Surprise! Your child isn’t autistic after all

Jan 28, 2014 at 8:00 a.m. ET

The guidelines to diagnose autism have changed — is your child still included?

Autism diagnosis

For many parents, it's hard enough finding out that your child has autism. Now a new study shows that new guidelines would limit the amount of children that meet the criteria for the disorder.

A new study finds that using the updated criteria for diagnosing autism in the Diagnostic and Statistical Manual of Mental Disorders would mean that about 28 percent of children diagnosed with autism won’t meet the criteria for the disorder.

According to the U.S. Centers for Disease Control and Prevention, one in every 88 children has an autism spectrum disorder (ASD); the new criteria under DSM-5 would change it to about one in 100 children.

What's in a diagnosis?

Why does it matter? The guide affects what health insurance plans will cover, but this isn't the first time that the guide changed the criteria for an autism diagnosis. It was revised in 1987 and in 1994. The former criteria came out in 2000, and the newest criteria — DSM-5 — came out in May 2013.

The DSM-5 does not distinguish among subtypes of ASD — such as autistic and Asperger's syndrome.

Instead, it recognizes only two domains of impairment: social communication; and restricted, repetitive patterns of behavior, interests or activities.

DSM-5 changes

A few key changes between the former version and the DSM-5 include the following:

  • Subcategories for things like Asperger's have been eliminated. A new category, "social communication disorder," or SCD, has been added.
  • Symptoms don't have to be present at the time of assessment; they count if they were exhibited in the past, too.
  • Patients must show problems with three specific types of social communication Asperger's syndrome — it used to be just two and there was a greater emphasis on language.
  • Patients must show "restricted, repetitive patterns of behavior, interests or activities" of at least two types. One type can be "hyper- or hyporeactivity to sensory input," which is often associated with autism but was not previously included.

What's SCD?

"Until proven otherwise, the treatments for ASD and SCD should remain the same or similar," said Yale child psychiatrist and epidemiologist Young-Shin Kim.

"It's important for children moving to a SCD diagnosis — and to their families — that they continue receiving the interventions they would have received with an autism diagnosis under the earlier DSM-IV criteria."

The study of it was published in the American Medical Association’s journal Psychiatry.

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