New Criteria Could Reduce the Number of Autism Diagnoses
The most recent criteria used for diagnosing autism that were placed into effect in 2008 could result in a reduction in the total number of autism cases. Based on the findings from a new study, the prevalence of autism could become one in 100 children, which is lower than the U.S. Centers for Disease Control and Prevention's (CDC) previous rate of one in 88 children.
"The trend in the incidence of autism spectrum disorders has been one of pretty steady increases. Whether the switch to DSM-5 would offset that yearly increase remains to be seen," said study author Matthew Maenner, an epidemiologist with the CDC according to HealthDay reported by Philly.
In this study, the researchers examined data on around 645,000 eight-year-old children from 14 areas within the U.S. The children were a part of the Autism and Developmental Disabilities Monitoring Network (ADDM). The researchers diagnosed the children based on the old and new criteria. They reported that in 2008, the older guidelines could have diagnosed 11.3 cases out of 1,000 people. In the new criteria, the number of cases out of 1,000 people fell to 10.
The researchers also calculated that around 81 percent of the children, which was 5,339 out of 6,577 kids, diagnosed with the old set of guidelines would still be diagnosed under the new rules.
"Most of the children who didn't make the cut, they didn't miss by a lot," Maenner said. "They only needed one additional criterion to meet the DSM-5 definition. They had four of the five."
The researchers stated that even though the new DSM-5 (Diagnostic and Statistical Manual) criteria for autism required five symptoms as opposed to two, the criteria are still somewhat flexible. Under the updated guidelines, doctors are now allowed to consider a child's past history of behaviors instead of solely monitoring current behaviors. However, some experts and critics are worried that the drop in autism cases would mean that children who might need help would no longer qualify for treatment.
"Our sense, from our survey and previous studies that have been published, is that individuals who are losing their autism diagnosis are getting a diagnosis of social communication disorder. The concern is there are no clinical guidelines for how to treat social communication disorder," Michael Rosanoff, an associate director of public health research at the non-profit advocacy group, Autism Speaks, said. "We're concerned about this."
The study was published in JAMA Psychiatry.