Because both components are required for diagnosis of autism spectrum disorder, social (pragmatic) communication disorder is diagnosed if no RRBs are present. Autism spectrum disorder encompasses the 4 separate disorders from the previous DSM-IV: autistic disorder (autism), Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified. The overarching category term used in ICD-11 is pervasive developmental disorder (PDD), a term now used synonymously with autism spectrum disorder (excluding Rett's syndrome) it is a behaviourally defined group of disorders, which is heterogeneous in both cause and manifestation.ĭSM-5 refers to autism spectrum disorder as a single condition with different levels of symptom severity in 2 core domains: 1) deficits in social communication and social interaction and 2) restricted repetitive behaviours (RRBs), interests, and activities and sensory anomalies. Autism spectrum disorders are diagnosed in children, young people and adults if these behaviours meet the criteria defined in the International Statistical Classification of Diseases and Related Health Problems (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) and have a significant impact on function. The term autism describes qualitative differences and impairments in reciprocal social interaction and social communication, combined with restricted interests and rigid and repetitive behaviours. In addition, it is important that clinicians do not exclude or delay referral for possible autism spectrum disorder because of an earlier diagnosis of ADHD. This is because there is evidence showing an increased prevalence of autism spectrum disorders in children and young people with ADHD. All rights reserved.This guideline was updated in 2017 to include attention deficit hyperactivity disorder (ADHD) in the list of factors that should be taken into account when considering a referral for possible autism spectrum disorder and when considering whether to carry out an autism spectrum disorder diagnostic assessment. A more stringent diagnostic rubric holds significant public health ramifications regarding service eligibility and compatibility of historical and future research.Ĭopyright © 2012 American Academy of Child and Adolescent Psychiatry. Revised criteria improve specificity but exclude a substantial portion of cognitively able individuals and those with ASDs other than autistic disorder. Proposed DSM-5 criteria could substantially alter the composition of the autism spectrum. Sensitivity varied by diagnostic subgroup (autistic disorder = 0.76 Asperger's disorder = 0.25 pervasive developmental disorder-not otherwise specified = 0.28) and cognitive ability (IQ < 70 = 0.70 IQ ≥ 70 = 0.46). Overall specificity was high, with 94.9% (95% confidence interval: 92%-97%) of individuals accurately excluded from the spectrum. When applying proposed DSM-5 diagnostic criteria for ASD, 60.6% (95% confidence interval: 57%-64%) of cases with a clinical diagnosis of an ASD met revised DSM-5 diagnostic criteria for ASD. Sensitivity and specificity for proposed DSM-5 diagnostic criteria were evaluated using field trial symptom checklists as follows: individual field trial checklist items (e.g., nonverbal communication) checklist items grouped together as described by a single DSM-5 symptom (e.g., nonverbal and verbal communication) individual DSM-5 criterion (e.g., social-communicative impairment) and overall diagnostic criteria. The study focused on a sample of 933 participants evaluated during the DSM-IV field trial 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. This study evaluated the potential impact of proposed DSM-5 diagnostic criteria for autism spectrum disorder (ASD).
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