An alarm has recently been sounded regarded the proposed changes in diagnostic criteria for Austism and I want to help clarify what is happening. I do not believe there is a reason to be concerned about this for NBC and IBC clients but in the wider world of children receiving services to treat conditions not significantly impairing their day-to-day function, there may be some cause for concern.

I’m attaching the official definitions of Autism from the DSM-IV-TR (the current standard for diagnosing Autism) and the DSM-5 proposed definition. You will see that the two definitions are extremely similar but it does seem that some of the higher-functioning children with Asperger’s disorder, “whose symptoms together do not limit or impair everyday functioning”, will no longer be classified as having an Autism spectrum disorder. This may be alarming to some parents as som authorities are suggesting that the new definition of “Autism”, which replaces the separate definitions of Asperger’s, Retts, Childhood Disintegrative Disorder, etc, will reduce the diagnosis of Autism spectrum disorders by as much as thirty two percent. I don’t think so but we don’t work with children who are superficially impaired so I don’t know how many of the total children currently diagnosed with Autism spectrum disorders are actually only superficially impaired. However, I suspect it’s not nearly thirty two percent of the total.

For every expert in the fields of psychiatry and psychology there is an equal and opposite expert. If and when the proposed definition of Autism is adopted by the American Psychiatric Association (APA) licensed physicians and mental health professionals will be able to render diagnoses on the basis of their clinical understanding of the child, as they should, and be able to use the Diagnostic and Statistical Manual (DSM) of the APA to assist them in that process. There is a terrific battle being waged against the definition of Austim by Asperger’s advocacy groups and others so the adoption of the proposed definition by the APA therefore it may not happen for some time. I am confident that a competent mental health professional will be able to render an Autism diagnosis in the case of any child whose condition seriously limits his/her functioning based on either DSM-IV-TR or DSM-5.

Since all the children we serve, those who receive Behavioral Health Rehabilitation Services (BHRS, sometimes mistakenly called “wraparound” services in Pennsylvania) must be seriously impaired in their everyday functioning ability the change to DSM-5 should have no significan impact on the diagnosis or delivery of BHRS to any of our clients. The standard since 1992 for measurement is to have a Global Assessment of Functioning (GAF) below 60.

Please pass this on to parents and teachers of our clients if you feel they have concerns about whether or not the DSM-5 proposed changes in the definition of Autism will adversely affect their child’s treatment or education program.

If you have questions please don’t hesitate to contact me.

Best wishes always,


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