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Autism Spectrum Disorder: Changing the Patterns

One important revision in the fourth edition that will be evident in upcoming release of DSM-V involves the reclassification of three pervasive developmental disorders into a more inclusive term Autistic Spectrum Disorder or ASD (APA, 2012). This paper will primarily discuss the rationale and opposing arguments for this change and implications on the management of these disorders. Autistic Disorder in the DSM-IV The DSM-IV defines pervasive developmental disorders (PDD) as conditions that present as problems affecting social interaction, language development and usage, and behavior of individuals. Currently, this classification includes autistic disorder, Rett's disorder, childhood disintegrative disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified or PDD-NOS. Each of these diagnoses is distinguished from the rest through specific characteristics and severity (Autism Research Institute, 2013). Specifically, the diagnosis of autistic disorder as directed the DSM-IV is used only if there are qualitative impairments in social interaction, impairment in communication, and restricted repetitive and stereotyped patterns of behavior or interests. The constellation of these clinically discernible signs practically creates a triad of domains that need to be satisfied to make the diagnosis. Two manifestations particularly related to the impairment in social interaction should be present including either a noticeable impairment in the utilization of multiple nonverbal behaviors (i.e. eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction), inability to develop relationships with peers in congruent to the developmental level, absence of spontaneous seeking to share enjoyment, interests, and achievements with other people, or a lack of social or emotional attachment and reciprocity (APA, 2000). Furthermore, one communication problem must be manifested. It can either be a delay or a total absence of a language. In the case when language has already been established, the autistic individual may show inability to sustain the conversation. Stereotyped language may also be present. Social imitative play may not be apparent in children with autistic disorder. At least one manifestation in the domain of restricted repetitive and stereotyped patterns of behavior or interests (RRB) is required for the diagnosis of autistic disorder in the DSM-IV. It can either be in the form of a useless ritual, preoccupation with inanimate objects, presence of mannerisms, or restricted interests (APA, 2000). Moreover, the DSM-IV requires that at least one in the three domains should show the impairment prior to the age of three. Other possible conditions like Rett’s disorder and childhood disintegrative disorder should be ruled out as these conditions also manifest similarly to autistic disorder, only with a few excluding features (Sadock & Sadock, 2007). Rationale for Changing DSM-IV Changes for the DSM-V aim to provide more specific, highly sensitive, precise, and reliable criteria for the diagnosis of ASD by particularly addressing the possible areas of ambiguity (Autism Research Institute, 2013). While continuous revisions have been undertaken in the DSM-IV several years after it has been ...Show more
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Autism Spectrum Disorder: Changing the Patterns Name of the Course Instructor Name Date Due Autism Spectrum Disorder: Changing the Patterns In psychiatric diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, developed by the American Psychiatry Association (APA) consists of the classification criteria and nomenclature used to achieve a universal understanding of terms between members of the healthcare team involved in the management of individuals with mental disorders…
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