DSM-V

This will seem waaaaaaay off topic, but people working in education should be aware of it.

With the coming change in the Diagnostic and Statistical Manual as a tool to identify disorders, the definition of Autism will change. Autism will no longer be one of several social-communication disorders—PDD-NOS, Autism, Asperger Syndrome, CDD, and Rett Syndrome. Instead, all these diagnoses will be called Autism (except Rett Syndrome) and classified by severity of disability. In addition, impairments of people with Autism will be classified differently. Where DSM-IV used the categories of communication, social interaction, and restricted interests and repetitive behaviors, DSM-V will combine communication and social interaction into one category. Also, language delay will no longer be a requirement for diagnosis.

One advantage for many of the new DSM-V definition is diagnostic consistency. Diagnosing Autism can be less precise than diagnosing such ailments as the flu or cancer where a blood sample or tissue tests are available for repeatable, consistent results. Instead, Autism is diagnosed from observed behavior, which can be variable. Therefore, Autism diagnoses are somewhat subjective–different doctors diagnose people different ways, and people with Autism behave differently on different days and in different surroundings. This difference can affect the diagnosis and treatment someone with Autism—particularly those who are high-functioning and may move among diagnoses. With the new DSM-V definition, all people exhibiting particular behaviors will be diagnosed with Autism ensuring diagnostic consistency.

Another advantage of the new DSM-V definition is the inclusion of people with social difficulties who do not exhibit language delays. Indeed, Autism may be masked in children who have little difficulty with language. In fact, Dr. Mostofsky mentioned specifically that advanced verbal skills can mask Autism until the child is much older. Early diagnosis is important for children with Autism, so including more people with social difficulties who do not exhibit language delays enables more children to get therapy and counseling when they are still developing.

A clear disadvantage of the new DSM-V definition is a concern that the new definition is too restrictive. As people with Autism are re-diagnosed, they may no longer meet the stricter criteria. As such, people may lose insurance coverage, such as counseling sessions from a psychologist or social skill groups. In addition, people with Autism may lose access to state or county services or benefits.

Another clear disadvantage with DSM-V is with nomenclature (or naming). One example is that of stigma. Under DSM-V, a person with high-functioning Autism will no longer be diagnosed with Asperger Syndrome. This can be problematic in many ways. For example, Asperger Syndrome sometimes has strange social currency in our current culture. Indeed, our culture has a recent fascination with Asperger Syndrome, which has been growing for some time. From the movie Rain Man in the 1990s to today’s Big Bang Theory and various popular novels (too many to list), Asperger Syndrome is a curiosity and thus, it is somehow more accepted in society than in the past. With the DSM-V, people who have Asperger Syndrome will change to having Autism, which can be seen as a significant increase in disability even though the person remains the same. Another example is resistance to change. People with Autism often dislike change. Changing the way their diagnosis is named will likely meet with (extreme) resistance from many people with Autism.

In the classroom, learners get help according to need, not diagnosis. However, the change may cause stress in families with ASD children, so it’s important to be aware of it.

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