Over the past two decades, an increase in access to large and diverse samples has given researchers the ability to determine that, in many cases, ASD symptoms are best represented in a two-domain model of social-communication deficits and restricted and repetitive interests/behaviors (RRB), rather than by the DSM-IV triad of symptoms that models communication deficits separate from social impairments. Less publicized were the content changes and the new symptom structure in DSM-5. The change in DSM-5 that received the most media attention is the removal of the DSM-IV clinical subtypes. found that over 90% of children with DSM-IV-defined PDDs were identified by DSM-5 criteria, and the specificity using the new diagnostic criteria was substantially improved compared with the DSM-IV criteria. Consequently, the fifth edition of the DSM (DSM-5) replaces the multi-categorical system with a single diagnostic dimension: ASD.Īlthough concerns have been raised about the validity and diagnostic sensitivity of the proposed DSM-5 criteria, a number of studies have emerged in support of the conceptual validity of the new criteria. A number of studies have reported limited reliability in how DSM-IV subtypes are assigned, with similar core symptom presentations across the categorical diagnoses and poor predictive ability of later outcome based on these subtypes. The Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV) used a multi-categorical system of diagnosing pervasive developmental disorders (PDDs), which included autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified, childhood disintegrative disorder, and Rett’s disorder, that created challenges to this effort. This effort has been largely unsuccessful because distinct, empirically defined subgroups have yet to be reliably identified. Over the past several decades, researchers have attempted to categorize the heterogeneity in autism spectrum disorders (ASDs).
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