The International Meeting for Autism Research (IMFAR) was held this month in Toronto. This meeting attracts nearly 2,000 participants and presents research from basic science to potential new treatments. Since few of us have the opportunity to attend these innovative sessions, I thought that I would try to review some of the presentations that may be of interest to all of us.
One of the sessions provided an update on the DSM V. Dr. Sue Swedo, chairman of the committee responsible for recommending changes to the DSM criteria, emphasized that the committee had no intention of reducing the number of people diagnosed on the autism spectrum. Dr. Swedo stated that the new criteria is intended to capture all individuals on the spectrum. The three categories of symptoms were reduced to two, and all the sub types will be collapsed under one category – spectrum disorders.
The reason for this change was that even expert clinicians cannot reliably distinguish among the different sub types when they make their diagnoses. The new element of DSM V is the “specifiers,” which will be part of the diagnostic evaluation. For example, it will be specified whether the child has an intellectual disability or a language delay. Also noted will be the pattern of onset, any genetic causes and any accompanying medical conditions.
As a result of the publicity from the April New York Times article, which stated that a large percentage of persons with Aspergers/high functioning autism would be excluded, over 6,000 comments about the new criteria were posted. These comments, with approximately half supporting the changes and half not supporting the changes, have led to a refinement in the language of the criteria. According to Dr. Swedo, the committee did not in any way wish to exclude individuals from the services that they need.
Autism Speaks will be funding a prospective study investigating whether, with the two new sets of criteria, more or fewer individuals are diagnosed with ASD. The discussion continues.
Just a reminder: If you would like to comment on the proposed changes, the final open comment period ends on June 15. Comments can be made online at the American Psychiatric Association website.