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Interview Revised Autism Criteria in New DSM Raises Concerns The American Psychiatric Association’s new Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) includes significant changes in the criteria for diagnosing autism spectrum disorder that have raised concerns among parents and advocates. Neelkamal Soares, MD, a UCLA developmental- behavioral pediatrics specialist, discusses the revisions and their implications. Why is the DSM important? All diagnosticians — primary care physicians, psychiatrists, specialists, psychologists, educators, et al. — rely on the DSM for diagnosing neurological and mental disorders. Clinicians look at the DSM and match the patient’s symptoms with the criteria for diagnosis. It’s important to note that the DSM does not provide any guidance on treatment; it is left to the professional organizations or physician groups to look at the evidence and develop treatment guidelines. But defining the diagnosis is important as a gateway to treatment for insurance purposes, from the public health perspective and for researchers. It can also impact eligibility for public services and self-identification for support groups and awareness organizations. What is different about DSM-5? In the last 10 years, we have seen tremendous advances in imaging, genetic and other technologies that are allowing us to link theory with actual physical findings in a way we never could before. One of the major changes involves a lifespan developmental approach. This is an acknowledgment that many disorders exist throughout the life of an individual, but they express themselves differently at different ages. It used to be believed, for example, that autism was only present in children; now we know that not to be the case. We also now use questionnaires and other instruments to determine the severity of a disorder. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631)