If readers allow more on this subjects matter, I believe that we need to talk more about the DSM-V, and not only around the potential loss of adequate service that has been hypothesized and understandably feared (and which I emphasize is important to address).
In the science realm, essential for us to understand these disorders which so many years after identification remain so puzzling in its dramatic variations and causation, I call attention to two articles I just read and that clearly spell out the authors' opinions about the difficulties in differentiation of the subtypes Asperger's Syndrome and PDD-NOS, and would support the changes proposed by the upcoming 5th edition of the DSM.
Catherine Lord, one of the most respected professionals when we talk autism, having done extensive research from early on, and been involved in the development of important diagnostic instruments for autism, such as the gold standard Autism Diagnostic Observation Schedule (ADOS), in the chapter* Diagnostic Instruments in Autistic Spectrum Disorders, with her co-author, states:
"There is an urgent need for instruments to address diagnoses beyond autism, particularly ASDs, such as PDD-NOS and Asperger’s Dis- order. In part, the absence of replicable, reli- able, and valid instruments in this area is related to the absence of clear diagnostic crite- ria for these disorders (Sponheim, 1996; Szat- mari et al., 2002). A lack of empirical data affects the ability to discriminate these disor- ders both from autism and from disorders out- side the autism spectrum (e.g., severe attention deficit; severe communication impairment), which in turn affects the development and the operationalization of these criteria."
More recently, Thomas Frazier and colleagues described extensive statistical research testing the DSM-V criteria for Autism Spectrum Disorder, which will oficialize ASD s a diagnosis and eliminate Asperger's and PDD-NOS. They tested 14.744 registered IAN (Interactive Autism Network) siblings and recommended:
"Results supported the validity of proposed DSM-5 criteria for ASD as provided in Phase I Field Trials criteria. Increased specificity of DSM-5 relative to DSM-IV-TR may reduce false positive diagnoses, a particularly relevant consideration for low base rate clinical settings. Phase II testing of DSM-5 should consider a relaxed algorithm, without which as many as 12% of ASD-affected individuals, particularly females, will be missed. Relaxed DSM-5 criteria may improve identification of ASD, decreasing societal costs through appropriate early diagnosis and maximizing intervention resources."
* In Handbook of Autism and Pervasive Developmental Disorders, Volume 2, Assessment, Interventions, and Policy, 3rd Edition, edited by Fred R. Volkmar, Rhea Paul, Ami Klin, Donald J. Cohen (Wiley)
** Journal of the American Academy of Child & Adolescent Psychiatry (2012), 51, 1.
