Background: The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, provides criteria for identifying mental and behavioral syndromes. The current edition, DSM-IV, contains a three-domain model for diagnosing Autism Spectrum Disorder (ASD), based on criteria for social interaction, communication and behaviors. The newly proposed criteria for ASD, to be published in DSM-V, have two domains for diagnosis—social interaction and behavior, with communicative criteria now considered part of social interaction.

What’s New: Studies evaluating the new ASD criteria have been limited in discerning their sensitivity—how accurately they diagnose people with ASD—as well as their specificity—how well they distinguish between people with ASD and those with other disorders. In a report published in the American Journal of Psychiatry, researchers describe a new study of over 5,000 children evaluated by way of observations and interviews with their parents. The study reports that the DSM-V criteria for ASD were as sensitive and more specific than those in DSM-IV—resulting in correct diagnoses 91 percent of the time.

Why it’s important: Previous studies have suggested that the proposed criteria for ASD could exclude many people with Asperger syndrome or pervasive developmental disorder-not otherwise specified (PDD-NOS). Without diagnoses, people with ASD could lose access to care. However, the new guidelines catch most cases of both syndromes.

Diagnosis Overview

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