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Ont,toms shoes sale. says her 14-year-old daughter Hannah has “done well” after receiving interventions for PDD-NOS since age 2 But she fears her daughter may regress if support services are withdrawn based on changes to the DSM“My concern is that my child will no longer fit the criteria for autism” she says “My concern is that my child will fit the criteria for the new social communication disorder And does that qualify [for services]”While parents consider the implications of a rough-draft document experts question whether proposed changes to the DSM would in fact exclude high-functioning individuals from being diagnosed with autism“I’m not sure that ‘tightening up’ is necessarily what we’re seeing here” says Vikram Dua a child and adolescent neuropsychiatrist in Vancouver He describes the revised criteria as “an attempt to better reflect what we know” about autismThe proposal to replace subcategories including Asperger’s and PDD-NOS with the umbrella term “autism spectrum disorder”would bring the DSM-5 closer to British Columbia Ministry of Health guidelines used since 2003 to assess and diagnose autism Dr Dua says “I think in some respects it’s a move in the right direction”Katherine Moxness a psychologist specializing in autism at the West Montreal Readaption Centre notes that studies have shown that clinicians are unable to reliably distinguish between subcategories of autism such as Asperger syndrome and PDD-NOS among higher-functioning individualsGrouping all forms of autism under the same label is “scientifically sound” Dr Moxness says “My only concern is how [the DSM-5]is going to get translated into service delivery” at the less severe end of the autism spectrum she saysBoth Dr Dua and Dr Moxness say they disagree with findings that suggest proposed criteria for autism in the DSM-5 would exclude the majority of people with Asperger’s and PDD-NOSSpecialists don’t rely solely on the DSM to diagnose autism adds Dr Dua Instead they use a variety of assessment tools in multiple sessions with a patient to determine whether an individual has autism or a cluster of disorders with similar traits In clinical practice he says “I don’t know if [the DSM-5]is going to change things too much”But Leah Miltchin president of the board of directors for Autism Ontario notes that in places where diagnostic services are less available general practitioners turn to the DSM “I’ve heard of people who have just taken their child to the family doctor and the family doctor says ‘Oh yeah he has PDD-NOS’ and kind of sends them on their way”Ms Miltchin says the onus will be on the medical community to be vigilant about applying the new diagnostic criteria – and on policy makers to “not just pick and choose who receives services and who doesn’t”In the meantime she says parents should be aware that changes to the DSM will be under review for months to come and their impact on services remains to be seen “I think we have to not panic” she saysDSM decodedThe DSM is short for the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders The manual is widely consulted by Canadian physicians as well as ministries of health and education along with the International Classification of Diseases produced by the World Health OrganizationIn May 2013 the DSM-IV – last revised in 2000 – will be replaced by the DSM-5 Here are the most significant proposed changes to autism in the DSM-5:*Autism spectrum disorder will be the only diagnosis for autism Subcategories including Asperger syndrome and PDD-NOS (pervasive developmental disorder – not otherwise specified) will not be recognized as separate conditions*Social and communication impairments will no longer be considered separate categories in the diagnostic criteria*Individuals must exhibit at least two restricted and repetitive behaviors and interests (such as stereotyped speech fixed interests and excessive adherence to routines) to be diagnosed with autism spectrum disorder*Labels such as “high functioning” and “low-functioning” will be replaced with severity levels: “requiring support” “requiring substantial support” “requiring very substantial support””Jonathan began receiving intensive therapies and support for moderate to severe autism at age 3,Cheap Fake Oakleys. Aviary and The Anonymous Chorus.
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