DSM-IV vs DSM-5 diagnostic criteria for toddlers with Autism

Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
Developmental neurorehabilitation (Impact Factor: 2.05). 06/2012; 15(3):185-90. DOI: 10.3109/17518423.2012.672341
Source: PubMed


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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    • "These results are particularly interesting considering the changes to ASD diagnostic criteria in DSM-5, which effectively collapses AS and AUT groups into one category, with further description of the severity of symptoms in both the social-communication and repetitive behaviors and interests domains. To date, the limited relevant research suggests conflicting conclusions about the proportion of atrisk toddlers meeting DSM-IV-TR criteria who would also meet DSM-5 criteria (e.g., Huerta et al. 2012; Matson et al. 2012). At this point, there is no research base examining the ability of early risk markers for ASD in infants to predict ASD diagnoses using DSM-5 criteria. "
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    ABSTRACT: Retrospective video analyses indicate that disruptions in gesture use occur as early as 9-12 months of age in infants later diagnosed with autism spectrum disorders (ASD). We report a prospective study of gesture use in 42 children identified as at-risk for ASD using a general population screening. At age 13-15 months, gesture were more disrupted in infants who, at 20-24 months, met cutoffs for "autism" on the ADOS than for those who met cutoffs for "autism spectrum" or those who did not meet cutoffs for either, whereas these latter two groups displayed similar patterns of gesture use. Total gestures predicted later receptive and expressive language outcomes; therefore, gesture use may help identify infants who can benefit from early communication interventions.
    No preview · Article · Feb 2015 · Journal of Autism and Developmental Disorders
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    • "BISCUIT-part 1, M-CHAT, and BDI-2. All ASD diagnoses were made by a licensed doctoral level psychologist with over 30 years of experience who had access to the information gathered from the assessment administrations and a record review, and made diagnoses based on clinical judgment using the DSM-IV-TR and the DSM-5 criteria Matson et al. (2012c) 2,721 toddlers at risk for DDs Pediatricians and healthcare professionals previously identified the toddlers as at risk for DD. A licensed doctoral psychologist administered the BISCUIT-part 1, the M-CHAT, and BDI-2° Taheri and Perry (2012) 131 children previously diagnosed with either autistic disorder or PDD-NOS aged 2–12 years Mullen, S-BIS, WPPSI or WPPSI, WISC, VABS, and CARS Worley and Matson (2012) 208 children with ASD aged 3–16 years Participants were recruited though advocacy groups, support groups, schools, and through an outpatient clinic. "
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    ABSTRACT: A systematic review of empirical papers comparing the application of DSM-IV and DSM5 diagnostic criteria for Autism Spectrum Disorders identified 12 papers. The application of DSM5 diagnostic criteria resulted in an approximately one third reduction in Autism Spectrum Disorders. The reduction was approximately two thirds for mild forms of Autism. The implications for practice and research are discussed.
    Preview · Article · Dec 2014
    • "To determine the ASD subgroups most likely to be affected by the changes in DSM-5 criteria, the seven studies which examined the impact of DSM-5 criteria on one or more specific DSM-IV-TR subgroups within ASD were analyzed separately (Dickerson Mayes et al. 2013; Gibbs et al. 2012; Matson et al. 2012c; Mattila et al. 2011; McPartland et al. 2012; Taheri and Perry 2012; You et al. 2011). Of these, one study (Dickerson Mayes et al. 2013) reported findings of two samples which were combined for purposes of meta-analysis. "
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    ABSTRACT: We conducted a systematic review and meta-analysis to determine the effect of changes to the Diagnostic and Statistical Manual (DSM)-5 on autism spectrum disorder (ASD) and explore policy implications. We identified 418 studies; 14 met inclusion criteria. Studies consistently reported decreases in ASD diagnosis (range 7.3-68.4 %) using DSM-5 criteria. There were statistically significant pooled decreases in ASD [31 % (20-44), p = 0.006] and DSM-IV-TR subgroups of Autistic disorder [22 % (16-29), p < 0.001] and pervasive developmental disorder-not otherwise specified (PDD-NOS) [70 % (55-82), p = 0.01]; however, Asperger's disorder pooled decrease was not significant [70 % (26-94), p = 0.38]. DSM-5 will likely decrease the number of individuals diagnosed with ASD, particularly the PDD-NOS subgroup. Research is needed on policies regarding services for individuals lacking diagnosis but requiring assistance.
    No preview · Article · Feb 2014 · Journal of Autism and Developmental Disorders
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