Autism diagnostic guideline tightening may ‘miss’ some autistic children

CC BY-ND by John Brawley

Recent changes to the American Psychatric Association’s Diagnostic and Statistical Manual (DSM) have tightened the criteria for the diagnosis of autism.

The new revision, DSM V will include Asperser’s Syndrome in it’s criteria, and any who were diagnosed with autistic disorder, pervasive developmental disorder or childhood disintegrative disorder, will now be diagnosed with an autistic spectrum disorder.

But according to research done by organisations like Autism Speaks, the tightening of criteria used in DSM V may mean some children will now fail to meet the criteria for diagnosis and the vital therapy and resources that are attainable after they are diagnosed.

An article dated January 25 in The New Scientist explains:

“Under the previous criteria of DSM-4, a person would be diagnosed with ASD by exhibiting at least six of 12 behaviours, which include problems with communication, interaction and repetition. Now, that same person would need to exhibit three deficits in social communication and interaction and at least two repetitive behaviours – the latter, say critics, makes the new criteria more restrictive.”

Autism speaks conducted a brief online survey when the changes were announced asking clinicians and parents of autistic children to contribute their experiences with the new diagnostic system.

Commenter JCP on the Autism Speaks website said:

My experience in Missouri has been that even though a pediatrician (sic), psychologist, neurologist, and psychiatrist agree my daughter ha HFA my insurance would not cover services without official testing. Also, her school would not refer her to special school district. Fortunately, I found a county program to “officially” test my child.

Whilst the changes in diagnostic criteria are unlikely to have a big effect in the UK, where a vast majority of children are referred through the National Health Service, treatment may be effected in the USA, due to the constraints of health insurance.

Some children already diagnosed are being asked to take a re-evaluation by some schools and educational centres under the new diagnostic guidelines. An anonymous contact told the New Scientist:

 “The regional centre that funds services for her son is seeking to have him re-evaluated despite a 10-year well-established diagnosis of ASD.”

If you have any experiences with the new guidelines, please come forward and leave your comment below, or email us at editor@autismdailynewscast.com