Nine Questions

For Teachers, Professionals and "experienced" parents, this article discusses leading Autism experts discussing problems with existing descriptions of Autism and how to diagnose/describe Autism better!

At a Autism Conference (February 3-5, 2008), leading Autism experts asked...

nine questions:
* what are the core symptom domains in autism?
* how are fixated interests and stereotypes related to each other, to autism, and to obsessions and compulsions?
* how does the presentation of autism change across the lifespan?
* how does developmental regression (and Childhood Disintegrative Disorder) fit into autism spectrum?
* Asperger’s Disorder, is it Autism?
* Is Autism a Life-Long Diagnosis?
* how does comorbidity affects symptoms of Autism?
* what role should neurobiology play in the DSM-V diagnostic criteria for autism?
* International, Cultural, and Gender considerations in the diagnosis of Autistic Spectrum Disorders.

After 3 days discussion ........ recommendations and further research regarding changes to DSM-V and ICD-11 diagnostic tools were made.

Group 1 made following suggestions:

- Reexamine the diagnostic criteria for ASD's:
- examine age of onset for Childhood Disintegrative Disorder
- examine age of onset for Autistic Disorder;
- describe better how to apply criteria for ASD to different ages.
- revise criteria for imaginative play (too restrictive re. ages).
- revise criteria for peer relationships (too broad).
- revise communication criteria (delays vs absence of speech).

and recommended following be considered in DSM-V (2012):

- explore the possibility of taking IQ into account (above/below IQ 50)
- clarify role/importance of historical symptoms vs current symptoms.
- currently, PDD-NOS is a “wastebasket” diagnostic category - refine.
- refine diagnosis relating to particular subgroups for example.
- add need for impairment (which also would need to be described);
- adding broader autism category, quality/personality/behavioural features.

Group 2 made following suggestions:

- continue to include aspects of triad of impariments (triad not essential)
- keep requirment for early onset (before 3years).
- keep the behavioral symtoms perspective.

and recommended following be considered in DSM-V (2012):
- Remove Retts from ASD
- Remove CDD (clarify age of onset for ASD for CDD as special case).
- "regression" needs better explanations.
- developmental level must be considered when making diagnosis.
- diagnostic criteria should explain better diagnosis
- (infants/kids/adults).
- Remove Aspergers Disorder (from this section).
- Remove term "PDD" .. should be simply "ASD".
- consider adding cognitive style as an autism symptom;
- rename PDD-NOS to ASD-NOS or ASDNOS.
- separate symptom assessment from disability (to be determined);
- for symtom improvements, clarify "partial” vs “full remission”
- Do not exclude ADHD from ASD (allow dual-diagnosis).

Group 3 made following recommendations:

- delete Asperger’s disorder;
- delete CDD; and
- create an ASD with two types
- Type 1 for typical Autism.
- Type 2 for atypical Autism (AS, PDNOS, etc).

and recommended following be considered in DSM-V (2012):
- If OCD occurs with ASD, is it part of ASD or separate/dual diagnosis.
- Do not exclude ADHD (and ASD) diagnosis.
- Better criteria for ASD across the life-span (infant,kid, adults).
- Define regression better.
- Discuss if ASD can "remit".. what this might look like.

Read the full article here

http://www.psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/...