and PDD-NOS Gone! Now What?
Autism Spectrum Disorder
Dr. Kathie F. Nunley
of you know by now, 2013 brought in the new Diagnostic and Statistical
Manual of Mental Disorders, version 5 (DSM-5). This is the manual
published by the American Psychiatric Association and used by
clinicians and practitioners as the basis for diagnoses of all
One of the
hottest or most discussed changes (and often misunderstood or
ignored) is the new criteria for Autism Spectrum Disorder (ASD).
a summary of the main bullet points (elaboration underneath)
will we use the terms Autistic Disorder, Asperger Syndrome,
Disintegrative Disorder, or Pervasive Developmental Disorder
Not Otherwise Specified (PDD-NOS)
now only one diagnosis: Autism Spectrum Disorder (ASD)
which is defined as having impairments in two domains: Social
/ communication / interaction and Restricted and Repetitive
to be diagnosed with ASD, a person must have, at some point
in early childhood, ALL 3 symptoms from the Social / communication
/ interaction domain:
reciprocating social and emotional interactions, inability
to initiate interactions and problems sharing emotions with
Problems maintaining relationships. Difficulty in age appropriate
communication problems such as inability to understand facial
must have 2 of the 4 symptoms from the Restricted and Repetitive
speech or motor movement or unusual use of objects.
adherence to routines or extreme resistance to change.
restrictive interests that are abnormal in intensity or focus.
or hypo reactivity to sensory input or unusual interest in
sensory aspects of environment.
So, in order
for a child to be diagnoses with ASD, he or she must exhibit
ALL of the 3 symptoms in the top bulleted list and at least
2 from the bottom bulleted list.
force team that worked on this new diagnostic criteria did so
in an attempt to clarify what had been a murky field. As has
been known for several years, there was no clear demarcation
between Autism, Aspergers or even PDD-NOS. Several studies showed
that the diagnosis at times simply depended more on the clinic
or practitioner who gave the diagnosis rather than the individual
A New Diagnosis
many people who worked and lived with children on the spectrum
felt the ASD classification was getting too broad and moving
away from the core symptoms. This may also have led to the addition
of a brand new classification in the DSM-5: Pragmatic
Social Communication Disorder. Many children who previously
would have received a diagnosis of Aspergers under the old DSM
IV, may better fit with the new SCD diagnosis of DSM-5, if they
are lacking the restricted and repetitive behaviors component.
items for parents, counselors, teachers and people with ASD
who received a firm diagnosis of Autism, Aspergers, or PDDNOS
under the old DSM-IV can retain the diagnosis of ASD. They do
not need to be re-evaluated.
who are comfortable identifying themselves with the label of
Aspergers may continue to do so.
coding rules for insurance reimbursement are did not change
over until October 2014 - and in some medical settings, old
codes may continue to be seen or even used.
change is difficult, the general consensus is that this move
will be an improvement for children, families and adults with
ASD in that it will be a clearer pathway to services.
the semantics may have changed, the mission remains strong.
We all continue to research, support and work hard to help persons
with ASD take advantage of their strengths to live successful
and fulfilling lives
F. Nunley is an educational psychologist, author, researcher
and speaker living in southern New Hampshire. Developer of the
Layered Curriculum® method of instruction, Dr. Nunley has
authored several books and articles on teaching in mixed-ability
classrooms and other problems facing today's teachers. Full
references and additional teaching and parental tips are available
at: http://Help4Teachers.com Email her:
Kathie (at) brains.org