DSM-5 absorbs autism mileposts into ‘autism spectrum disorder’

“Autism Awareness” puzzle-piece ribbon magnet on a car

The American Psychiatry Association Board of Trustees voted Dec. 1 to approve the Diagnostic and Statistical Manual, fifth edition (DSM-5).

Most significant to me is the absorption of Asperger’s syndrome and other autism spectrum mileposts into one diagnosis of “autism spectrum disorder.”

Since the proposed changes were opened to public comment, writers argued the relative benefits to keeping “Asperger’s syndrome” as its own diagnosis versus using the umbrella term. Many of these arguments were well-thought out and offered valid points, including self-identity with a particular term.

Other labels to be absorbed under the umbrella term are “childhood disintegrative disorder” and “pervasive developmental disorder (not otherwise specified).”

As a woman who learned at age 39 that I was on the autism continuum, the label matters less to me than assuring that our abilities and challenges continue to be recognized on a “spectrum” of intensities.

I grew up without any explanation of why I was “different” from other people. Receiving an Asperger’s syndrome diagnosis was a revelation for me.

The removal of Asperger’s syndrome as a distinct diagnosis is the subject of Forum with Michael Krasney, broadcast today on KQED 88.5 FM. As stated in web publicity, “The APA says the change will lead to more accurate diagnoses for people with autism -- but critics say removing the diagnosis may result in fewer people getting the services and care they need.”

I don’t think anyone can predict with absolute certainty how diagnosis will be affected. One study, published Oct. 1 in the American Journal of Psychology, suggested, that among 4,453 children diagnosed with autism under DSM-4 criteria, 91 percent would still qualify for diagnosis.

The true test, as stated in an Oct. 2 Disability Scoop summary, “will come when clinicians of varying pedigrees will be left to interpret the changes.”

Members of the autism community can be proud of our advocacy among members of the public who responded to proposed changes to the DSM.

According to the APA, there was much more public interest and media scrutiny of the DSM-5 than any previous revisions: “More than 13,000 website comments and 12,000 additional comments from emails, letters and other forms of communication were received.”