Study: Prior research has exaggerated impact of new autism criteria

Largest study to date finds that just 10% of children would be excluded

A study released on Tuesday found that the proposed changes to the autism diagnosis will not reduce the proportion of children with the diagnosis as much as previous research has suggested.

The study—published online in The American Journal of Psychiatry—is the largest study to date to examine the potential impact of the proposed autism changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which is scheduled to take effect in May 2013.

Under the current DSM, more than one million people have a diagnosis for autism, Asperger syndrome, or "pervasive developmental disorder, not otherwise specified" (PDD-NOS). An expert panel convened by the American Psychiatric Association is proposing a new definition of autism for the DSM-V that would consolidate autism, Asperger syndrome, and PDD-NOS diagnoses into "autism spectrum disorder" and narrow diagnosis criteria.

To assess the impact of the diagnosis change, researchers analyzed case files of 4,453 children with autism diagnoses under the current criteria and determined whether the children would qualify under the proposed definition. (Catherine Lord, director of the Center for Autism and the Developing Brain and the senior researcher on the study, serves on the expert panel that proposed the criteria.)

The study found that only 9% of the children with autism diagnoses under the DSM-IV would be excluded under the proposed DSM-V. Moreover, the study found that many of those children would be included with further consideration from their physicians.

The study findings contradict earlier research suggesting that the new criteria could exclude many children from autism diagnoses. For example, Yale University researchers earlier this year reported that 25% of children diagnosed with autism in 1993 would no longer fit the criteria. Moreover, they found that about 75% of Asperger's patients and 85% of PDD-NOS patients would be excluded under the criteria (Carey, New York Times, 10/2; Preidt, HealthDay, 10/2).


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