DSM V Autism Classification Changes
The DSM-5, the Diagnostic and Statistical manual of Mental Disorders was released May 2013. I see improvements and perhaps steps in the wrong direction. However, regardless of classification, the entire DSM manual used in psychiatry is a catalogue to symptoms, which are grouped into diagnosis, and from making those diagnosis, doctors can prescribe medications. What is sadly missing is any effort to classify disorders based on their cause. In the infectious disease world, you have strep, or TB, or HIV, etc. all based on the cause and thus treatment is generally targeting elimination of the cause of illness. What is desperately needed in the world of psychiatry and mental health (and indeed much of medicine that involves chronic disease) is an effort to identify and catalogue illness and disease by its etiology (cause).
In the new classification, children with a diagnosis of “autistic disorder”, “pervasive developmental disorder not otherwise specified (PDD-NOS)”, “Aspergers disorder”, and “childhood disintegrative disorder” will now be classified as ASD (Autism Spectrum Disorder). In the new DSM-V, instead of just the three areas of social, language, and repetitive movement impairments, there is now:
1. Deficits in social interaction and
2. Communication and
3. Repetitive and restrictive behaviors, interests, and activities (now includes unusual sensory behaviors like indifference to pain, excessive smelling of objects and visual perseverance of lights)
There are 3 levels of severity:
Level 1- Needs some support
Level 2- Substantial support
Level 3- Very substantial support scored for both communication and interaction/behavior activities.
DSM-V now allows for dual diagnosis to include ASD/ADHD.
There is a new condition called SCD (Social Communication Disorder) for children who do not have repetitive or restrictive behaviors and thus don’t qualify for ASD. This category will ultimately include many who in the past would have been diagnosed Aspergers or PDD-NOS.
For a condition that now affects 1 in every 50 children, I would be much more excited if we were classifying those with the symptoms listed above as ASD-Vitamin B-12 deficient, ASD-Heavy metal toxic, ASD-Chronic viral infection, ASD-Autoimmune triggered, ASD-Vaccine induced, ASD-MTHFR genotype, etc.
We have a long way to go before the numbers of affected children in this country can revert back to the 1 or 2 in 10,000 that it once was 60 years ago. With some simple steps (vaccinate carefully and selectively, proper diet from prenatal on, take key supplements from prenatal on including Vitamin D, B-12 and folate, probiotics) and avoiding aspartame, GMO, and pesticides, it is possible to get a lot closer to those preferred rates.