Stringent DSM-5 criteria may affect prevalence rates of autism spectrum disorders

Despite similarities in behavior, some children diagnosed with autism spectrum disorders under the DSM-IV-TR could lose their diagnosis as a result of the new manual’s stricter diagnostic criteria.

A recent study shows that 46.7% of toddlers diagnosed with autism spectrum disorders (ASDs) under the DSM-IV-TR (the previous version of the diagnosis manual) will no longer meet autism spectrum criteria under the DSM-5. The new version of the go-to psychiatric manual imposes a rigorous set of criteria for diagnosis, requiring more total symptoms to be met in the areas of social/communication deficits and repetitive/restrictive behaviors than did the DSM-IV-TR.

Children with the most severe symptoms and challenging behaviors probably will be able to retain their ASD diagnosis under the DSM-5, but the investigators expressed concern about the decreased sensitivity of the new requirements, stating that "individuals who no longer qualify for an ASD diagnosis ... will nonetheless continue to have significant behavioral issues warranting behavioral intervention," especially because the DSM-IV-TR group more closely resembled the DSM-5 group in this study.

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NOTE: Students who are currently identified as a student with autism under the Montana Administrative Rules will remain eligible for special education services unless the Evaluation Report team chooses to conduct an re-determination of eligibility and need for special education services.

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