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Revised Psychiatric Disorders 'Bible' Changes Disability Definitions

The long-awaited fifth revision of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM-5, was released last weekend by the American Psychiatric Assocation with several revisions that affect conditions such as autism and attention deficit hyperactivity disorder that are common in school contexts.

The manual was last published in 1994 and updated in 2000. Many of these changes reflected in the DSM-5 have been the subject of widespread debate for several months. The diagnostic criteria also have potential to affect schools, though the Individuals with Disabilities Education Act has its own definitions of disabilities covered under special education law.

Among the changes is the removal of Asperger syndrome, and other subsets of autism such as childhood disintegrative disorder and "pervasive development disorder-not otherwise specified." Those disorders will now be folded into the larger category of autism spectrum disorders. The new manual also creates a "social communication disorder" to reflect the experience of people who have trouble communicating but do not have repetitive behavior sometimes associated with autism. The DSM-5 fact sheet on autism spectrum disorders explains the rationale behind the changes; the advocacy group Autism Speaks has also created a FAQ document on the DSM-5 changes.

Attention deficit hyperactivity disorder also has some new diagnostic criteria, namely, that the symptoms must have been present before the age of 12. The earlier manual required that the symptoms must have been present before the age of 7. The new manual also says ADHD should not be diagnosed when the symptoms are better attributed to another disorder, such as bipolar disorder or anxiety.

Other changes have been made to the diagnosis and terminology of intellectual disability, specific learning disorder, and conduct disorder.

Stay tuned for an upcoming article on what these changes may mean for parents and educators.

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