There is concern among the autism community that changes to the Diagnostic and Statistical Manual of Mental Disorders will result in replacing specific diagnoses like Asperger’s syndrome and PDD-NOS with just one general Autism Spectrum Disorder (ASD).
Some people have attributed the current increase in autism diagnoses to widened criteria for diagnosis rather than any increased incidences. Proposed changes in the definition of autism would drastically reduce the ballooning rate at which the ASDs are diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services.
The definition is now being reassessed by a panel of experts selected by the American Psychiatric Association. The D.S.M., as the manual is known, is the standard reference for mental disorders, driving research, treatment and insurance decisions. Most experts expect that the new manual will narrow the criteria for autism; the question is how much. The psychiatrists’ association has the difficult choice of deciding how to make the distinction between unusual and abnormal when defining autism.
Tens of thousands of people receive state-backed services to help offset the disorders’ disabling effects, which include sometimes severe learning and social problems, and the diagnosis is in many ways central to their lives. The proposed changes would probably exclude people with a diagnosis who were higher functioning.
Disagreement about the impact of the changes to the manual will almost certainly increase critical analysis of the finer details of the psychiatric association’s new definition. The revisions are about 90 percent complete and will be final by December, according to Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions.