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The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?

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Abstract

The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20–47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When applying a mild level of impairment (cutoff: 1 SD below the mean on the VABS), 88 % of the cases fulfilled the impairment criterion. Sixty-nine percent fulfilled the impairment criterion at a moderate level (1.5 SDs) and 33 % at a severe level (2 SDs). Findings indicate that a strict application of the new DSM-5 impairment criterion might compromise early diagnosis of ASD.

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Acknowledgments

We sincerely thank Per-Olof Björck, head of the southeastern part of the Division of Child and Adolescent Psychiatry in Stockholm, for facilitating the realization of this study. Sven Bölte was supported by the Swedish Research Council. This study was supported by the Swedish Research Council in partnership with FAS, FORMAS and VINNOVA (cross-disciplinary research program concerning children’s and youth’s mental health), Riksbankens Jubileumsfond and Jerringfonden.

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Authors and Affiliations

  1. Pediatric Neuropsychiatry Unit, Department of Children’s and Women’s Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden

    Eric Zander & Sven Bölte

  2. Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden

    Eric Zander & Sven Bölte

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  1. Eric Zander
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  2. Sven Bölte
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Correspondence to Eric Zander.

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Table 4 Percentage of children with ASD fulfilling the DSM-5 impairment proxy criterion and the separate Vineland-II domains at different levels
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Zander, E., Bölte, S. The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?. J Autism Dev Disord 45, 3634–3643 (2015). https://doi.org/10.1007/s10803-015-2512-8

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