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Review of Studies Finds DSM-5 Could Reduce Autism Diagnoses by a Third

A review of multiple studies concludes that new guidelines for diagnosing autism spectrum disorder (ASD) could reduce the number of individuals receiving the diagnosis by nearly a third. The review appears in the Journal of Autism and Developmental Disorders.

The new guidelines came into use with the publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) last May. The newly published review – by Columbia University researchers – summarizes the findings of previous studies on the likely effects of the DSM-5 changes on autism diagnoses. Most of these earlier studies have been reported on this website. (See our full DSM-5 coverage here.)

Some of the earlier research suggested that a subset of children who would have received an autism diagnosis under the older DSM-IV criteria would now receive a diagnosis of social communication disorder (SCD).

Social communication disorder involves problems with social and communication skills, but without the repetitive behaviors and restricted interests typical of autism. Because SCD is a newly defined disorder, it does not yet have formal guidelines for treatment.

Of concern, an ongoing online survey by Autism Speaks has drawn accounts of children losing behavioral therapy and special education services after their autism diagnosis was changed to SCD. This is contrary to the recommendations of the DSM-5 committee that drew up the new criteria for diagnosing autism. It stated that no one who already has an autism diagnosis should be required to be reevaluated under the new criteria.

“This raises serious concerns,” said Autism Speaks Chief Science Officer Rob Ring. “Autism Speaks advocates for all individuals who would benefit from autism-related services.”

Please also see “Guidance on Social Communication Disorder” by Autism Speaks child psychologist Lauren Elder, and “DSM-5 & Autism: Autism-Speaks Study Clarifies Impact of New Criteria.” Read the full DSM-5 diagnostic criteria for SCD and ASD here.