In a few months, Asperger’s Syndrome will no longer be an entry in the great big book of diagnoses or as it is more commonly referred to, the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition or the DSM-5 for short. Known for decades as the premier location for researching, classifying and diagnoses of disease, the DSM-5 is an authority which aims to define and classify mental disorders to improve diagnoses, treatment and research.
Asperger’s Syndrome also known as AS, which is a type of Autism, is a developmental disorder that impacts the ability to communicate and socialize among other things. The last edition of the DSM which was released in 1994 divided the criteria for Asperger’s into 5 sections. These included the following:
- Qualitative impairment in social interaction.
- Restricted repetitive and stereotyped patterns of behavior, interests, and activities.
- Clinically significant impairment in social, occupational, or other important areas of functioning.
- No clinically significant general delay in language
- No clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior, other than in social interaction, and curiosity about the environment in childhood.
- And criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
However, 18 years later and after much revision, the new version will group all autism into one category. Clinicians will be expected to consider social communication or interaction difficulties and restricted or repetitive behaviors and interests then rank them on severity scales and need for support. There is also a new ‘social communication disorder’ category in the DSM-5. This is separate from the ‘social communication or interaction difficulties’ that were mentioned before. It covers persons with problems in this area but who do not manifest symptoms that fall in the restricted behaviors area. But this raises a two-fold problem. Firstly, this diagnoses does not exist. Neither is it recognized as a disorder by educational institutions and insurance companies. How then will this be fixed? Will these entities begin to recognize it based on the information in the DSM-5? Secondly, there was a study done by DSM-5 architect Catherine Lord. Children with Pervasive developmental disorder not otherwise specified or PDD-NOS, were most likely not to meet the new autism criteria so, presumably, they are the population which the social communication disorder category is expected to capture right? Wrong. In this study, the children failed because they did not have dysfunction in the social area although they did in the repetitive behavior area. This then leaves the question, who will fall into that category?
According to the revision committee, the aim of the change is not to expand the number of people diagnosed with mental illness, but to ensure that those affected were accurately diagnosed so that they could get the most appropriate treatment.
But the changes will affect the diagnosis and treatment of millions of children and adults worldwide. It will also influence medical insurance and special education services. While the most that can be done is to wait on the revised edition to be published in May, prior consideration needs to be made on how those diagnosed with the ranges of Autism including Asperger’s will be affected.