Journal of Autism and Developmental Disorders

, Volume 45, Issue 8, pp 2541–2552 | Cite as

The Effects of DSM-5 Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review

Original Paper

Abstract

A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and DSM-5 ASD criteria. Consistent with previous reviews, the majority of included studies indicated between 50 and 75 % of individuals will maintain diagnoses. We conducted visual analyses of subgroups using harvest plots and found the greatest decreases among high-functioning populations with IQs over 70 and/or previous diagnoses of PDD-NOS or Asperger’s disorder. We discuss the potential research and clinical implications of reduced numbers of individuals diagnosed with ASD.

Keywords

ASD Asperger’s Autism DSM-IV-TR DSM-5 Diagnosis 

Supplementary material

10803_2015_2423_MOESM1_ESM.pdf (138 kb)
Supplementary material 1 (PDF 137 kb)

References

  1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: APA Press.Google Scholar
  2. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., text rev.). Washington, DC: APA Press.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA Press.Google Scholar
  4. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: APA Press.Google Scholar
  5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA Press.Google Scholar
  6. Asperger, H. (1944). Die “autistichen Psychopathen” im Kindersalter. Archive fur psychiatrie und Nervenkrankheiten, 117, 76–136.CrossRefGoogle Scholar
  7. Barton, M. L., Robins, D. L., Jashar, D., Brennan, L., & Fein, D. (2013). Sensitivity and specificity of proposed DSM-5 criteria for autism spectrum disorder in toddlers. Journal of Autism and Developmental Disorders, 43(5), 1184–1195. doi:10.1007/s10803-013-1817-8.PubMedCentralPubMedCrossRefGoogle Scholar
  8. Beighley, J. S., & Matson, J. L. (2014). Comparing social skills in children diagnosed with autism spectrum disorder according to the DSM-IV-TR and the DSM-5. Journal of Developmental and Physical Disabilities, 26, 689–701. doi:10.1007/s10882-014-9382-4.CrossRefGoogle Scholar
  9. Beighley, J. S., Matson, J. L., Rieske, R. D., Cervantes, P. E., Goldin, R., & Jang, J. (2014). Differences in stereotypic behavior in adults diagnosed with autism spectrum disorders using the DSM-IV-TR and the DSM-5. Journal of Developmental and Physical Disabilities, 26(2), 193–202. doi:10.1007/s10882-013-9356-y.CrossRefGoogle Scholar
  10. Beighley, J. S., Matson, J. L., Rieske, R. D., Jang, J., Cervantes, P. E., & Goldin, R. L. (2013). Comparing challenging behavior in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Developmental Neurorehabilitation, 16(6), 375–381. doi:10.3109/17518423.2012.760119.PubMedCrossRefGoogle Scholar
  11. Factor, D. C., Freeman, N. L., & Kardash, A. (1989). Brief report: A comparison of DSM-III and DSM-III-R criteria for autism. Journal of Autism and Developmental Disorders, 19(4), 637–640.PubMedCrossRefGoogle Scholar
  12. Frazier, T. W., Youngstrom, E. A., Speer, L., Embacher, R., Law, P., Constantino, J., & Eng, C. (2012). Validation of proposed DSM-5 criteria for autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 51(1), 28.e23–40.e23. doi:10.1016/j.jaac.2011.09.021.CrossRefGoogle Scholar
  13. Gibbs, V., Aldridge, F., Chandler, F., Witzlsperger, E., & Smith, K. (2012). An exploratory study comparing diagnostic outcomes for autism spectrum disorders under DSM-IV-TR with the proposed DSM-5 revision. Journal of Autism and Developmental Disorders, 42(8), 1750–1756. doi:10.1007/s10803-012-1560-6.PubMedCrossRefGoogle Scholar
  14. Greenhaigh, T., & Peacock, R. (2005). Effectiveness and efficiency of search methods in systematic review of complex evidence: Audit of primary sources. British Medical Journal, 331, 1064–1065.CrossRefGoogle Scholar
  15. Grzadzinski, R., Huerta, M., & Lord, C. (2013). DSM-5 and autism spectrum disorders (ASDs): An opportunity for identifying ASD subtypes. Molecular Autism, 4(1), 12.PubMedCentralPubMedCrossRefGoogle Scholar
  16. Hertzig, M. E., Snow, M. E., New, E., & Shapiro, T. (1990). DSM-III and DSM-III-R diagnosis of autism and pervasive developmental disorder in nursery school children. Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 123–126.PubMedCrossRefGoogle Scholar
  17. Hiller, R. M., Young, R. L., & Weber, N. (2014). Sex differences in autism spectrum disorder based on dsm-5 criteria: Evidence from clinician and teacher reporting. Journal of Abnormal Child Psychology, 42, 1381–1393. doi:10.1007/s10802-014-9881-x.PubMedCrossRefGoogle Scholar
  18. Huerta, M., Bishop, S. L., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. American Journal of Psychiatry, 169(10), 1056–1064. doi:10.1176/appi.ajp.2012.12020276.PubMedCrossRefGoogle Scholar
  19. Ibanez, L. V., Stone, W. L., & Coonrod, E. E. (2014). Screening for autism in young children. In F. R. Volkmar, R. Paul, S. J. Rogers, & K. A. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders, Vol. 2 (4th ed., pp. 585–608). Hoboken: Wiley.Google Scholar
  20. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.Google Scholar
  21. Kim, Y. S., Fombonne, E., Koh, Y. J., Kim, S. J., Cheon, K. A., & Leventhal, B. L. (2014). A comparison of DSM-IV pervasive developmental disorder and DSM-5 autism spectrum disorder prevalence in an epidemiologic sample. Journal of the American Academy of Child and Adolescent Psychiatry, 53(5), 500–508. doi:10.1016/j.jaac.2013.12.021.PubMedCentralPubMedCrossRefGoogle Scholar
  22. Kulage, K. M., Smaldone, A. M., & Cohn, E. G. (2014). How will DSM-5 affect autism diagnosis? A systematic literature review and meta-analysis. Journal of Autism and Developmental Disorders, 44(8), 1918–1932. doi:10.1007/s10803-014-2065-2.PubMedCrossRefGoogle Scholar
  23. Lord, C., Corsello, C., & Grzadzinski, R. (2014). Diagnositc instruments in autistic spectrum disorders. In F. R. Volkmar, R. Paul, S. J. Rogers, & K. A. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders, Vol. 2 (4th ed., pp. 610–650). Hoboken: Wiley.Google Scholar
  24. Lord, C., Risi, S., Lambrecht, L., Cook, E. H, Jr, Leventhal, B. L., DiLavore, P. C., & Rutter, M. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.PubMedCrossRefGoogle Scholar
  25. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.PubMedCrossRefGoogle Scholar
  26. Maenner, M. J., Rice, C. E., Arneson, C. L., Cunniff, C., Schieve, L. A., Carpenter, L. A., & Durkin, M. S. (2014). Potential impact of DSM-5 criteria on autism spectrum disorder prevalence estimates. JAMA Psychiatry, 71(3), 292–300. doi:10.1001/jamapsychiatry.2013.3893.PubMedCentralPubMedCrossRefGoogle Scholar
  27. Mahjouri, S., & Lord, C. E. (2012). What the DSM-5 portends for research, diagnosis, and treatment of autism spectrum disorders. Current Psychiatry Reports, 14(6), 739–747. doi:10.1007/s11920-012-0327-2.PubMedCrossRefGoogle Scholar
  28. Matson, J. L., Belva, B. C., Horovitz, M., Kozlowski, A. M., & Bamburg, J. W. (2012a). Comparing symptoms of autism spectrum disorders in a developmentally disabled adult population using the current DSM-IV-TR diagnostic criteria and the proposed DSM-5 diagnostic criteria. Journal of Developmental and Physical Disabilities, 24(4), 403–414. doi:10.1007/s10882-012-9278-0.CrossRefGoogle Scholar
  29. Matson, J. L., Kozlowski, A. M., Hattier, M. A., Horovitz, M., & Sipes, M. (2012b). DSM-IV vs DSM-5 diagnostic criteria for toddlers with autism. Developmental Neurorehabilitation, 15(3), 185–190. doi:10.3109/17518423.2012.672341.PubMedCrossRefGoogle Scholar
  30. Mattila, M. L., Kielinen, M., Linna, S. L., Jussila, K., Ebeling, H., Bloigu, R., & Moilanen, I. (2011). Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: an epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry, 50(6), 583.e511–592.e511. doi:10.1016/j.jaac.2011.04.001.CrossRefGoogle Scholar
  31. Mayes, S. D. (2012). Checklist for autism spectrum disorder. Wood Dale, IL: Stoelting.CrossRefGoogle Scholar
  32. Mayes, S. D., Black, A., & Tierney, C. D. (2013). DSM-5 under-identifies PDDNOS: Diagnostic agreement between the DSM-5, DSM-IV, and checklist for autism spectrum disorder. Research in Autism Spectrum Disorders, 7(2), 298–306. doi:10.1016/j.rasd.2012.08.011.CrossRefGoogle Scholar
  33. Mayes, S. D., Calhoun, S. L., Murray, M. J., Pearl, A., Black, A., & Tierney, C. D. (2014). Final DSM-5 under-identifies mild autism spectrum disorder: Agreement between the DSM-5, CARS, CASD, and clinical diagnoses. Research in Autism Spectrum Disorders, 8(2), 68–73. doi:10.1016/j.rasd.2013.11.002.CrossRefGoogle Scholar
  34. Mazefsky, C., McPartland, J., Gastgeb, H., & Minshew, N. (2013). Brief report: Comparability of DSM-IV and DSM-5 ASD research samples. Journal of Autism and Developmental Disorders, 43(5), 1236–1242. doi:10.1007/s10803-012-1665-y.PubMedCentralPubMedCrossRefGoogle Scholar
  35. McPartland, J. C., Reichow, B., & Volkmar, F. R. (2012). Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 368–383. doi:10.1016/j.jaac.2012.01.007.PubMedCentralPubMedCrossRefGoogle Scholar
  36. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. doi:10.1371/journal.pmed.1000097.PubMedCentralPubMedCrossRefGoogle Scholar
  37. Neal, D., Matson, J. L., & Hattier, M. A. (2012). A comparison of diagnostic criteria on the autism spectrum disorder observation for children (ASD-OC). Developmental Neurorehabilitation, 15(5), 329–335. doi:10.3109/17518423.2012.697492.PubMedCrossRefGoogle Scholar
  38. Newborg, J. (2005). Battelle Developmental Inventory, Vol. q (2nd ed.). Itasca, IL: Riverside.Google Scholar
  39. Orinstein, A. J., Helt, M., Troyb, E., Tyson, K. E., Barton, M. L., Eigsti, I. M., et al. (2014). Intervention for optimal outcome in children and adolescents with a history of autism. Journal of Developmental and Behavioral Pediatrics, 35(4), 247–256.PubMedCentralPubMedCrossRefGoogle Scholar
  40. Pelphrey, K. A., & McPartland, J. C. (2012). Brain development: neural signature predicts autism’s emergence. Current Biology, 22(4), R127–R128. doi:10.1016/j.cub.2012.01.025.PubMedCrossRefGoogle Scholar
  41. Rieske, R. D., Matson, J. L., Beighley, J. S., Cervantes, P. E., Goldin, R. L., & Jang, J. (2013). Comorbid psychopathology rates in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Developmental Neurorehabilitation,. doi:10.3109/17518423.2013.790519.Google Scholar
  42. Ritvo, E. R., & Freeman, B. J. (1977). National Society for Autistic Children definition of the syndrome of autism. Journal of Pediatric Psychology, 2(4), 142–145.CrossRefGoogle Scholar
  43. Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144. doi:10.1023/A:1010738829569.PubMedCrossRefGoogle Scholar
  44. Rutter, M. (1978). Diagnosis and definitions of childhood autism. Journal of Autism and Developmental Disorders, 8(2), 139–161.CrossRefGoogle Scholar
  45. Rutter, M., & Thupar, A. (2014). Genetics of autism spectrum disorder. In F. R. Volkmar, R. Paul, K. Pelphrey, & S. Roger (Eds.), Handbook of autism (4th ed.). Hoboken, NJ: John Wiley.Google Scholar
  46. Schopler, E., Reichler, R. J., DeVellis, R., & Daly, K. (1980). Towards objective classificaiton of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders, 10(1), 91–103.PubMedCrossRefGoogle Scholar
  47. Schopler, E., Reichler, R., & Renner, B. (1986). The Childhood Autism Rating Scale. Los Angeles: Western Psychological Services.Google Scholar
  48. Siegel, B., Anders, T. F., Ciaranello, R. D., Bienenstock, B., & Kraemer, H. C. (1986). Empirically derived subclassification of the autistic syndrome. Journal of Autism and Developmental Disorders, 16(3), 275–293.PubMedCrossRefGoogle Scholar
  49. Sturmey, P., & Dalfern, S. (2014). The effects of DSM5 autism diagnostic criteria on number of individuals diagnosed with autism spectrum disorders: A systematic review. Review Journal of Autism and Developmental Disorders, 1, 249–252. doi:10.1007/s40489-014-0016-7.CrossRefGoogle Scholar
  50. Szatmari, P. (1992). The validity of autistic spectrum disorders: A literature review. Journal of Autism and Developmental Disorders, 22(4), 583–600.PubMedCrossRefGoogle Scholar
  51. Taheri, A., & Perry, A. (2012). Exploring the proposed DSM-5 criteria in a clinical sample. Journal of Autism and Developmental Disorders, 42(9), 1810–1817. doi:10.1007/s10803-012-1599-4.PubMedCrossRefGoogle Scholar
  52. Taheri, A., Perry, A., & Factor, D. C. (2014). Brief report: A further examination of the DSM-5 autism spectrum disorder criteria in practice. Journal on Developmental Disabilities, 21(1), 116–121.Google Scholar
  53. Turygin, N. C., Matson, J. L., Adams, H., & Belva, B. (2013a). The effect of DSM-5 criteria on externalizing, internalizing, behavioral and adaptive symptoms in children diagnosed with autism. Developmental Neurorehabilitation, 16(4), 277–282. doi:10.3109/17518423.2013.769281.PubMedCrossRefGoogle Scholar
  54. Turygin, N., Matson, J. L., Beighley, J., & Adams, H. (2013b). The effect of DSM-5 criteria on the developmental quotient in toddlers diagnosed with autism spectrum disorder. Developmental Neurorehabilitation, 16(1), 38–43. doi:10.3109/17518423.2012.712065.PubMedCrossRefGoogle Scholar
  55. Volkmar, F. R., & Klin, A. (2005). Issues in the classification of autism and related conditions. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (3rd ed., pp. 5–41). Hoboken, NJ: Wiley.Google Scholar
  56. Volkmar, F. R., Klin, A., Siegel, B., Szatmari, P., Lord, C., Campbell, M., et al. (1994). Field trial for autistic disorder in DSM-IV. American Journal of Psychiatry, 151(9), 1361–1367.PubMedCrossRefGoogle Scholar
  57. Volkmar, F. R., & Reichow, B. (2013). Autism in DSM-5: Progress and challenges. Molecular Autism, 4(13), 1–6.Google Scholar
  58. Volkmar, F. R., Reichow, B., & McPartland, J. (2012). Classification of autism and related conditions: Progress, challenges, and opportunities. Dialogues in Clinical Neuroscience, 14(3), 229–237.PubMedCentralPubMedGoogle Scholar
  59. Volkmar, F. R., Reichow, B., Westphal, A., & Mandell, D. S. (2014a). Autism and the autism spectrum: Diagnostic concepts. In F. R. Volkmar, R. Paul, S. J. Rogers, & K. A. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders, Vol. 1 (4th ed., pp. 5–41). Hoboken, NJ: Wiley.CrossRefGoogle Scholar
  60. Volkmar, F. R., Reichow, B., Westphal, A., & Mandell, D. S. (2014b). Autism and the autism spectrum: Diagnostic concepts. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders, Vol. 1 (4th ed., pp. 3–23). Hoboken, NJ: Wiley.CrossRefGoogle Scholar
  61. Waterhouse, L., Wing, L., Spitzer, R. L., & Siegel, B. (1993). Diagnosis by DSM-III-R versus ICD-10 criteria. Journal of Autism and Developmental Disorders, 23(3), 572–573.PubMedGoogle Scholar
  62. World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.Google Scholar
  63. Worley, J. A., & Matson, J. L. (2012). Comparing symptoms of autism spectrum disorders using the current DSM-IV-TR diagnostic criteria and the proposed DSM-V diagnostic criteria. Research in Autism Spectrum Disorders, 6(2), 965–970. doi:10.1016/j.rasd.2011.12.012.CrossRefGoogle Scholar
  64. Young, R. L. (2007). Autism Detection in Early Childhood (ADEC) manual. Camberwell: ACER Press.Google Scholar
  65. Young, R. L., & Rodi, M. L. (2014). Redefining autism spectrum disorder using DSM-5: The implications of the proposed DSM-5 criteria for autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(4), 758–765. doi:10.1007/s10803-013-1927-3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Isaac C. Smith
    • 1
  • Brian Reichow
    • 2
  • Fred R. Volkmar
    • 1
  1. 1.Yale Child Study CenterNew HavenUSA
  2. 2.University of Florida College of EducationUniversity of FloridaGainesvilleUSA

Personalised recommendations