The ICD-10 criteria do not include sensory problems as a formal criterion.ĭSM-5 includes sensory hyper/hyposensitivities as part of the ‘non-social’ RRBI cluster of symptoms. Sensory problems are common in autism: how are these represented in the criteria? This allows for what was formerly Asperger syndrome within a continuum of different developmental profiles. Social communication difficulties and RRBIs must have been present in early childhood however, ‘functional impairment’ need not be apparent till later.ĭSM-5 criteria accommodate cases where early childhood symptoms only become apparent later than 3 years of age. For instance, if a child has limited language (a communication problem) this will almost inevitably limit social interaction.īy what age must symptoms have appeared for diagnostic criteria to be met?įor childhood autism (but not for Asperger syndrome) ‘functional impairment’ in social interaction, or in language use for communication, must have appeared by age 3 years. Clinicians had found it hard to categorise symptoms as either, as the difficulties are interrelated. ICD-11 mirrors this DSM-5 approach, but does differentiate autism with and without intellectual disability.ģ) restrictive, repetitive activities and interests (RRBIs).Ģ) restrictive, repetitive activities and interests sensory difficulties.ĭSM-5 and ICD-11 both merge communication and social interaction into one social communication symptom cluster. DSM-5 has relinquished subtypes such as Asperger in favour of a single continuous spectrum, reflecting the variability of symptoms and how they are expressed. In ICD-10, the ‘spectrum’ is divided into three subtypes. Table _unit4.2.1 Differences between ICD-10 and DSM-5, with explanatory notesĬhildhood autism Asperger syndrome Pervasive developmental disorder – unspecified (information insufficient to diagnose autism or Asperger syndrome). A clinician may decide, for instance, that a person’s mild problems of social communication, and slightly repetitive behaviours and interests are not sufficiently disruptive to merit diagnosis. For all autism diagnoses, an overarching criterion is whether the observed symptoms are sufficient to undermine the individual’s functioning in everyday life. Table 1 summarises the key differences between ICD-10 and DSM-5, with some additional notes on ICD-11. It will mirror DSM-5 in most key respects but includes some different features which are being viewed as improvements (Zeldovich, 2017). After presentation to WHO member states in 2019, it will come into use in 2022. The details of ICD-11 were released in June 2018. At the time of finalising this module, both remain in operation. It is important to understand the evolution from ICD-10 to DSM-5. DSM-5 (the fifth version of the manual) was introduced in 2013 and reflects more recent thinking, including the removal of Asperger syndrome as a separable sub-type. ICD-10 (the tenth version of the ICD) was introduced in 1992 (WHO, 1992) and reflects thinking about the autism spectrum at that time, including some ideas that may be familiar, such as considering Asperger syndrome a separable sub-type of autism. How these are used as the basis for diagnosis depends on which diagnostic system is used. However, the appropriateness of western-oriented criteria for diagnosis in different cultures is questionable, as will be discussed later on.Īs you learned in Weeks 1 and 2, autism involves ‘social’ and ‘non-social’ characteristics. Both systems are also used in many other parts of the world. DSM is favoured in the USA while ICD is widely used in Europe, although the DSM criteria are also influential in Europe. There are two main official sources for autism diagnosis, the Diagnostic and Statistical Manual of Mental Disorders (DSM) (published by the American Psychiatric Association), and the International Classification of Diseases (ICD) (published by the World Health Organisation). Diagnosis, whether of a physical or psychological condition, involves comparing an individual’s symptoms with diagnostic criteria which specify which symptoms must be present for a specific diagnosis to be appropriate, together with any criteria that rule out this particular diagnosis.
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