You may remember the hype. Almost one year ago, the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published. Unless you are in the field, it may not ring a bell. However, what you most likely DO remember are the thought-provoking (yet incredibly uninformative) news headlines that read something along the lines of, “Autism Diagnosis Reduced by a Third!” No, unfortunately, there was no overnight cure for autism or even a sudden dramatic decrease of those who are affected by it. What happened was a change in diagnostic criteria, and I’m going to tell you why this matters while sparing you a ton of reading. You’re welcome.
Here is what happened. Many psychiatrists and other like professionals were uncomfortable with there being such a broad range of standards comprised with testing “on the spectrum”; they were too vague. Therefore, a team of psychiatrists, or the DSM-5 committee, created what they considered to be clearer and more precise diagnostic criteria, hoping that these new standards would effectively translate to those who are involved with screening for autism. Categories contribute to mutual understandings and psychiatrists love categories. Lo and behold, instead of three categories of ASD symptoms, which were previously lumped into one key diagnosis, there are now two – social-communication impairment and repetitive/restricted behaviors. However, here’s the “but”, and it’s a big “but”… Now, a Social Communication Impairment without at least two repetitive/restricted behaviors (think here of the odd fascinations, awkward body movements, inflexible routines, etc.) are no longer considered autism, but are now categorized as Social Communication Disorder (SCD).
Stay with me, because this part is important. Although the DSM-5 committee recommended the contrary, many schools and health insurers are asking that children be rescreened under the new guidelines, hence losing their diagnosis. As a result, several children are losing crucial services because they are now identified as having SCD instead of ASD. Automatically one would assume that these children would simply apply for services related to SCD and begin to receive relevant methods of intervention and therapy, right? Wrong. How about this for a caveat: SCD is a newly refined disorder and there are no formal guidelines for treatment. Talk about putting the cart before the horse, eh?
Autism Speaks wants to ensure that autism services are provided to all who need them. Currently, they are conducting a survey and study for those whose services have recently been revoked as a consequence of reevaluation under the DSM-5. Please share your DSM-5 experiences.
A good read: Why are Children Losing their Autism Diagnosis?