Monday, 16 July 2012


DSM-IV vs DSM-5
American Psychiatric Association
Proposed revision of Autistic Disorder Classification

The American Psychiatric Association (APA) is revising its diagnostic manual, known as Diagnostic and Statistical Manual (DSM). This is one of the two main international sets of diagnostic criteria for autism spectrum disorders, including Asperger syndrome.
The main set of criteria used in the UK is the World Health Organisation’s International Classification of Diseases (ICD).  This is the important bit – we use ICD-10 in the UK, which is not scheduled for review until 2015, and there are no plans to remove the classification of Asperger Syndrome from it.  In fact, the beta version of ICD-11 very clearly retains Asperger Syndrome.
The changes to the DSM include altering the way all conditions are classified, providing an indication of severity and reducing the number of 'not otherwise specified' diagnoses (such as 'Pervasive Developmental Disorder Not Otherwise Specified').
At present, the people involved feel that there is not enough research to show a definite distinction between Asperger syndrome and high-functioning autism spectrum disorder. So they feel it better to incorporate both of these terms into the overall category of autism spectrum disorder.  It does not mean that the terms will fall into misuse – in fact, I think it is more likely that the term Asperger Syndrome will be retained as a marker for where someone might be on the autism spectrum.  In other words – nothing will change, apart from instead of Asperger’s disorder being listed as a separate disorder, as in DSM-IV,  it will be subsumed into the overall category of autistic disorder, as in DSM-5.  This is stated in the APA’s rationale for changing the classification:
“New name for category, autism spectrum disorder, which includes autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified”
There is not felt to be any need to “airbrush” Asperger Syndrome out of existence, either by The National Autistic Society, or many of the more local representative organisations across the UK.  I think that Asperger Syndrome will continue to be used within common parlance, much as it has been since the early 1990’s, despite being listed in DSM-IV as “Asperger’s Disorder”.

David Moat Autism Treatment Consultant The Therapy Room Cambridge

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