New Autism Definition Might Mean Fewer Cases




Proposed changes to the definition of autism might mean that fewer children will be diagnosed with the disease, resulting in less health, educational, and social services offered to those that would normally be covered.

The current definition is under review by an expert panel appointed by the American Psychiatric Association (APA). The updated definition is expected to appear in the fifth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders, which should be completed by December. The D.S.M is the standard reference for mental disorders, treatment and insurance decisions.

“The proposed changes would put an end to the autism epidemic,” said Dr. Fred R. Volkmar, director of the Child Study Center at Yale University School of Medicine and an author of the new analysis. “We would nip it in the bud — think of it that way.”

Autism rates have skyrocketed since the early 1980’s, and recent estimates show that as many as 1 in 100 children might be affected with the disease under the current definition.

“I don’t know how they’re getting those numbers,” said Catherine Lord, a member of the task force working on the diagnosis.

Currently, one million children and adults are diagnosed with autism or a related disorder, like Asperger syndrome or “pervasive developmental disorder, not otherwise specified” — or P.D.D.-N.O.S. The proposed change to the definition would umbrella all three diagnoses into one category: autism spectrum disorder. This would eliminate Asperger syndrome and P.D.D.-N.O.S. from the manual.

In order to be diagnosed with autism or a related disorder currently, patients have to exhibit 6 or more of 12 behaviors. Under the proposed revision, a patient would have to exhibit “three deficits in social interaction and communication and at least two repetitive behaviors — a much narrower menu,” according to the NYTimes.

Thousands of children and adults who are diagnosed with autism receive special assistance from the state. Some parents are worried that the updated definition, which is 90% complete according to Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions, will prevent their children from getting much-needed assistance.

Mary Meyer, of Ramsey, N.J., told the NYTimes that an Asperger syndrome diagnosis was essential in getting her daughter, 37,  access to services that have “helped tremendously.”

“I’m very concerned about the change in diagnosis because I wonder if my daughter would even qualify now,” she said. “She’s on disability, which is partly based on the Asperger’s, and I’m hoping to get her into supportive housing, which also depends on her diagnosis.”

To see the proposed new definition, click here (FYI: The zoom bar is on the top of the page)