Diagnosis of Asperger Syndrome - Proposed Changes To DSM-5

Proposed Changes To DSM-5

One of the proposed changes to DSM-5 is to do away with Asperger syndrome as a separate diagnosis and fold it under autism spectrum disorders, with severity measures within the broader diagnosis.

In the proposed revision, individuals must meet the criteria in sections A, B, C and D to receive a diagnosis of Autism Spectrum Disorder .

A. Deficits in social communication and interaction not caused by general developmental delays. Must have all 3 areas of symptoms present.

1) Deficits in social-emotional reciprocity; failure to have a back and forth conversation.

2) Deficits in nonverbal communication such as abnormal eye contact and body language or difficulty using and understanding nonverbal communication, and lack of facial expressions or gestures.

3) Deficits in creating and maintaining relationships appropriate to developmental level (apart from relationships with caregivers). This may include trouble adjusting behavior to suit different social contexts, difficulties with imaginative play and making friends, and a lack of interest in other people.

B. Demonstration of restricted and repetitive patterns of behavior, interest or activities. Must present two of the following.

1) Repetitive speech, repetitive motor movements or repetitive use of objects (echolalia, idiosyncratic phrases).

2) Adherence to routines, ritualized patterns of verbal or nonverbal behavior, or strong resistance to change (insists on eating the same food, repetitive questioning, or great distress at small changes).

3) Fixated interests that are abnormally intense or focus (strong attachment to unusual objects, restricted interests).

4) Over or under reactivity to sensory input or abnormal interest in sensory aspects of environment (such as indifference to pain, heat or cold, negative response to certain sounds or textures, extreme smelling or touching or objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (May not become apparent until social demand exceeds limited capacity).

D. Symptoms collectively limit and hinder everyday functioning.

The proposed removal of Asperger’s Syndrome from the DSM has been controversial as it is commonly used by health insurers, researchers, state agencies, schools, and individuals with the disorder. Experts are concerned that eliminating the Asperger’s label will prevent mildly affected people from being evaluated for Autism.