How our understanding of the behavioral characteristics of autism has evolved

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Hans Asperger. Image credit: Tismoo Biotecnologia

You can draw a straight line from the initial descriptions of many conditions – claustrophobia, for example, or vertigo – to their diagnostic criteria. Not so with autism. Its history has taken a less direct path with several detours, according to Jeffrey Baker, professor of pediatrics.

Here is how the “Diagnostic and Statistical Manual of Mental Disorders” (DSM), the diagnostic manual used in the United States, has reflected our evolving understanding of autism.

[T]he DSM-5 introduced the term ‘autism spectrum disorder.’ This diagnosis is characterized by two groups of features: “persistent impairment in reciprocal social communication and social interaction” and “restricted, repetitive patterns of behavior,” both present in early childhood. Each group includes specific behaviors, a certain number of which clinicians have to identify. The manual eliminated Asperger syndrome, PDD-NOS and classic autism.

Many were concerned that after their diagnosis disappeared from the book, they would lose services or insurance coverage. Those who identified themselves as having Asperger syndrome said the diagnosis gave them a sense of belonging and an explanation for their challenges; they feared that removing the diagnosis was synonymous to losing their identity.

Experts continue to view autism as a continuous spectrum of conditions. There are no planned revisions to the DSM for now, but the language in a draft of the ICD-11 — which is expected to debut in May 2018 — mirrors the DSM-5’s criteria.

Read full, original post: The evolution of ‘autism’ as a diagnosis, explained

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