Autism Spectrum Disorders (ASDs) will get new guidelines from 2013 as the American Psychiatric Association publishes the revised ‘Diagnostic and Statistical Manual for Mental Disorders’ or DSM-5.

According to a study by Yale Child Study Center, the proposed change in the definition for autism may affect the proportion of individuals who qualify for diagnosis of autism spectrum disorder.

“Given the potential implications of these findings for service eligibility, our findings offer important information for consideration by the task force in finalizing DSM-5 diagnostic criteria,” said Dr. Fred Volkmar, the director of Yale Child Study Center.

The study included 933 individuals who were evaluated for autism in the field trial for DSM-4. They found that a quarter of those who were diagnosed with classic autism and more than half of those with Asperger’s Syndrome would not meet the new criteria for autism.

According to the Centers for Disease Control and Prevention (CDC), ASDs are a group of developmental disabilities that can cause significant social, communication and behavioral challenges. People with ASDs handle information in their brain differently than other people.

ASDs are ‘spectrum disorders’. The intensity of the disability varies from person to person. In some cases the disability is so mild that it can go undetected for many years.

In the US, 1 in 88 children and 1 in every 54 boys are born with autism - CDC says.

Asperger’s syndrome is often considered as ‘mild’ form of autism. Under the proposed criteria, this syndrome will be merged under ASDs which will be rated as severe, moderate or mild.

Higher functioning individuals may be kept out of autism spectrum than people with intellectual disability, the study suggests.

“Use of such labels, particularly in the United States, can have important implications for service, Volkmar said.” Major changes in diagnosis also pose issues for comparing results across research.

The revised version of the manual is already being criticized by many experts.

In an open letter to DSM-5 experts say that DSM’s proposal to lower diagnostic threshold is “scientifically premature and holds numerous risks”. It is feared that bringing in more people in the realm of disorders would lead to “excessive medicalization and stigmatization of transitive, even normative distress.” Lowering the criteria, they suggest, “poses the epidemiological risk of triggering false-positive epidemics.”

Diagnostic and Statistical Manual for Mental Disorders is the standard classification of mental disorders used by mental health professionals in the US. It lists diagnostic criteria for every psychiatric disorder that is recognized by the US healthcare system. The manual is used by healthcare professionals, researchers, clinicians, nurses, counselors, social-workers. The manual is helpful in collecting and comparing statistics about psychiatric disorders. A proposed revision thus, would bring a lot of confusion among the people who work with people with psychiatric disorder.

The research is published in the April issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

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