DSM-IV vs DSM-5 diagnostic criteria for toddlers with autism.
ABSTRACT To evaluate prevalence rates of autism and autism symptomatology in toddlers using DSM-IV vs DSM-5 criteria.
Two thousand seven hundred and twenty-one toddlers at risk for a developmental disability participated. DSM-IV and DSM-5 criteria were applied and overall prevalence using each set of criteria was established. Groups were also compared on BISCUIT-Part 1 scores to determine if groups differed on autism symptomatology.
DSM-5 resulted in 47.79% fewer toddlers being diagnosed with ASD compared to those on the DSM-IV. Toddlers diagnosed according to DSM-5 exhibited greater levels of autism symptomatology than those diagnosed with DSM-IV, but the latter group still exhibited significant levels of autism symptomatology.
The proposed DSM-5 will result in far fewer persons being diagnosed with ASD. These results replicate findings from two previous studies, with older children/adolescents and adults. As a result of these new criteria, far fewer people will qualify for needed autism services.
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ABSTRACT: There has been a marked increase in interest in early identification of young children with and at risk for autism. This interest has reflected advances in research as well as an awareness of the potential for major changes in long-term outcome as a result of intervention. Several issues have complicated these efforts. There continue to be challenges to implementation of effective screening and diagnostic approaches in young children. Although the body of evidence-based research on treatment has increased, it remains limited. Despite these issues, important findings have emerged that may assist in fostering better approaches to screening, diagnosis, and documenting treatment impact.International Journal of Speech-Language Pathology 12/2013; DOI:10.3109/17549507.2013.862859 · 1.41 Impact Factor
Article: The Neuropathology of Autism[Show abstract] [Hide abstract]
ABSTRACT: Autism is a behaviorally defined neurodevelopmental disorder that affects over 1% of new births in the United States and about 2% of boys. The etiologies are unknown and they are genetically complex. There may be epigenetic effects, environmental influences, and other factors that contribute to the mechanisms and affected neural pathway(s). The underlying neuropathology of the disorder has been evolving in the literature to include specific brain areas in the cerebellum, limbic system, and cortex. Part(s) of structures appear to be affected most rather than the entire structure, for example, select nuclei of the amygdala, the fusiform face area, and so forth. Altered cortical organization characterized by more frequent and narrower minicolumns and early overgrowth of the frontal portion of the brain, affects connectivity. Abnormalities include cytoarchitectonic laminar differences, excess white matter neurons, decreased numbers of GABAergic cerebellar Purkinje cells, and other events that can be traced developmentally and cause anomalies in circuitry. Problems with neurotransmission are evident by recent receptor and binding site studies especially in the inhibitory GABA system likely contributing to an imbalance of excitatory/inhibitory transmission. As postmortem findings are related to core behavior symptoms, and technology improves, researchers are gaining a much better perspective of contributing factors to the disorder.12/2012; 2012:703675. DOI:10.6064/2012/703675
Article: Where to from here for[Show abstract] [Hide abstract]
ABSTRACT: In this commentary, I provide additional areas of focus in moving forward with understanding and helping those with autism spectrum disorders (ASD) and anxiety. Many of these issues have been experienced by those in the child anxiety realm as well, and so insights and findings from that field seem pertinent. Although there are many topics relevant to the study of anxiety in those with ASD, I briefly highlight several that are particularly pressing, including the downward and lateral extensions of anxiety findings from the typically developing literature, the use of multiple informants in assessment, the consideration of age and intellectual functioning in development and diagnosis, and the potential impact from the proposed revisions in DSM‐5.Clinical Psychology Science and Practice 01/2012; 19(4). DOI:10.1111/cpsp.12014 · 2.92 Impact Factor