The new autism diagnosis

Just as autism has begun to be better understood, the American Psychiatric Association has recently changed the diagnosis of autism, leaving many parents confused about how the new diagnosis works and how it will affect their family. Here are some of the main changes to the diagnosis of autism:

• There is now one single diagnosis called autism spectrum disorder (ASD). The previous diagnoses of autistic disorder, Asperger’s syndrome, pervasive development disorder not otherwise specified (PDD/NOS), and childhood disintegrative disorder no longer exist and have been merged into a single ASD diagnosis. Also, Rett Syndrome is no longer included in the ASD diagnosis.
• ASD is now described by three different levels, according to how severe the symptoms are. Specialists will look at the severity of a child’s symptoms in two specific areas: social communication/interaction and abnormal interests/behaviors.
• The total number of criteria have been reduced, but a child must demonstrate more symptoms than previously to meet criteria for ASD.

In conjunction with changing the definition of autism, the symptoms used to diagnose the condition have been changed, although not by much. Below are the symptoms used to diagnose autism.

Social communication and social interaction (now must have all 3): 

The total number of criteria have been reduced, but a child must demonstrate more symptoms than previously to meet criteria for ASD.

• Problems with back-and-forth social interactions (known as “social-emotional reciprocity”). This could range from difficulty engaging in typical conversations to a complete lack of social interaction.  This is a change from the previous criteria which specifically included a language delay.
• Problems with nonverbal communication, such as eye contact or facial expressions.
• Problems building relationships, such as understanding how to act in different social situations, engaging in pretend play with others, or no apparent interest in other people.

Behavior (must have at least 2): 

• Repetitive speech (called “echolalia”), movements, or use of objects.
• Excessive need to follow routines or rituals, or extreme resistance to change.
• Intense fixation on objects or interests.
• Sensory problems, such as abnormal reactions to sounds, textures, sights, or other sensory stimulation.  This is a new addition to the diagnostic criteria.

How will the new autism diagnosis impact the future of autism? Only time will tell.  Despite the changes, the importance of early identification and intervention remains the same.

Reviewed by Dr. Sara Connolly, February 2019