Tuesday, May 8, 2012

New Data Shows Impact of ASD Criteria Changes to DSM

Study Damps Fears on Autism Change

PHILADELPHIA—Proposed new diagnostic criteria for autism don't appear to reduce the number of children diagnosed with that condition, according to preliminary data presented at the American Psychiatric Association annual meeting on Sunday.
Those findings could damp the controversy that has surrounded suggested changes to the main psychiatric diagnostic manual in the U.S., the Diagnostic and Statistical Manual of Mental Disorders, or DSM, about how autism and related disorders that are characterized by social impairments and repetitive behavior are categorized.
One of the main changes, which has yet to be finished, recommends combining several disorders, including Asperger's syndrome and "pervasive developmental delay not otherwise specified," with autism into one broad category known as autism-spectrum disorder.
In January, researchers at Yale University presented an analysis that suggested the new criteria wouldn't diagnose every child who had received the diagnosis using the current criteria, which might lead to service being denied to some 35% of currently diagnosed children.
Diagnoses can be important for parents to persuade their health insurers to pay for treatment and for schools to cover special-education services.
On Sunday, the committee overseeing the changes to the autism criteria announced data from so-called field trials conducted by several academic centers showing that children diagnosed with autism or related disorders using the current criteria almost always received a diagnosis using the proposed new criteria as well.
The prevalence of autism using both criteria was essentially unchanged, though there were a few cases where children were diagnosed by one set of criteria and not the other, according to Susan Swedo, head of the work group and a senior researcher at the National Institute of Mental Health. Over 600 children were tested as part of these trials.
The concern that children who need services for autism-related symptoms will be denied them because of proposed changes to the autism diagnostic criteria is "not true," said Dr. Swedo.
The group proposed the more-encompassing autism-spectrum disorder label, and also introduced a separate, new disorder for children with social-communication issues but lacking other features of autism. The goal is to have clinicians better distinguish among certain developmental disorders.
More accurate diagnosis will help children get the right services they need, said Dr. Swedo.
Write to Shirley S. Wang at shirley.wang@wsj.com
A version of this article appeared May 7, 2012, on page A3 in some U.S. editions of The Wall Street Journal, with the headline: Study Damps Fears on Autism Change.

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