A Simple Guide to the DSM and Autism

Lexicon [Measures] - DSM

PlainSpeak. In Plain Language for the Lay Reader

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a big book that doctors and mental health professionals use to diagnose and understand mental health conditions. 

Here’s a quick history of the DSM, focusing on how it has changed its understanding of autism over the years.

The Early Years: DSM-I and DSM-II

• DSM-I (1952): The first edition of the DSM didn’t include autism. Back then, people didn’t really know about autism.
• DSM-II (1968): The second edition mentioned “schizophrenic reaction, childhood type,” because people thought autism was related to childhood schizophrenia.

Autism Emerges: DSM-III and DSM-III-R

• DSM-III (1980): This edition was a big deal because it introduced "Infantile Autism" as its own category. This was the first time autism was seen as different from schizophrenia.
• DSM-III-R (1987): The revised edition changed the name to "Autistic Disorder" and provided more detailed criteria for diagnosing it, recognizing a wider range of symptoms.

Refining the Diagnosis: DSM-IV and DSM-IV-TR

• DSM-IV (1994): This edition added more details. Autism was now part of a group called Pervasive Developmental Disorders (PDD), which included:

  • Autistic Disorder
  • Asperger’s Disorder
  • Rett’s Disorder
  • Childhood Disintegrative Disorder
  • Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)

  This allowed doctors to better identify different types of autism.

• DSM-IV-TR (2000): This version didn’t change much but updated and clarified the existing information.

The Modern Era: DSM-5

• DSM-5 (2013): The most recent edition made major changes to how autism is diagnosed:
  • Autism Spectrum Disorder (ASD): The DSM-5 combined all the previous types of autism into one diagnosis called Autism Spectrum Disorder (ASD). This reflects the idea that autism is a single condition with different levels of severity.
  • Two Domains: The criteria for diagnosing ASD are now based on two main areas:
    1. Social Communication and Interaction: Problems with social communication and interaction in different situations.
    2. Restricted, Repetitive Behaviors: Repetitive movements, strict routines, very focused interests, and unusual reactions to sensory experiences.
  • Severity Levels: The DSM-5 includes levels to show how much support someone with ASD might need:
    • Level 1: Requires support
    • Level 2: Requires substantial support
    • Level 3: Requires very substantial support
  • Specifiers and Comorbidities: Doctors can add more details about a person’s ASD, like if they have intellectual or language difficulties. The DSM-5 also recognizes that people with ASD often have other conditions like anxiety, depression, or ADHD.

Summary

The DSM has changed a lot over the years to better understand and diagnose autism. From not recognizing autism at all to seeing it as a broad spectrum of conditions, these updates help doctors and families understand and support people with autism better.

Related Posts: [DSM], [Diagnosis],[Measures]