2012-04-10

The Opinions About the DSM-V Autism Spectrum Disorder Diagnosis - Still Controversial

We'll keep adding...


Autism Speaks:
"Autism Speaks is concerned that planned revisions of the definition of autism spectrum disorder (ASD) may restrict diagnoses in ways that may deny vital medical treatments and social services to some people on the autism spectrum. These revisions concern the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), scheduled for publication in spring 2013."
Dr. Allen Frances, Huff Post Nov-2012

The DSM-5 autism group has been blinded by an intellectual conflict of interest. Eager to introduce its concept of an autism spectrum, the group somehow lost sight of a crucial and obvious fact: Its proposed criteria set is written so exclusively that it must inevitably reduce the diagnosis of autism.I personally believe that autism is currently being overdiagnosed because it has been too closely coupled to school services. I am all for providing needed school services but am very much against flawed and sloppy psychiatric diagnosis. As a society, we should get kids the services they need without tagging many of them with an inaccurate diagnosis that can sometimes haunt their lives with a stigmatizing and damaging (mis)label.

Dr. Bill Ahearn:
“Better diagnosis will lead to better and more specific treatment.” 
Thomas Frazier and colleagues:
"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."
John Elder Robinson:
  • I have no doubt that process will be troublesome, costly, and time consuming but I doubt very much it will result in people who had a disability diagnosis coming out with nothing.
  • In my opinion, the biggest change in the new definition is the addition of a severity grade.
  • (...) I think people with autism are at risk to lose services (not because of the DSM changes) because ignorant, ethically challenged, or financially pressured bureaucrats will use the diagnostic evolution as justification for changes that may benefit some other group at our expense.
Dr. Brian H. King
I am certain that children will continue to challenge our diagnostic constructs with their complexity, and I know that we will want to resist chiseling DSM-5 criteria into stone. But I also believe that by refining the diagnostic criteria to reflect current science, we're that much closer to getting it right.