It is official. Next month’s publication of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition will not feature Asperger’s Syndrome as one of the ranges of Autism. Actually, Asperger’s, which is usually applied to those with no intellectual disability or language deficit, PDD-NOS and childhood disintegrative disorder will be incorporated into the single diagnosis of ‘Autism Spectrum Disorder’
According to the board that reviewed the almost 20 year old manual for next month’s publishing, there wasn’t any evidence that the DSM-IV diagnoses reflected reality. They said there was no consistency in the way either Asperger’s or PDD-NOS was applied.
About four years ago, the American Psychiatry Association, announced that subcategories of Autism that were previously recognized, would be omitted as separate categories from the DSM-5. The promise has been fulfilled and next month, they will be lumped into a broader, more scale based diagnosis to be referred to as ‘Autism Spectrum Disorder’.
Now while this may cause some controversy, there may be benefits to this new categorization. The worry of losing an original diagnosis can also be put to rest. While the loss of the term may be culturally and historically significant, under this new diagnosis, those who were initially diagnosed with the disease will not ‘grandfathered’ into the new spectrum. However, for new patients, diagnoses may be harder to get.
There are a few things to consider before the controversy begins however. Firstly, how much easier or harder will the changes make it to distinguish between Asperger’s and concepts such as ‘giftedness’? Secondly, currently educational services tend to offer less to those with Asperger’s versus those diagnosed with what can be described as a ‘classical’ Autism diagnosis. Will bringing all types of Autism in one place make it harder for these institutions to offer fewer services merely because of the difference in the diagnosis category? And thirdly, in relation to what was described as the inconsistency of how Asperger’s and other cases of Autism are diagnosed, this new criteria should provide the missing consistency and clarity with which the diseases are diagnosed. Shouldn’t it?
The revision of the manual and the changes being put forward are based on research, analysis and expert opinion. When the APA board met last year, they said the revisions were made with the hope that the diagnoses made will be more specific, reliable and valid.
Yes numerous issues may arise as a result of the change in diagnosing the ranges of Autism, but there are also a few possible benefits that the change could bring. Yes it will impact individuals and families who are diagnosed under the current spectrum, but until it is seen how diagnosticians and clinicians use the new criteria in evaluations and the impact it may have on service availability, an open mind must be kept, while trusting that in all their wisdom, the changes made by the APA will be more beneficial than detrimental.