Most psychiatrists applaud this consolidation because, as several recently published studies have shown, the new criteria are more precise: they rarely assign autism to people who do not have it. However, the DSM-5 criteria may be a little too strict, ignoring some autistic people with milder symptoms. Two recently published studies suggest an easy fix: if the new criteria require that patients meet one fewer symptom—four out of seven instead of five out of seven—high-functioning autistic people will not be excluded. (To learn more about the strengths and weaknesses of the APA's changes to the definition of autism, read the companion piece: "Redefining Autism".)

7 Comments

1. 1. DrBrocktagon 09:20 AM 1/30/12

   There was a similar discussion over on the Autism and Oughtisms blog last year, in response to my own blogpost where I did the same calculation for DSM IV (I arrived at 2027 too).
   
   http://autismandoughtisms.wordpress.com/2011/09/02/drastic-drop-in-asd-diagnosis-variations-from-dsm-iv-2027-to-the-proposed-dsm-5-just-11/
   
   http://crackingtheenigma.blogspot.com/2011/02/exactly-how-many-ways-are-there-to-get.html
   
   As you say, the drop from 2027 to 11 sounds dramatic but is pretty meaningless.
   
   The 8 symptoms under Social and Communication are being replaced with one single symptom, “Deficits in social-emotional reciprocity”. But to meet this criterion you can show anything “from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction”.
   
   Not consolidation so much as repackaging.

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2. 2. Goettel 12:24 PM 1/30/12

   As long as the (industry sponsored) DRM groups arbitrary collections of symptoms together into voted-on 'definitions' I wouldn't trust it for any diagnosis.

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3. 3. Goettel 12:24 PM 1/30/12

   *DSM

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4. 4. Teako 08:05 PM 1/30/12

   The over-diagnosis of autism in our school districts has sucked all of the money out of the gifted programs because by federal law you are essentially handcuffed from making any cuts for any economic reason at all.

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5. 5. AutismDad 11:46 AM 1/31/12

   My son is autistic and mentally retarded, and we can use extre help with him, but it's true, gifted kids, like my other two, are a far better investment, and they get very little. My daughter is in an after school program so that we have more time for my son's lessons, but the after school, which is great, focuses on "needy" kids. Again not good investments compared to the smart kids. We are broke and need to spend our borrowed money more wisely.

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6. 6. AutismDad 02:11 PM 1/31/12

   Another things should be said about "autism". The psychiatric definition and legal and political side of this may be a mess, but the basic brain research into causes is blasting along, and should be financed, there are tremendous public health benefits almost at hand.

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7. 7. Daniel35 10:16 PM 2/2/12

   I tend to think in terms of spectra rather than categories, as in the "autism spectrum", except as language requires otherwise. How many people can claim zero characteristics of any mental condition? What is "normal" and who can claim it in any category, and who would want to? Giving help should be based on how much is needed, and whether or not they'd be more socially productive if left to choose their own treatment, not on whether they 'have" the condition. Some creative artists and inventors have been seen as high on the autism spectrum.
   

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