DSM-5 – Proposed Diagnostic Criteria for Autism « Autism

 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Changes:

TIMELY ADVOCACY ISSUE FOR 2012:

Status on Comments:

• Is There Opportunity to Provide Further Comments? (American Psychiatric Association – DSM-5 Development)
  Beginning May 4th, 2011, we asked you, our visitors, to review and comment on the proposed DSM-5 organizational structure and criteria changes. Please note that this 2nd commenting period ended on June 15, 2011. We received over 2000 comments during this 2nd posting, and the DSM work groups have reviewed these, as well as other information that has been obtained since the draft criteria were last posted. 

  It is important to remember that the proposed chapter structure featured here is only a draft. These proposed headings were reviewed by the DSM-5 Task Force in November 2010. An article by APA Past-President Carol A. Bernstein, M.D., published in Psychiatric News, provides an informative background as to why they were developed. Furthermore, the proposed diagnostic criteria revisions on this site are also not final. They are receiving ongoing review by the DSM-5 Task Force and the APA Board of Trustees. Many of the diagnostic criteria sets were tested in the DSM-5 field trials in academic sites, and all criteria sets will be eligible for use in the field trials in routine clinical practice settings. Results from these field trials may inform further changes in the diagnostic criteria.
   
  The 2nd commenting period was not the final opportunity for you to submit feedback. In spring 2012, we will open the site for a third and final round of comments from visitors, which will again be systematically reviewed by each of the work groups for consideration of additional changes. [emphasis added]

Issue:

• DSM-5 Proposed Criteria for Autism Spectrum Disorder Designed to Provide More Accurate Diagnosis and Treatment (American Psychiatric Assn. Press Release – 1/20/12)
  The American Psychiatric Association (APA) has proposed new diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for autism. While final decisions are still months away, the recommendations reflect the work of dozens of the nation’s top scientific and research minds and are supported by more than a decade of intensive study and analysis. The proposal by the DSM-5 Neurodevelopmental Work Group recommends a new category called autism spectrum disorder which would incorporate several previously separate diagnoses, including autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified.
• DSM-5: The Future of Psychiatric Diagnosis (American Psychiatric Association)
  Publication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 will mark one the most anticipated events in the mental health field. As part of the development process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are now available for public review.

Statements and Calls for Advocacy:

DSM – 5 (Autism Society)
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, most recently released as the DSM-5 in 2013, is used by many organizations, individuals and government to diagnosis psychiatric disorders such as autism.
The DSM-5 redefined autism. Its predecessor, the DSM-IV-TR, included five Pervasive Developmental Disorders (PDDs): Autistic Disorder, Asperger’s Disorder, Rett’s Disorder, Childhood Disintegrative Disorder and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).
In the DSM-5, Autistic Disorder, Asperger’s Disorder and PDD-NOS are replaced by the diagnosis of Autism Spectrum Disorder. Additionally, the DSM-5 also reduces social-related elements of autism into social communication impairment and repetitive/restricted behaviors, though the labels of Asperger’s and PDD-NOS are still in common use.

DSM-V Changes: what we need to do and why it is so important that we stop this (letter from Global and Regional Asperger Syndrome Partnership (GRASP) – 1-22-12)
With 10 months before the final version of the new DSM is due, we have a chance of reversing the Committee's intentions of significantly reducing the numbers of those who would qualify for a diagnosis. Once again, the New York Times is speculating that the new criteria would qualify only 76% of those currently diagnosed with classic autism, 24% of those currently diagnosed with Asperger's, and 16% of those currently diagnosed with PDD-NOS.

Articles:

• How the Definition of Autism May Change (New York Times – 1/19/12)
  Pages from the American Psychiatric Association's manual with the current and proposed new definition of Autism.
• Meta-Structure in DSM-5 Process (Psychiatric News – 3/4/11)
  As we move forward with the continuing development of DSM-5, I thought it might be helpful to review some of the history behind DSM with a specific focus on what is referred to as the "meta-structure."
• New Autism Definition Could Exclude Many From Diagnosis (Education Week – 1/20/12)
  News reports from around the country say that the definition of the disability is being reassessed by a panel appointed by the American Psychiatric Association. The group is wrapping up work on the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, which The New York Times reports is the manual's first major revision in 17 years. The Times talked to Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine and an author of a new analysis designed to weigh the potential effect of the proposal. He said the changes would narrow the diagnosis so much that it could effectively end the autism surge. "We would nip it in the bud," he told The Times.
• New Definition of Autism Will Exclude Many, Study Suggests (New York Times – 1/19/12)
  Proposed changes in the definition of autism would sharply reduce the skyrocketing rate at which the disorder is diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services, a new analysis suggests.
• Redefining Autism (New York Times – 1/19/12)
  In a preliminary analysis, three researchers estimate that far fewer people with autism or a related disorder would meet the criteria for autism spectrum disorder after a change proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M.

Update on Medicaid Planning Issues for People with Disabilities and Elders

• Resources and links regarding DSM-5 proposed criteria for Autism Spectrum Disorder (PEKD – Jan. 2012)
  Material from a presentation Patti did to the Oakland County Bar Association with updated material regarding the DSM-5 proposed criteria, including links, news releases and related materials in one pdf document.
• Also includes resources related to other estate planning matters for elders and people with disabilities, including Special Needs Trusts, The ABLE Act of 2011 and How and When to Use a Pooled Special Needs Trust