The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?
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The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20–47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When applying a mild level of impairment (cutoff: 1 SD below the mean on the VABS), 88 % of the cases fulfilled the impairment criterion. Sixty-nine percent fulfilled the impairment criterion at a moderate level (1.5 SDs) and 33 % at a severe level (2 SDs). Findings indicate that a strict application of the new DSM-5 impairment criterion might compromise early diagnosis of ASD.
KeywordsClassification Psychiatry Assessment Adaptive functioning Neurodevelopmental disorders
We sincerely thank Per-Olof Björck, head of the southeastern part of the Division of Child and Adolescent Psychiatry in Stockholm, for facilitating the realization of this study. Sven Bölte was supported by the Swedish Research Council. This study was supported by the Swedish Research Council in partnership with FAS, FORMAS and VINNOVA (cross-disciplinary research program concerning children’s and youth’s mental health), Riksbankens Jubileumsfond and Jerringfonden.
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