DSM Reclassification of Autism Spectrum Disorder
docx
keyboard_arrow_up
School
Grand Canyon University *
*We aren’t endorsed by this school
Course
672
Subject
Arts Humanities
Date
Jan 9, 2024
Type
docx
Pages
7
Uploaded by AmbassadorBatMaster975
1
DSM Reclassification of Autism Spectrum Disorder Brian Fazio
College of Humanities and Social Science, Grand Canyon University
PCN 672 Developmental Disabilities
Dr. Mariama Sandifer
December 20, 2023
2
DSM Reclassification of Autism Spectrum Disorder Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects a significant number of individuals worldwide. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a crucial tool used by mental health professionals to diagnose and classify psychiatric disorders, including ASD. Over the years, the DSM has undergone revisions and updates to improve diagnostic accuracy and treatment approaches. This paper explores the reclassification of ASD in the latest edition of the DSM, known as DSM-5-TR, and its implications in home and school settings. The study examines the transition from the DSM-IV-
TR classifications of autism, Asperger's syndrome, Rhett's syndrome, and pervasive developmental disorder to the DSM-5-TR inclusive diagnosis of autism spectrum disorders. It emphasizes the advantages and drawbacks of these modifications in domestic and educational environments. The DSM-5-TR incorporates precise elucidations to certain diagnostic criteria that
have been sanctioned by the DSM Steering Committee and the APA Assembly and Board of Trustees (Association, 2022). General Changes from DSM-IV-TR to DSM-V-TR
Significant modifications have been made to the DSM-5, one of which is the amalgamation of many childhood diseases into a single-spectrum condition known as Autism Spectrum Disorder (ASD). According to Lobar (2016), the phrase "autism spectrum disorders" encompasses Asperger's disorder, Rhett's syndrome, autism, and PPD (persistent developmental diseases). A unified spectrum disorder facilitates the therapist's ability to recognize and address the patient's condition more effectively. The number of key symptom categories was reduced from three to two. The two types of symptoms include impaired social involvement and
3
communication and restricted repeated behavior and interactions. The severity ratings have been modified to consider potential therapy courses. The severity is denoted by levels of 1, 2, or 3 based on how much support the person needs. The age range has also been expanded to represent
better some symptoms that may manifest later in life, and flexibility has been introduced when symptoms manifest (Lobar, 2016). As with any progressive change, there are a host of potential benefits and consequences with the application of DSM-5-TR on individuals who have ASD. A potential benefit that may positively impact individuals struggling includes an improvement in diagnostic specificity making criteria more specific. This will allow treatment to focus more on an individual’s symptoms. On the flip side, the new classification and diagnostic criteria for ASD
may make diagnosis potentially more restrictive. This raises concerns about the potential loss of treatment or services for children. If a child loses service, it is essential to investigate all available options and keep abreast of any changes as updates to DSM happen regularly. A study reviewed by Volkmar, Fred R., and Reichow, Brian (2013) Gibbs and colleagues compared DSM-IV-TR and DSM-5 diagnoses in a sample of 132 children [26]. Of the 111 who had received a diagnosis of autism or related
PDD in DSM-IV-TR, 26 did not meet the criteria in DSM-5; most of those excluded from ASD in DSM-5 would have received a diagnosis of PDD-NOS in DSM-IV-TR. (p. 5)
Disenfranchisement of people with Asperger Syndrome is one issue with the new methods that are being proposed (Baron-Cohen, 2009). Self-advocates and families frequently regard Asperger Syndrome as a less stigmatizing term that better describes milder forms of Autism Spectrum Disorder than autism. Although PDD-NOS is likewise widely seen as less stigmatizing, its use causes so much uncertainty that its advocates are few. More crucially, given
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
4
that people with Asperger Syndrome and PDD-NOS are not eligible for autistic services or benefits in some jurisdictions, the actual data do not support the creation of distinct categories for
these conditions. The overarching objective of the new criteria is to improve fairness in terms of treatments covered by third-party payers among the current subcategories. However, in 2013, the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) merged all four types into one, resulting in a single condition with different levels of symptom and severity. In the DSM-5, Asperger's disorder, formerly regarded as the least severe form of autism, was eliminated. This decision was based on the understanding that the symptoms of Asperger's disorder fall along a single spectrum, ranging from moderate to severe deficits in social communication and limiting repetitive behaviors/interests. The purpose of this modification was to enhance the accuracy and precision of the criteria used to diagnose Autism Spectrum Disorder (ASD) and to identify more precise areas for therapy that address the particular deficits observed (Germain et al., 2015).
A widespread developmental condition has identical symptoms to Asperger syndrome but
is characterized by a higher degree of severity. Rhett's syndrome is an uncommon inherited neurological illness characterized by a profound disability that impacts several facets of life, such
as speech, mobility, feeding, and respiration. The main objective of the DSM-5-TR is to thoroughly revise the explanatory language accompanying each DSM diagnosis, drawing on literature reviews conducted in the last decade.
Lastly, within DSM IV, individuals must struggle with and meet at least 6 of 16 specific criteria in order to be labeled with any form of autistic disorder. However, DSM 5 requires an individual to meet 6 out of 7 to be diagnosed with ASD (Hasbrouck et al., 2015). This change makes it more difficult for individuals to receive the services needed to succeed. Autism spectrum disorders are characterized by deficiencies in social communication and interaction,
5
along with the manifestation of restricted and repetitive behaviors, interests, and activities (Association, 2022).
DSM-5-TR changes in the Home and School Setting
The DSM-5-TR changes in home and school settings have both advantages and consequences. The new criteria improve diagnosis accuracy, increasing access to services and support for patients with autism spectrum disorder. However, these criteria have become more restrictive, potentially affecting eligibility for specific services and support. Within domestic environments, established patterns, resistance to alterations, and heightened sensitivity to stimuli might impede the process of consuming food, obtaining sufficient rest, maintaining regular self-
care, and achieving scholastic success. Children diagnosed with ASD also have challenges in the areas of planning, organizing, and adapting to change, which may have a detrimental effect on their overall well-being. Everyday care tasks like getting a haircut or taking care of your teeth might become difficult for the child at home due to insistence on routines, reluctance to change, and sensory sensitivity. Parents may need to adapt as best they can if they get reduced help for their child. In school settings, the more specific criteria may lead to underdiagnoses of children who may benefit from accommodation. An official diagnosis is needed for 504 and IEP plans, special education aides, and other school services. This could result in teachers and school counselors supporting students without a diagnosis, potentially affecting their educational outlook and self-
esteem. Additionally, not receiving school-based services can harm their ability to interact with peers and increase their susceptibility to bullying and manipulation. With the changes in DSM-5-
TR from the previous version, it is more important than ever that parents and teachers be observant and document any issues. Having the whole picture with improved documentation can
6
help a child who previously was disqualified for services now qualify. Applied or Positive Behavior has positively impacted a child’s behavior. Collecting data is one of the critical features
of that program. Working with your child’s school district can allow for a platform where gaps or changes can be voiced compared to a parent trying the same alone. Conclusion
The Diagnostic and Statistical Manual (DSM), a crucial tool for diagnosing psychiatric disorders in the US, has been updated since 1952. It offers a concrete evaluation of issues, aids clinicians in setting treatment objectives, and measures intervention effectiveness. However, potential risks include oversimplification and misdiagnoses. Parents will also need to understand that it can take a while to accurately find the correct diagnoses due to overlapping symptoms and
the complexity of the disorders. Over time, children may outgrow, and diagnoses may change, leading to confusion, which is why keeping and rescheduling missed appointments is essential.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
7
References
Association, A. P. (2022). Diagnostic and statistical manual of mental disorders, text revision dsm-5-tr
(5th ed.). Amer Psychiatric Pub Inc.
Baron-Cohen, S. (2009). Does autism need a cure? The Lancet
, 373
(9675), 1595–1596. https://doi.org/10.1016/s0140-6736(09)60891-6
Germain, B., Eppinger, M. A., Mostofsky, S. H., DiCicco-Bloom, E., & Maria, B. L. (2015). Recent advances in understanding and managing autism spectrum disorders. Journal of Child Neurology
, 30
(14), 1887–1920. https://doi.org/10.1177/0883073815601499
Hasbrouck, S., Phillips, K., & Downer, J. (2015). How changes in the dsm-5 will likely affect professionals working with youth with mood disorders and/or substance abuse. Beyond Behavior
, 24
(2), 14–19. Retrieved December 16, 2023, from https://doi.org/10.1177/107429561502400203
Lobar, S. L. (2016). Dsm-v changes for autism spectrum disorder (asd): Implications for diagnosis, management, and care coordination for children with asds. Journal of Pediatric Health Care
, 30
(4), 359–365. Retrieved December 16, 2023, from https://doi.org/10.1016/j.pedhc.2015.09.005
Volkmar, F. R., & Reichow, B. (2013). Autism in dsm-5: Progress and challenges. Molecular Autism
, 4
(1), 13. https://doi.org/10.1186/2040-2392-4-13