In honor of National Autism Awareness Month, I thought it would be important to highlight the changes autism spectrum disorders will be facing in the DSM-V, the fifth edition of psychiatrist’s Diagnostic and Statistical Manual of Mental Disorders. The DSM-V will be released May 2013, according to the American Psychiatric Association, and will replace the existing DSM-IV TR, which has held its place as clinical psychology’s guidebook to categorizing and diagnosing mental disorders since 1994.
Asperger’s Disorder is generally characterized as a mild form of Autism in which individuals are high functioning, exhibit no language or cognitive delay but still lack use and understanding of conventional social cues and gestures, seem clumsy and socially awkward, and might obsess about one particular object or activity. It is not that they don’t want to engage in social interaction, they just don’t know how.
According to the creators of this future “psych bible”, Asperger’s is not “substantially” different than other forms of high functioning autism, so the proposal is to subsume Asperger’s into the broad category Autistic Disorders and to eliminate it as a separate diagnosis.
“… Anyone who shows the Asperger type pattern of good language and IQ but significantly impaired social-communication and repetitive/restricted behavior and interests, who might previously have been given the Asperger disorder diagnosis, should now meet criteria for ASD, and be described dimensionally.” – American Psychiatric Association
More often than with severe forms of Autism, Asperger’s disorder is diagnosed later in life – around adolescence – rather than early childhood. Unlike children with higher spectrum Autistic Disorders, those with Asperger’s do not exhibit language delay or impairment and often have an average to high IQ; therefore, the Asperger’s diagnosis is easily missed in childhood when language and academic intelligence milestones are still being met. Not until adolescence when more complex social skills are in demand do parents see problems emerging.
To account for this age discrepancy, the DSM-V will include detailed symptoms for all ages, so the Asperger’s diagnosis won’t be missed in adolescents and adults and those with higher IQ and language ability. Language impairment will also no longer be a necessary criterion for autism spectrum disorders.
The main rationale behind this decision is that researchers have determined that the Asperger’s diagnoses in clinical settings have not been effective; the term is used too loosely and is too easily tagged onto individuals who otherwise would not meet criteria for autism spectrum disorders.
For some, however, the specific diagnosis is helpful in understanding themselves and for seeking specialized treatment and counseling specific of high-functioning autism.
But most likely, the characteristics will not be forgotten; those who need treatment for high-functioning autism will get what they need, and those who do not necessarily meet the criteria will be recognized as such.