How has DSM-5 Affected Autism Diagnosis? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis

Abstract

We conducted a 5-year follow-up systematic review and meta-analysis to determine change in frequency of autism spectrum disorder (ASD) diagnosis since diagnostic and statistical manual 5 (DSM-5) publication and explore the impact of Social Communication Disorder (SCD). For 33 included studies, use of DSM-5 criteria suggests decreases in diagnosis for ASD [20.8% (16.0–26.7), p < 0.001], DSM-IV-TR Autistic Disorder [10.1% (6.2–16.0), p < 0.001], and Asperger’s [23.3% (12.9–38.5), p = 0.001]; pervasive developmental disorder-not otherwise specified decrease was not significant [46.1% (34.6–58.0), p = 0.52]. Less than one-third [28.8% (13.9–50.5), p = 0.06] of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for SCD. Findings suggest smaller decreases in ASD diagnoses compared to earlier reviews. Future research is needed as concerns remain for impaired individuals without a diagnosis.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. Adak, B., & Halder, S. (2017). Systematic review on prevalence for autism spectrum disorder with respect to gender and socio-economic status. Journal of Mental Disorders and Treatment, 3(1), 133.

    Article  Google Scholar 

  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disordersfourth edition, text revison (DSM-IV-TR). Washington, DC: American Psychiatric Association.

    Google Scholar 

  3. American Psychiatric Association. (2013a). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Washington, DC: American Psychiatric Association.

    Google Scholar 

  4. American Psychiatric Association. (2013b). Social (pragmatic) communication disorder. Retrieved from https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Social-Communication-Disorder.pdf.

  5. Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., … Dowling, N. F. (2018). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 Sites, United States, 2014. MMWR Surveillance Summary, 67(6), 1–23. https://doi.org/10.15585/mmwr.ss6706a1.

    Article  Google Scholar 

  6. Baird, G., & Norbury, C. F. (2016). Social (pragmatic) communication disorders and autism spectrum disorder. Archives of Disease in Childhood, 101(8), 745–751. https://doi.org/10.1136/archdischild-2014-306944.

    Article  PubMed  Google 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. The Journal of Autism and Developmental Disorders, 43(5), 1184–1195. https://doi.org/10.1007/s10803-013-1817-8.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. Belardinelli, C., Raza, M., & Taneli, T. (2016). Comorbid behavioral problems and psychiatric disorders in autism spectrum disorders. Journal of Childhood & Developmental Disorders, 2(2), 1–9.

    Article  Google Scholar 

  10. Bi, X. A., Liu, Y., Jiang, Q., Shu, Q., Sun, Q., & Dai, J. (2018). The diagnosis of autism spectrum disorder based on the random neural network cluster. Frontiers in Human Neuroscience, 12, 257. https://doi.org/10.3389/fnhum.2018.00257.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Candon, M. K., Barry, C. L., Epstein, A. J., Marcus, S. C., Kennedy-Hendricks, A., Xie, M., & Mandell, D. S. (2018). The differential effects of insurance mandates on health care spending for children’s autism spectrum disorder. Medical Care, 56(3), 228–232. https://doi.org/10.1097/mlr.0000000000000863.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders–autism and developmental disabilities monitoring network, 14 sites, United States, 2008. MMWR Surveillance Summary, 61(3), 1–19.

    Google Scholar 

  13. Christiansz, J. A., Gray, K. M., Taffe, J., & Tonge, B. J. (2016). Autism spectrum disorder in the DSM-5: Diagnostic sensitivity and specificity in early childhood. The Journal of Autism and Developmental Disorders, 46(6), 2054–2063. https://doi.org/10.1007/s10803-016-2734-4.

    Article  PubMed  Google Scholar 

  14. Dawkins, T., Meyer, A. T., & Van Bourgondien, M. E. (2016). The relationship between the childhood autism rating scale: Second edition and clinical diagnosis utilizing the DSM-IV-TR and the DSM-5. The Journal of Autism and Developmental Disorders, 46(10), 3361–3368. https://doi.org/10.1007/s10803-016-2860-z.

    Article  PubMed  Google Scholar 

  15. Dawson, G. (2013). Early intensive behavioral intervention appears beneficial for young children with autism spectrum disorders. The Journal of Pediatrics, 162(5), 1080–1081. https://doi.org/10.1016/j.jpeds.2013.02.049.

    Article  PubMed  Google Scholar 

  16. Dickerson Mayes, S., Black, A., & Tierney, C. D. (2013). DSM-5 under-identified PDDNOS: Diagnostic agreement between the DSM-5, DSM-IV, and checklist for autism spectrum disorder. Research in Autism Spectrum Disorders, 7(2), 298–306.

    Article  Google Scholar 

  17. Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcin, C., … Fombonne, E. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5(3), 160–179. https://doi.org/10.1002/aur.239.

    Article  Google Scholar 

  18. Foley-Nicpon, M., Fosenburg, S. L., Wurster, K. G., & Assouline, S. G. (2017). Identifying high ability children with DSM-5 autism spectrum or social communication disorder: Performance on autism diagnostic instruments. The Journal of Autism and Developmental Disorders, 47(2), 460–471. https://doi.org/10.1007/s10803-016-2973-4.

    Article  PubMed  Google Scholar 

  19. Fombonne, E., Quirke, S., & Hagen, A. (2009). Prevalence and interpretation of recent trends in rates of pervasive developmental disorders. McGill Journal of Medicine, 12(2), 73.

    PubMed  PubMed Central  Google Scholar 

  20. Ford, L. (2014). Co-occurrence of psychiatric disorders in individuals with autism spectrum disorders. In S. X. Ming & B. A. Pletcher (Eds.), Navigating the medical maze with a child with autism spectrum disorder (pp. 36–49). London: Jessica Kingsley Publishers.

    Google Scholar 

  21. Goldman, S. (2013). Opinion: Sex, gender and the diagnosis of autism—a biosocial view of the male preponderance. Research in Autism Spectrum Disorders, 7(6), 675–679. https://doi.org/10.1016/j.rasd.2013.02.006.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Greaves-Lord, K., Eussen, M. L., Verhulst, F. C., Minderaa, R. B., Mandy, W., Hudziak, J. J., … Hartman, C. A. (2013). Empirically based phenotypic profiles of children with pervasive developmental disorders: Interpretation in the light of the DSM-5. The Journal of Autism and Developmental Disorders, 43(8), 1784–1797. https://doi.org/10.1007/s10803-012-1724-4.

    Article  Google Scholar 

  23. Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., … Szatmari, P. (2015). Sex and gender differences in autism spectrum disorder: Summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6, 36. https://doi.org/10.1186/s13229-015-0019-y.

  24. Harstad, E. B., Fogler, J., Sideridis, G., Weas, S., Mauras, C., & Barbaresi, W. J. (2015). Comparing diagnostic outcomes of autism spectrum disorder using DSM-IV-TR and DSM-5 criteria. The Journal of Autism and Developmental Disorders, 45(5), 1437–1450. https://doi.org/10.1007/s10803-014-2306-4.

    Article  PubMed  Google Scholar 

  25. Helles, A., Gillberg, C. I., Gillberg, C., & Billstedt, E. (2015). Asperger syndrome in males over two decades: Stability and predictors of diagnosis. Journal of Child Psychology and Psychiatry, 56(6), 711–718. https://doi.org/10.1111/jcpp.12334.

    Article  PubMed  Google Scholar 

  26. Hicks, S. D., Rajan, A. T., Wagner, K. E., Barns, S., Carpenter, R. L., & Middleton, F. A. (2018). Validation of a salivary RNA test for childhood autism spectrum disorder. Frontiers in Genetics, 9, 534. https://doi.org/10.3389/fgene.2018.00534.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557.

    Article  PubMed  PubMed Central  Google Scholar 

  28. 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(8), 1381–1393. https://doi.org/10.1007/s10802-014-9881-x.

    Article  PubMed  PubMed Central  Google Scholar 

  29. 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. The American Journal of Psychiatry, 169(10), 1056–1064. https://doi.org/10.1176/appi.ajp.2012.12020276.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Jacquemont, S., Coe, B. P., Hersch, M., Duyzend, M. H., Krumm, N., Bergmann, S., … Eichler, E. E. (2014). A higher mutational burden in females supports a “female protective model” in neurodevelopmental disorders. American Journal of Human Genetics, 94(3), 415–425. https://doi.org/10.1016/j.ajhg.2014.02.001.

    Article  Google Scholar 

  31. Jashar, D. T., Brennan, L. A., Barton, M. L., & Fein, D. (2016). Cognitive and adaptive skills in toddlers who meet criteria for autism in DSM-IV but not DSM-5. The Journal of Autism and Developmental Disorders, 46(12), 3667–3677. https://doi.org/10.1007/s10803-016-2901-7.

    Article  PubMed  Google Scholar 

  32. 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. American Academy of Child & Adolescent Psychiatry, 53(5), 500–508. https://doi.org/10.1016/j.jaac.2013.12.021.

    Article  Google Scholar 

  33. Kogan, M. D., Vladutiu, C. J., Schieve, L. A., Ghandour, R. M., Blumberg, S. J., Zablotsky, B., … Lu, M. C. (2018). The prevalence of parent-reported autism spectrum disorder among US children. Pediatrics. https://doi.org/10.1542/peds.2017-4161.

    Article  Google Scholar 

  34. Konst, M. J., Matson, J. L., Goldin, R., & Rieske, R. (2014). How does ASD symptomology correlate with ADHD presentations? Research in Developmental Disabilities, 35(9), 2252–2259. https://doi.org/10.1016/j.ridd.2014.05.017.

    Article  PubMed  Google Scholar 

  35. Kulage, K. M., Smaldone, A. M., & Cohn, E. G. (2014). How will DSM-5 affect autism diagnosis? A systematic literature review and meta-analysis. The Journal of Autism and Developmental Disorders, 44(8), 1918–1932. https://doi.org/10.1007/s10803-014-2065-2.

    Article  PubMed  Google Scholar 

  36. Lai, M. C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: setting the scene for future research. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1), 11–24. https://doi.org/10.1016/j.jaac.2014.10.003.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Levin, A. R., Varcin, K. J., O’Leary, H. M., Tager-Flusberg, H., & Nelson, C. A. (2017). EEG power at 3 months in infants at high familial risk for autism. Journal of Neurodevelopmental Disorders, 9(1), 34. https://doi.org/10.1186/s11689-017-9214-9.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Levy, S. E., Mandell, D. S., & Schultz, R. T. (2009). Autism. Lancet, 374(9701), 1627–1638. https://doi.org/10.1016/s0140-6736(09)61376-3.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Li, G., Liu, M., Sun, Q., Shen, D., & Wang, L. (2018). Early diagnosis of autism disease by multi-channel CNNs. Machine Learning in Medical Imaging, 11046, 303–309. https://doi.org/10.1007/978-3-030-00919-9_35.

    Article  PubMed  Google Scholar 

  40. Lucas, N., Macaskill, P., Irwig, L., & Bogduk, N. (2010). The development of a quality appraisal tool for studies of diagnostic reliability (QAREL). Journal of Clinical Epidemiology, 63(8), 854–861. https://doi.org/10.1016/j.jclinepi.2009.10.002.

    Article  PubMed  Google Scholar 

  41. Lucas, N., Macaskill, P., Irwig, L., Moran, R., Rickards, L., Turner, R., & Bogduk, N. (2013). The reliability of a quality appraisal tool for studies of diagnostic reliability (QAREL). BMC Medical Research Methodology, 13, 111. https://doi.org/10.1186/1471-2288-13-111.

    Article  PubMed  PubMed Central  Google Scholar 

  42. 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. https://doi.org/10.1001/jamapsychiatry.2013.3893.

    Article  Google Scholar 

  43. Magana, S., & Vanegas, S. B. (2017). Diagnostic utility of the ADI-R and DSM-5 in the assessment of latino children and adolescents. The Journal of Autism and Developmental Disorders, 47(5), 1278–1287. https://doi.org/10.1007/s10803-017-3043-2.

    Article  PubMed  Google Scholar 

  44. Matson, J. L., Kozlowski, A. M., Hattier, M. A., Horovitz, M., & Sipes, M. (2012). DSM-IV vs DSM-5 diagnostic criteria for toddlers with autsim. Developmental Neurorehabilitation, 15(3), 185–190. https://doi.org/10.3109/17518423.2012.672341.

    Article  PubMed  Google Scholar 

  45. 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 & Adolescent Psychiatry, 50(6), 583–592.e511. https://doi.org/10.1016/j.jaac.2011.04.001.

    Article  Google Scholar 

  46. Mazurek, M., Lu, F., Symecko, H., Butter, E., Bing, N., Hundley, R., … Handen, B. (2017). A prospective study of the concordance of DSM-IV and DSM-5 diagnostic criteria for autism spectrum disorder. The Journal of Autism & Developmental Disorders, 47(9), 2783–2794. https://doi.org/10.1007/s10803-017-3200-7.

    Article  Google Scholar 

  47. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology, 62(10), 1006–1012. https://doi.org/10.1016/j.jclinepi.2009.06.005.

    Article  PubMed  Google Scholar 

  48. Mugzach, O., Peleg, M., Bagley, S. C., Guter, S. J., Cook, E. H., & Altman, R. B. (2015). An ontology for autism spectrum disorder (ASD) to infer ASD phenotypes from autism diagnostic interview-revised data. Journal of Biomedical Informatics, 56, 333–347. https://doi.org/10.1016/j.jbi.2015.06.026.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Muhle, R. A., Reed, H. E., Stratigos, K. A., & Veenstra-VanderWeele, J. (2018). The emerging clinical neuroscience of autism spectrum disorder: A review. JAMA Psychiatry, 75(5), 514–523. https://doi.org/10.1001/jamapsychiatry.2017.4685.

    Article  PubMed  Google Scholar 

  50. Norbury, C. F. (2014). Practitioner review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications. Journal of Child Psychology and Psychiatry, 55(3), 204–216. https://doi.org/10.1111/jcpp.12154.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Ocakoglu, F. T., Kayan, B., Kose, S., Ozbaran, N. B., Erermis, H. S., Bildik, T., & Aydin, C. (2015). Reassessment of pervasive development disorder-not otherwise specified outcome according to DSM-5 diagnostical criteria. Klinik Psikofarmakologi Bulteni, 25, S64–S65.

    Google Scholar 

  52. Ohashi, K., Mizuno, Y., Miyachi, T., Asai, T., Imaeda, M., & Saitoh, S. (2015). Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder. Pediatrics International, 57(6), 1097–1100. https://doi.org/10.1111/ped.12704.

    Article  PubMed  Google Scholar 

  53. Orinstein, A. J., Helt, M., Troyb, E., Tyson, K. E., Barton, M. L., Eigsti, I. M., … Fein, D. A. (2014). Intervention for optimal outcome in children and adolescents with a history of autism. Journal of Developmental & Behavioral Pediatrics, 35(4), 247–256. https://doi.org/10.1097/dbp.0000000000000037.

    Article  Google Scholar 

  54. Persaud, R. (1996). Misleading meta-analysis. “Fail safe N” is a useful mathematical measure of the stability of results. BMJ, 312(7023), 125.

    Article  Google Scholar 

  55. Reichow, B., Hume, K., Barton, E. E., & Boyd, B. A. (2018). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 5, Cd009260. https://doi.org/10.1002/14651858.CD009260.pub3.

    Article  PubMed  Google Scholar 

  56. Rice, C., & Autism and Developmental Disabilities Monitoring Network Surveillance Year 2000 Principal Investigators. (2007). Prevalence of autism spectrum disorders–autism and developmental disabilities monitoring network, six sites, United States, 2000. MMWR Surveillance Summary, 56(SS01), 1–11.

    Google Scholar 

  57. Rieske, R. D., Matson, J. L., Beighley, J. S., Cervantes, P. E., Goldin, R. L., & Jang, J. (2015). Comorbid psychopathology rates in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Developmental Neurorehabilitation, 18(4), 218–223. https://doi.org/10.3109/17518423.2013.790519.

    Article  PubMed  Google Scholar 

  58. Righi, G., Tierney, A. L., Tager-Flusberg, H., & Nelson, C. A. (2014). Functional connectivity in the first year of life in infants at risk for autism spectrum disorder: an EEG study. PLoS ONE, 9(8), e105176. https://doi.org/10.1371/journal.pone.0105176.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Rogers, S. (2016). Early start denver model. In R. G. Romanczyk & J. McEachin (Eds.), Comprehensive models of autism spectrum disorder treatment: Points of divergence and convergence (pp. 45–62). New York: Springer Publishing Company.

    Google Scholar 

  60. Romero, M., Aguilar, J. M., Del-Rey-Mejias, A., Mayoral, F., Rapado, M., Pecina, M., … Lara, J. P. (2016). Psychiatric comorbidities in autism spectrum disorder: A comparative study between DSM-IV-TR and DSM-5 diagnosis. International Journal of Clinical and Health Psychology, 16(3), 266–275.

    Article  Google Scholar 

  61. Salomone, E., Beranova, S., Bonnet-Brilhault, F., Briciet Lauritsen, M., Budisteanu, M., Buitelaar, J., … Charman, T. (2016). Use of early intervention for young children with autism spectrum disorder across Europe. Autism, 20(2), 233–249. https://doi.org/10.1177/1362361315577218.

    Article  Google Scholar 

  62. Schieve, L. A., Rice, C., Boyle, C., Visser, S. N., & Blumberg, S. J. (2006). Mental health in the United States: Parental report of diagnosed autism in children aged 4–17 years–United States, 2003–2004. Morbidity and Mortality Weekly Report, 55(17), 481–486.

    Google Scholar 

  63. Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., … Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. The Journal of Autism and Developmental Disorders, 45(8), 2411–2428. https://doi.org/10.1007/s10803-015-2407-8.

    Article  PubMed  Google Scholar 

  64. Shen, M. D., Nordahl, C. W., Li, D. D., Lee, A., Angkustsiri, K., Emerson, R. W., … Amaral, D. G. (2018). Extra-axial cerebrospinal fluid in high-risk and normal-risk children with autism aged 2–4 years: a case-control study. Lancet Psychiatry, 5(11), 895–904. https://doi.org/10.1016/s2215-0366(18)30294-3.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Signorelli, M. S., Petrosino, B., Magnano di San Lio, F., & Aguglia, E. (2015). Asperger syndrome in adults and DSM-5: What does the future hold? European Neuropsychopharmacology, 25(Suppl 2), S650.

    Article  Google Scholar 

  66. Singh, J. S., & Bunyak, G. (2018). Autism disparities: A systematic review and meta-ethnography of qualitative research. Qualitative Health Research. https://doi.org/10.1177/1049732318808245.

    Article  PubMed  Google Scholar 

  67. Smith, A. M., King, J. J., West, P. R., Ludwig, M. A., Donley, E. L. R., Burrier, R. E., & Amaral, D. G. (2018). Amino acid dysregulation metabotypes: Potential biomarkers for diagnosis and individualized treatment for subtypes of autism spectrum disorder. Biological Psychiatry. https://doi.org/10.1016/j.biopsych.2018.08.016.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Smith, I. C., Reichow, B., & Volkmar, F. R. (2015). The effects of DSM-5 criteria on number of individuals diagnosed with autism spectrum disorder: A systematic review. The Journal of Autism and Developmental Disorders, 45(8), 2541–2552. https://doi.org/10.1007/s10803-015-2423-8.

    Article  PubMed  Google Scholar 

  69. Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. A. (2018). Prevalence of co-occurring medical and behavioral conditions/symptoms among 4- and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. The Journal of Autism and Developmental Disorders, 48(8), 2663–2676. https://doi.org/10.1007/s10803-018-3521-1.

    Article  PubMed  Google Scholar 

  70. Solerdelcoll Arimany, M., Blazquez, A., Calvo, R., Varela, E., Puig, O., & Lazaro, L. (2017). Diagnostic stability of autism spectrum disorders with the DSM-5 diagnostic criteria. European Neuropsychopharmacology, 27, S1104.

    Article  Google Scholar 

  71. Sturmey, P., & Dalfern, S. (2014). The effect 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.

    Article  Google Scholar 

  72. Sumi, S., Miyachi, T., Ohya, K., Ohashi, K., & Saitoh, S. (2014). Application of the final DSM-5 criteria for young children with autism spectrum disorder. Autism-Open Access, 4(3), 135.

    Google Scholar 

  73. Sung, M., Goh, T. J., Tan, B. L. J., Chan, J. S., & Liew, H. S. A. (2018). Comparison of DSM-IV-TR and DSM-5 criteria in diagnosing autism spectrum disorders in Singapore. The Journal of Autism and Developmental Disorders, 48(10), 3273–3281. https://doi.org/10.1007/s10803-018-3594-x.

    Article  PubMed  Google Scholar 

  74. Swineford, L. B., Thurm, A., Baird, G., Wetherby, A. M., & Swedo, S. (2014). Social (pragmatic) communication disorder: A research review of this new DSM-5 diagnostic category. Journal of Neurodevelopmental Disorders. 6(1), 41.

    Article  Google Scholar 

  75. Taheri, A., & Perry, A. (2012). Exploring the proposed DSM-5 criteria in a clinical sample. The Journal of Autism and Developmental Disorders, 42(9), 1810–1817. https://doi.org/10.1007/s10803-012-1599-4.

    Article  PubMed  Google Scholar 

  76. Taheri, A., Perry, A., & Factor, D. C. (2014). A further examination of the DSM-5 autism spectrum disorder criteria in practice. Journal on Developmental Disabilities, 20(1), 116–121.

    Google Scholar 

  77. Tartaglia, N. R., Wilson, R., Miller, J. S., Rafalko, J., Cordeiro, L., Davis, S., … Ross, J. (2017). Autism spectrum disorder in males with sex chromosome aneuploidy: XXY/Klinefelter syndrome, XYY, and XXYY. Journal of Developmental & Behavioral Pediatrics, 38(3), 197–207. https://doi.org/10.1097/dbp.0000000000000429.

    Article  Google Scholar 

  78. Treffert, D. A. (1970). Epidemiology of infantile autism. Archives of General Psychiatry, 22(5), 431–438.

    Article  Google Scholar 

  79. Turcotte, P., Mathew, M., Shea, L. L., Brusilovskiy, E., & Nonnemacher, S. L. (2016). Service needs across the lifespan for individuals with autism. The Journal of Autism and Developmental Disorders, 46(7), 2480–2489. https://doi.org/10.1007/s10803-016-2787-4.

    Article  PubMed  Google Scholar 

  80. Turygin, N. C., Matson, J. L., Adams, H., & Belva, B. (2013). The effect of DSM-5 criteria on externalizing, internalizing, behavioral and adaptive symptoms in children diagnosed with autism. Developmental Neurorehabilitation, 16(4), 277–282. https://doi.org/10.3109/17518423.2013.769281.

    Article  PubMed  Google Scholar 

  81. van Steensel, F. J., Bogels, S. M., & de Bruin, E. I. (2015). DSM-IV versus DSM-5 autism spectrum disorder and social anxiety disorder in childhood: Similarities and differences. Journal of Child and Family Studies, 24(9), 2752–2756.

    Article  Google Scholar 

  82. Visser, S., & Tops, W. (2017). Social pragmatic communication disorder and autism spectrum disorder: Two of a kind? A narrative review. Annals of Psychiatry and Mental Health. 5(6).

  83. Volkmar, F. R., Szatmari, P., & Sparrow, S. S. (1993). Sex differences in pervasive developmental disorders. The Journal of Autism and Developmental Disorders, 23(4), 579–591.

    Article  Google Scholar 

  84. Weitlauf, A. S., McPheeters, M. L., Peters, B., Sathe, N., Travis, R., Aiello, R., … Warren, Z. (2014). AHRQ comparative effectiveness reviews. In Therapies for children with autism spectrum disorder: Behavioral interventions update. Rockville, MD: Agency for Healthcare Research and Quality (US).

  85. Wheeler, A. C., Mussey, J., Villagomez, A., Bishop, E., Raspa, M., Edwards, A., … Bailey, D. B. Jr. (2015). DSM-5 changes and the prevalence of parent-reported autism spectrum symptoms in Fragile X syndrome. The Journal of Autism and Developmental Disorders, 45(3), 816–829. https://doi.org/10.1007/s10803-014-2246-z.

    Article  Google Scholar 

  86. Wilson, C. E., Gillan, N., Spain, D., Robertson, D., Roberts, G., Murphy, C. M., … Murphy, D. G. (2013). Comparison of ICD-10R, DSM-IV-TR and DSM-5 in an adult autism spectrum disorder diagnostic clinic. The Journal of Autism and Developmental Disorders, 43(11), 2515–2525. https://doi.org/10.1007/s10803-013-1799-6.

    Article  Google Scholar 

  87. Wing, L., & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification. The Journal of Autism and Developmental Disorders, 9(1), 11–29.

    Article  Google Scholar 

  88. Wong, C. M., & Koh, H. C. (2016). Brief report: Investigating the implications of applying the new DSM-5 criteria for diagnosing autism spectrum disorder in a preschool population in Singapore. The Journal of Autism and Developmental Disorders, 46(9), 3177–3182. https://doi.org/10.1007/s10803-016-2841-2.

    Article  PubMed  Google Scholar 

  89. Xu, G., Strathearn, L., Liu, B., et al. (2018). Prevalence and treatment patterns of autism spectrum disorder in the United States, 2016. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2018.4208.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Yaylaci, F., & Miral, S. (2017). A comparison of DSM-IV-TR and DSM-5 diagnostic classifications in the clinical diagnosis of autistic spectrum disorder. The Journal of Autism and Developmental Disorders, 47(1), 101–109. https://doi.org/10.1007/s10803-016-2937-8.

    Article  PubMed  Google Scholar 

  91. You, Y., Wu, B.-L., & Shen, Y. (2011). A pilot study on the diagnostic performance of DSM-IV and DSM-V for autism spectrum disorder. North American Journal of Medicine and Science, 4(3), 116–123.

    Article  Google Scholar 

  92. 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. The Journal of Autism and Developmental Disorders, 44(4), 758–765. https://doi.org/10.1007/s10803-013-1927-3.

    Article  PubMed  Google Scholar 

  93. Yuan, H., & Dollaghan, C. (2018). Measuring the diagnostic features of social (pragmatic) communication disorder: An exploratory study. American Journal of Speech-Language Pathology, 27(2), 647–656. https://doi.org/10.1044/2018_ajslp-16-0219.

    Article  PubMed  Google Scholar 

  94. Zander, E., & Bolte, S. (2015). The new DSM-5 impairment criterion: A challenge to early autism spectrum disorder diagnosis? The Journal of Autism and Developmental Disorders, 45(11), 3634–3643. https://doi.org/10.1007/s10803-015-2512-8.

    Article  PubMed  Google Scholar 

  95. Zhao, F., Zhang, H., Rekik, I., An, Z., & Shen, D. (2018). Diagnosis of autism spectrum disorders using multi-level high-order functional networks derived from resting-state functional MRI. Frontiers in Human Neuroscience, 12, 184. https://doi.org/10.3389/fnhum.2018.00184.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This study is a follow-up systematic literature review and meta-analysis to Kulage, K. M., Smaldone, A. M., & Cohn, E. G. (2014). How will DSM-5 affect autism diagnosis? A systematic literature review and meta-analysis. The Journal of Autism and Developmental Disorders, 44(8), 1918–1932, https://doi.org/10.1007/s10803-014-2065-2.

Funding

This study was not supported by any type of external or grant funding.

Author information

Affiliations

Authors

Contributions

KMK conceived of the study, participated in the design and coordination of the study, and drafted and revised the manuscript. JG conducted the initial literature search and JU updated the literature search; both coordinated the study workflow in Covidence, drafted part of the methods section, and revised the manuscript. DR participated in the design and coordination of the study, drafted the introduction, and revised the manuscript. JMB provided clinical context in interpretation of study findings, drafted part of the results and discussion sections, and revised the manuscript. AMS conceived of the study, participated in the design and coordination of the study, performed analyses, and drafted and revised the manuscript. KMK, JG, JU, DR, and AMS participated in the literature screening, quality appraisal, and data extraction. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kristine M. Kulage MA, MPH.

Ethics declarations

Conflict of interest

All authors declare they have no conflicts of interest.

Ethical Approval

This manuscript does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (docx 82 KB)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kulage, K.M., Goldberg, J., Usseglio, J. et al. How has DSM-5 Affected Autism Diagnosis? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis. J Autism Dev Disord 50, 2102–2127 (2020). https://doi.org/10.1007/s10803-019-03967-5

Download citation

Keywords

  • Autism Spectrum Disorder
  • DSM-5
  • Diagnosis
  • Asperger’s Disorder
  • PDD-NOS
  • Social Communication Disorder