In addition, DSM-5 introduces a dimensional approach that allows researchers to capture variability within samples in two important ways. The emphasis on specificity in the DSM-5 improves researchers’ ability to identify samples of interest. Other DSM-IV symptoms have been retained in DSM-5, but their definition has been revised in order to increase specificity. One feature of unusual communication, stereotyped language, has been reassigned to the RRB domain to reflect results from factor analytic studies and are useful in distinguishing ASD from other disorders DSM-5 includes unusual sensory responses in the RRB domain to reflect research showing that these behaviors are prevalent in ASD In addition, although the criteria for DSM-IV Autistic Disorder required a delay in or complete lack of development in expressive language, this requirement has been eliminated in DSM-5 because research has shown that this characteristic is neither specific nor universal to individuals with ASDĬhanges within symptom domains have also been warranted. , rather than by the DSM-IV triad of symptoms that models communication deficits separate from social impairments. Over the past two decades, an increase in access to large and diverse samples has given researchers the ability to determine that, in many cases, ASD symptoms are best represented in a two-domain model of social-communication deficits and restricted and repetitive interests/behaviors (RRB) Less publicized were the content changes and the new symptom structure in DSM-5. The change in DSM-5 that received the most media attention is the removal of the DSM-IV clinical subtypes. found that over 90% of children with DSM-IV-defined PDDs were identified by DSM-5 criteria, and the specificity using the new diagnostic criteria was substantially improved compared with the DSM-IV criteria. , a number of studies have emerged in support of the conceptual validity of the new criteria Consequently, the fifth edition of the DSM (DSM-5) replaces the multi-categorical system with a single diagnostic dimension: ASD.Īlthough concerns have been raised about the validity and diagnostic sensitivity of the proposed DSM-5 criteria and poor predictive ability of later outcome based on these subtypes , with similar core symptom presentations across the categorical diagnoses A number of studies have reported limited reliability in how DSM-IV subtypes are assigned The Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV) used a multi-categorical system of diagnosing pervasive developmental disorders (PDDs), which included autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified, childhood disintegrative disorder, and Rett’s disorder, that created challenges to this effort. This effort has been largely unsuccessful because distinct, empirically defined subgroups have yet to be reliably identified. Over the past several decades, researchers have attempted to categorize the heterogeneity in autism spectrum disorders (ASDs)
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