( 10) mapped items from the Social Communication Questionnaire ( 11) and the Social Responsiveness Scale ( 12) to DSM-5 criteria and found 19% to 22% of children with DSM-IV PDD diagnoses did not meet the proposed criteria. This revision, which has been implemented in the latest DSM-5 draft, increased sensitivity, particularly in the “high-functioning” subgroup (i.e., full scale IQs ≥70). Furthermore, unlike the early draft, the improved model included “unusual sensory behaviors” and the removal of onset criteria of 36 months. For example, sensitivity was improved when they required, “routines AND/OR rituals” instead of “routines AND rituals”. The poor sensitivity of the early draft criteria, and the remarkable increase in sensitivity with the new draft, are likely explained by Mattila and colleagues’ stringent interpretation of the 2010 criteria. Notably, when the authors used criteria more similar to the current DSM-5 criteria), approximately 96% of children with PDD diagnoses were classified correctly. ( 9) examined an early draft of the criteria (2010) and found that only 46% of children with PDD diagnoses were identified as meeting ASD criteria. Using existing data from parent questionnaires, the Autism Diagnostic Interview-Revised ( 7), and the Autism Diagnostic Observation Schedule ( 8), Mattila et al. McPartland and colleagues assessed the sensitivity and specificity of the proposed DSM-5 criteria by using the DSM-IV field trial checklist items and found DSM-5 to perform quite poorly. Though this work confirms the conceptual validity of the proposed changes to DSM-IV, it tells us little about the sensitivity of the new criteria.īecause of the newness of the proposed criteria, only a handful of studies have examined the DSM-5 criteria and all have examined slightly different versions of the criteria under consideration. In contrast, the original DSM-IV model did not meet statistical criteria for an acceptable fit. Mandy and colleagues ( 6) tested this model, including sensory behaviors aspart of the restricted and repetitive behavior criterion, and found this to be an excellent fitting model. In contrast to the original model, communication deficits are subsumed with social impairments. To date, various empirical studies have found support for a 2-domain ASD symptom model ( 3– 5). This is of major significance to families concerned that their affected children might not meet the new criteria for ASD, and therefore lose necessary services. In particular, it is unclear whether the revised criteria will inadvertently narrow the definition ofPDD. 1, 2), little is known about the sensitivity and specificity of the new criteria. Though these changes are based on empirical data (e.g. The proposed changes to DSM-IV diagnostic criteria for pervasive developmental disorders (PDD) include: shifting from a multi-categorical model to a single diagnostic category of Autism Spectrum Disorder (ASD), replacing the three-domain model with a two-domain model, relaxing age of onset criteria, and adding symptoms not previously included in DSM-IV, such as sensory interests and aversions.
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