The term Autism has been used since the early 1900s to describe a pattern of symptoms and behaviors that can often include social interaction and communication deficits. In 1943, Dr. Leo Kanner, considered the father of child psychiatry, diagnosed the first cases of Early Infantile Autism. The American Psychiatric Association (APA) published the definition of autism in their DSM-III (Diagnostic and Statistical Manual of Mental Disorders) in 1980, which fueled the research surrounding this diagnosis and its treatment options.
Autism is among a class of a larger group of disorders labeled Pervasive Developmental Disorders (PDD). In 1987, the APA published an updated DSM-IIIR, where the term Infantile Autism became Autism Disorder and listed 16 criteria to foster specific and consistent diagnoses. In the DSM-IV (1994), the APA outlined the overarching group of Pervasive Developmental Disorders (PDD) into four different diagnoses: Autism Spectrum Disorder (ASD), Asperger’s Disorder (AD), Childhood Disintegrative Disorder (CDD), Pervasive Developmental Disorders-Not Otherwise Specified (PDD-NOS).
Autism Spectrum Disorder (ASD) and Asperger’s Disorder (AD)
In the APA DSM-IV’s 1994 definition, Autism Spectrum Disorder (ASD) was described as behavior that involved social interactions deficits, communication impairments, deficits in imaginative play skills, and/or rigid and repetitive patterns of behavior/activities. Their 1994 definition of Asperger’s Disorder (AD) focused on social interaction, impairment, and repetitive or rigid patterns of behavior with no marked communication or cognitive deficit.
Autism Spectrum Disorder (ASD) and Social (Pragmatic) Communication Disorder:
Published in 2013, the DSM-V changed the Autism Spectrum Diagnosis definition and criteria for diagnosis yet again. The previous DMS-IV’s pervasive developmental disorders (Autism Spectrum Disorder, Asperger’s Disorder, CDD, PDD-NOS) have been removed and an updated classification of Autism Spectrum Disorder (ASD) has been published in the fifth edition. ASD now includes only two main symptoms-deficits in social communication, interactions and restricted, repetitive patterns of behavior. The updated ASD definition includes 3 severity levels: 1-“requiring support”, 2- “requiring substantial support”, 3-“requiring very substantial support”.
A new diagnosis of Social (Pragmatic) Communication Disorder (SCD) was released with this most recent DSM-V and is “characterized by a persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability” (2013 American Psychiatric Association).
What does this mean for children with a current Asperger’s Disorder diagnosis?
According to the APA’s 2013 release, the updated definitions are meant to facilitate a more medically consistent and scientifically efficient way of diagnosing ASD. They claim that anyone who was diagnosed with Autism Spectrum Disorder or Asperger’s Disorder by the DSM-IV criteria should still meet the DSM-V’s criteria for ASD or another disorder listed in the fifth edition (such as possibly SCD).
What does this mean for children who display ‘Asperger’s like’ symptoms?
A visit to a doctor regarding health concerns is the crucial first step in gaining treatment and help for our loved ones. For children and families impacted by Autism Spectrum Disorder, a medical diagnosis by a doctor is necessary in order for medical insurance to cover any possible treatment options. According to a study by American Psychiatric Association (2013), 91% of children with the previous DSM-IV PDD diagnoses (ASD, Asperger’s, CDD, PDD-NOS) found a DSM-V diagnosis with the updated criteria.
Another study conducted in 2015 by Smith, Reichow, and Volkmar showed only 50-75% of individuals maintained diagnoses from the DSM-IV disorders. This indicates more research is needed as to how the latest DSM definitions have impacted individuals previously diagnosed and individuals without severe cognitive or communicative deficits.