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May
18

Autism diagnosis criteria changes go into effect today

The American Psychiatric Association is releasing the fifth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-5) today, which provides standard criteria for the classification of mental disorders by mental health professionals across the United States. One significant change in DSM-5 is new classification criteria for Autism Spectrum Disorders (ASD), and the elimination of the diagnosis of Asperger's syndrome, which will be reclassified as part of ASD.

The American Psychiatric Association is releasing the fifth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-5) today, which provides standard criteria for the classification of mental disorders by mental health professionals across the United States. One significant change in DSM-5 is new classification criteria for Autism Spectrum Disorders (ASD), and the elimination of the diagnosis of Asperger's syndrome, which will be reclassified as part of ASD.

In DSM-5, diagnosis criteria standards for ASD have been reduced from 12 to seven: three in the social/communication category and four in the restricted and repetitive behavior category, Additionally, a "severity qualifier" has been added to indicate how much support the person needs to function.

Because diagnoses affect insurance coverage for therapies and treatments, access to special educational and behavioral services in schools, and disability benefits, the publication of the new diagnosis criteria for ASD creates concern for many. One commonly voiced concern is that many individuals will no longer meet the criteria for ASD and thus be ineligible for services.

"In my opinion as a practicing psychologist, there is no need for anyone to panic about the DSM-5 criteria," said psychologist Barb Luskin, Ph.D., L.P. "The new criteria would make at most a small difference in how I have diagnosed over the past 10 years. I cannot think of anyone I know who has a diagnosis under the DSM-4 who would not also meet the DSM-5 criteria."

Luskin, a licensed psychologist with the Autism Society of Minnesota, has provided assessments and counseling for children and adults with ASD for more than 30 years. She believes it will take several years to assess the impact of the new DSM-5 criteria.

According to Luskin, most programs in Minnesota provide services to people with disabilities based on severity of individual need rather than a diagnostic code. If a person has a diagnosed disability, they also need to justify service based on inability to function independently in a variety of areas. This is independent of a specific diagnosis and is not affected by the changes in DSM-5.

Individuals with ASD are commonly reassessed on a regular basis to determine if they continue to meet diagnosis criteria. This evaluation is based on need for service more than specific label. If an individual continues to meet those criteria of need they still should qualify for services.

"There is concern about how to classify individuals who have the characteristics described in either DSM-4 or DSM-5, but who do not need additional support to function well," Luskin said. "Technically they would not be diagnosed under either system, yet many people with high functioning forms of autism feel the diagnosis is helpful to them. This is primarily a philosophical question, since the DSM is used to label conditions that need intervention rather than to identify differences as such."