the changes here are some important points to remember:


  1. The prevalence of autism has increased dramatically in the last 10 years in part due to increased awareness but also related to diagnostic practices.
  2. DSM-5 was developed with the goal of a clearer, simpler, more reliable diagnosis which recognized the “essential shared feature of the autism spectrum”
  3. The diagnoses of autism, Asperger’s Disorder, and Pervasive Developmental Disorder have been replaced by one diagnosis of Autism Spectrum Disorder
    1. Experts don’t agree on which patients would be diagnosed with Asperger’s disorder and which patients would be diagnosed with autism using DSM-IV.
    2. Research has not shown that the outcome for Asperger’s Disorder is different from high functioning autism.
    3. DSM-5 combines criteria for social and language symptoms into one domain of social communicative and interactive problems and now all three criteria must be met.
    4. DSM-5 continues with the same set of criteria for repetitive, restricted behaviors but also includes symptoms for sensory problems.
    5. Studies which compare DSM-IV and DSM-5 criteria for autism show that DSM-5 will diagnose Autism Spectrum Disorder less often.
      1. A well-publicized study by McPartland showed that 61% of cases with autism disorders would not meet DSM-5 diagnoses
      2. A more recent study with a larger patient group showed that DSM-5 would diagnose 91% of those children with a DSM-IV diagnosis of an autism disorder.
      3. DSM-5 is more specific than DSM-IV; that means that if a clinician using DSM-5 diagnoses a person with autism, it is more likely the person actually has the disorder.
      4. Various studies encouraged modifications to DSM-5 to require fewer symptoms to be present to meet the diagnosis. However, the committee which created the new criteria did not accept these suggestions. Instead DSM-5 allows symptoms to be present either by history or currently and features more descriptions examples to meet the diagnosis.
      5. DSM-5 is an evolutionary step for the diagnosis of autism based on consensus opinion of leading experts in the field.


For more information visit the KY Autism Training Center website or YouTube channel to view Dr. Lohr’s archived presentation about the DSM-IV and Changes to the Autism Diagnosis. More information is also available on the following article PDF | TXT and e-newsletter.


W. David Lohr, M.D. is an Assistant Professor of Child Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY


KY Autism Training Center Summer 2013 Newsletter August 2013