The Changes to the DSM

 

The new Diagnostic Statistical Manual has arrived with much controversy. There are major changes in two all too common diagnoses, ADHD and Asperger’s Syndrome. The major change is that Asperger’s Syndrome has been removed from the lexicon. Individuals with that diagnosis will no longer be classified in that way.  Some will receive an Autism Spectrum Disorder diagnosis and others may receive a Social Communication Disorder diagnosis.  Further, Autism Disorder is now called Autism Spectrum Disorder.

ASD requires “persistent deficits in social communication and social interaction; repetitive patterns of behaviors, interests or activities; the presence of symptoms in early childhood and the symptoms limit and impair everyday functioning.” (Pathfinders for Autism)  Autism is now diagnosed by the presence of social communication and interaction deficits as well as patterned behavior, interests and activities.  These symptoms arise in early childhood and continue throughout the individual’s life.  Moreover, they affect how the individual functions on a daily basis. ASD is also modified by the level of supports required, ranging from the most severe (3) to the most mild (1).

The DSM 5 also includes a new diagnosis, Social Communication Disorder.  “This diagnosis addresses impairment of pragmatics and is diagnosed based upon difficulty in the social uses of verbal and nonverbal communication.” In other words, people with this diagnosis have difficulty understanding verbal and nonverbal communication in their natural contexts. It limits social functioning.  It is not related to an Autism Syndrome Diagnosis.  Finally, it is present in early childhood.

The impact of this change is uncertain.  What is known is that people with Asperger’s Syndrome, who are generally more cognitively able, will be left out of the diagnosis. Some may fall into the Social Communication Disorder, others may not.

Related to service delivery, it is important to know that neither DDA nor the MD State Department of Education follow the DSM.  Therefore, there should not be any service delivery interruption due to these changes.

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