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New Autism Definition May Exclude Many

New Autism Definition May Exclude Many

Proposed changes to the definition of autism, currently under review by an expert panel appointed by the American Psychiatric Association, are expected to significantly reduce the soaring rate of autism diagnoses. The panel is completing work on the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders, or “The DSM.” Cases of of autism and related disorders such as Asperger syndrome or “pervasive developmental disorder, not otherwise specified” (PDD-NOS) have skyrocketed since the early 1980s, and many researchers believe the numbers are inflated due to vague criteria. The proposed change would consolidate all three diagnoses under one category, autism spectrum disorder, removing Asperger syndrome and PDD-NOS from the manual. Under the current criteria, one can qualify for the diagnosis by exhibiting six or more of 12 behaviors. Under the proposed criteria, the patient would have to exhibit deficits on a much narrower menu: three deficits in social interaction and communication and at least two repetitive behaviors. “We need to carefully monitor the impact of these diagnostic changes on access to services and ensure that no one is being denied the services they need,”  Mark Roithmayr, president of Autism Speaks, told  The New York Times. “Some treatments and services are driven solely by a person’s diagnosis, while other services may depend on other criteria such as age, IQ level or medical history.” Physician’s Weekly wants to know… What do you think about changing the definition of autism? What benefits and/or pitfalls do you...
Autism Spectrum Disorders Diagnoses Vary Widely

Autism Spectrum Disorders Diagnoses Vary Widely

Best-estimate clinical diagnoses of pediatric patients with autism spectrum disorders (ASDs) appear to vary widely across regions, according to a study published online in Archives of General Psychiatry. Diagnostic instruments have been valuable for ASDs by helping to define populations, merge samples, and compare results across studies. However, the use of best-estimate clinical diagnoses has been the gold standard in ASD evaluation. An observational study analyzed 12 university-based research sites, including 2,102 participants (mostly male) between ages 4 and 18 who had a clinical diagnosis of an ASD. Although there was consistent use of standardized measures and similar distributions of scores across sites, the proportion of children assigned to one of three ASD categories (autistic disorder, pervasive developmental disorder-not otherwise specified, and Asperger syndrome) varied significantly between sites. The biggest factors in diagnosis included verbal IQ, language level, and core features of autism (communication and repetitive behaviors). However, clinicians at each site used the available information and set cut-offs on certain measures to establish a diagnosis differently. Physician’s Weekly wants to know… Do you feel the diagnosis of autism spectrum disorders varies within your medical community? Could insurance coverage play a role in the diagnosis...
Autism Checklist at 12-Months May Facilitate Treatment

Autism Checklist at 12-Months May Facilitate Treatment

A simple 24-item checklist may help physicians identify children with autism spectrum disorders (ASDs) as early as 1-year old, triggering earlier and potentially more effective treatment. The checklist can be completed by parents or caregivers in 5 minutes and scored in less than 2 minutes by medical staff. In a new pilot study published online in the Journal of Pediatrics, nearly 10,500 babies were screened by the checklist which covers three areas: social and emotional communication, receptive and expressive speech, and symbolic behavior. Of those infants, 184 failed the screen and were further evaluated and tracked. Of those 184, researchers claimed that 32 received a provisional or final diagnosis of ASDs, 56 were diagnosed with language delays (5 of which ended up being false positives), 9 were diagnosed with developmental delays, and 36 were diagnosed with “other” deficits. The remaining 46 infants were false positives. While such a program needs further evaluation and long-term follow-up, the take home message is clear: pediatricians can play a significant role in identifying children with possible ASD at a very young age, prompting earlier diagnosis and treatment—a critical factor in the management of developmental...
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