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A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

Journal of Autism and Developmental Disorders volume 47, pages 2783–2794 (2017)Cite this article

Abstract

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger’s disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

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Acknowledgments

The authors are extremely grateful to all the families and clinicians who participated in this study. This Network activity was supported by Autism Speaks and cooperative agreement UA3 MC11054 through the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program to the Massachusetts General Hospital. This work was conducted through the Autism Speaks Autism Treatment Network.

Funding

This project was supported by Autism Speaks and cooperative agreement UA3 MC11054 through the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program to the Massachusetts General Hospital. This work was conducted through the Autism Speaks Autism Treatment Network.

Author Contributions

MOM and BLH conceptualized and designed the study and drafted the initial manuscript. FL performed the statistical analyses and helped to draft the manuscript. EAM participated in the design of the study and guided statistical analyses. HS helped coordinate multi-site research processes and protocol development. EB, NMB, RJH, MP, and SMK collaborated in project development and data collection, and critically reviewed and revised the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Health Psychology, Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, 205 Portland Street, Columbia, MO, 65211, USA

    Micah O. Mazurek & Stephen M. Kanne

  2. Curry School of Education, University of Virginia, Charlottesville, VA, USA

    Micah O. Mazurek

  3. Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA

    Frances Lu, Heather Symecko & Eric A. Macklin

  4. Besser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, USA

    Heather Symecko

  5. Department of Pediatrics and Psychology, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA

    Eric Butter

  6. Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Nicole M. Bing

  7. Division of Developmental Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA

    Rachel J. Hundley

  8. Department of Pediatrics, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Marie Poulsen

  9. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Eric A. Macklin

  10. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Benjamin L. Handen

Authors
  1. Micah O. Mazurek
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  2. Frances Lu
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  3. Heather Symecko
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  4. Eric Butter
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  5. Nicole M. Bing
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  6. Rachel J. Hundley
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  7. Marie Poulsen
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  8. Stephen M. Kanne
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  9. Eric A. Macklin
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  10. Benjamin L. Handen
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Corresponding author

Correspondence to Micah O. Mazurek.

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Conflict of interest

Dr. Mazurek has received research support from National Institute of Mental Health (NIMH), Autism Speaks, and Health Resources and Services Administration (HRSA). Ms. Lu has received research support from Autism Speaks and HRSA. Dr. Butter has received research funding from NIMH, the Maternal and Child Health Bureau, Autism Speaks, the Simons Foundation for Autism Research, and the United State Department of Defense and has received fees as a training consultant from Roche Products, Ltd. Dr. Hundley has received speaker fees from Western Psychological Services. Dr. Macklin serves as a DSMB member for Acorda Therapeutics and Shire Human Genetic Therapies and receives research support from Adolph Coors Foundation, ALS Association, ALS Finding a Cure, Autism Speaks, Biotie Therapies, Michael J Fox Foundation, FDA, HRSA, NIH, and PCORI. Dr. Handen has received research support from Curemark, Neuropharm, Lilly, Forest, Bristol Myers Squibb, Roche, Pediamed, Pfizer and Autism Speaks.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Mazurek, M.O., Lu, F., Symecko, H. et al. A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder. J Autism Dev Disord 47, 2783–2794 (2017). https://doi.org/10.1007/s10803-017-3200-7

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