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Proposed Changes for Autism Spectrum Disorders in the Diagnostic and Statistical Manual (DSM) can have a Profound Impact

September 20th, 2012

Our guest blog this week is written by Lisa B. Rudley, Vice President of Private Client Services for Clark Dodge Asset Management. Lisa is responsible for Client Advisory Services and Business Development and brings over 15 years of financial investment services expertise.

By Lisa Rudley

A coalition of groups within the autism community is extremely concerned about potential impacts of the proposed criteria for Autism Spectrum Disorders (ASD) in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) – 5th Edition. The new criteria are supposed to be finalized by December 2012 for May 2013 publication. The ramifications of a new autism definition are far reaching and could be devastating. Among other changes, the new autism criteria will eliminate Asperger Syndrome and PDD-NOS, although children with these conditions could still be diagnosed with autism if they meet the DSM-5 criteria. A child who does not present with restricted or repetitive behaviors would not meet the criteria for autism. Everything from epidemiology to services could be affected for individuals with autism. Those dealing with autism need more answers and support, not more hurdles.

Since February 2012, five studies have been published indicating the proposed DSM-5 ASD criteria will significantly reduce the number of people diagnosed with ASD compared to the current DSM-IVTR criteria:

McPartland and Volkmar – 39.4% decrease
Worley and Matson – 32.2% decrease
Matson et al. – 47.8% decrease
Gibbs et al. – 23.4% decrease
Taheri and Perry – 37% decrease

In addition, Field Trials which identified 83 children with ASD, were reported by Dr. Swedo, chair of the APA’s Workgroup on Neurodevelopmental Disorders (NDD). These trials indicated that the decrease in the number of identified ASD cases using the proposed criteria would be in the single digits, but this would be counter-balanced by the inclusion of some cases that had been missed by the DSM-IVTR. The NDD Workgroup is concerned primarily with the new criteria accurately diagnosing new cases of ASD as they present in the community and does not think that the decreases in the published studies are accurate. Currently, there is no data on adult patients using the new criteria.

Online Survey to Collect Data on New ASD Cases Using the Proposed Criteria

SafeMinds and the Holland Center want to collect and analyze much more data on the proposed criteria through an online survey to assess its impact on autism diagnosis in the community.

This survey can be used by any clinician who speaks English anywhere in the world. The data will be made available to the NDD Workgroup directly. Cases are needed urgently given the tight time frame for publication of the proposed criteria!

Please spread this information and link to any clinician who diagnoses people with autism:

New York State Legislation to Protect People with Autism

Last legislative session, Assemblyman Thomas Abinanti from the 92nd District (D-Greenburgh) sponsored legislation, A9983 that will define “autism” under New York State law as the currently used criteria set out in the Diagnostic and Statistical Manual (DSM-IVTR), a definition that has been in use since 1994. Assemblyman Abinanti along with many of his assembly and senate colleagues believe that the proposed changes would significantly impact people with the diagnosis of autism today and in the future.  Also, the cost to the New York State to re-diagnose people with autism would be extremely costly when these precious resources could be used help people with autism.  The bill was very close to going to the floor of both houses for a vote and Assemblyman Abinanti is expected to reintroduce in the upcoming session starting in January, 2013.

(Some of this information was reprinted with permission from SafeMinds and the Holland Center)

Lisa B. Rudley is Vice President of Private Client Services for Clark Dodge Asset Management   Lisa is responsible for Client Advisory Services and Business Development and brings over 15 years of financial investment services expertise.  She earned her BA from Richard Stockton College of NJ in 1988 and received an MBA in finance with a designation in international business from Fordham University in 1995. Lisa lives in Briarcliff Manor, NY with her husband and three children. As a parent of a child diagnosed with an autism spectrum disorder, Lisa has a comprehensive understanding of the “Special Needs” community. Currently, Lisa serves on the boards of the Elizabeth Birt Center for Autism Law and Advocacy (EBCALA) and Autism Action Network (AAN)  She is the President of the Ossining Special Education Parents Teachers Organization (SEPTO) and is the co-founder of the NAA NY Metro Westchester sub-chapter support group servicing over 600 families in the Westchester area.
Contact:  Lisa Rudley:

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