Potential Impact ofDSM-5Criteria on Autism Spectrum Disorder Prevalence Estimates

Abstract

Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders characterized by impairments in social interaction and communication, as well as repetitive behaviors and restricted interests. The American Psychiatric Association first described infantile autism as a distinct condition in the DSM-III and introduced the category of pervasive developmental disorders (PDDs).¹ In 1987, the American Psychiatric Association revised the diagnostic label from infantile autism to autistic disorder and slightly expanded the diagnostic criteria in the DSM-III-R.² In 1994, the American Psychiatric Association included several subtypes in the DSM-IV: autistic disorder, Asperger disorder, Rett disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS).³ Since the 1994 revision, population prevalence estimates of ASD have regularly included 3 of the 5 PDDs: autistic disorder, Asperger disorder, and PDD-NOS. The criteria described in the DSM-IV-TR published in 2000 were largely unchanged from those presented in the DSM-IV and the International Statistical Classification of Diseases, 10th Revision.^4,5 Although the term ASD did not appear in the DSM-IV-TR, it is popularly used in place of PDD (inclusive of subtypes), which is how we use it here.