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DSM-5 Changes: Social Communication and Autism Spectrum Disorders

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The Diagnostic and Statistical Manual of Mental Disorders is the manual that serves as the universal authority for psychiatric diagnosis and recommended treatments in the United States. The latest version, DSM-5, was published by the American Psychiatric Association in May 2013. The last version, DSM-IV, was published back in 1994.

I was curious about some of the specific changes to autism and Asperger’s syndrome, and thought I would post some of the other changes related to developmental learning disorders for other parents. I’ve also covered a little bit about the new diagnosis category social communication disorder.

New Diagnosis: Social Communication Disorder

1) What does the new term social communication disorder (SCD) cover?

The term social communication disorder replaces language disorder, which included expressive and mixed receptive-expressive language disorders. It also replaces speech sound disorder, which was called phonological disorder and childhood-onset fluency disorder, which was the term used for stuttering.

2) What else does social communication disorder include?

Social communication disorder also includes social (pragmatic) communication disorder, a diagnosis for those who display persistent difficulties in using, understanding and interpretation of verbal and nonverbal communication (e.g., body language).

Social (pragmatic) communication disorder is one of the hallmarks of a person diagnosed with autism spectrum disorder. SCD can also be used as a diagnosis on its own if a person doesn’t display repetitive behaviors, interests or activities of autism spectrum disorder. (1)

3) Why did they revise this area of the DSM?

This new diagnosis category has two advantages.

One, those with social communication disorder will be able to be referred for language therapy. Up until now, unless a student had a diagnosis of ASD (autism spectrum disorder), they may not have gotten a referral for treatment if their only problem was SCM alone.

Second, the definition of SCD includes non-verbal communication. This brings more “official” recognition that the student has a global communications issue. Now an assessment and diagnosis will be forced to include methods of testing and evaluating of how a person processes non-verbal communication as well. (3)

Changes to Definition of Autism Spectrum Disorder

1) What does autism spectrum disorder (ASD) mean in DSM-5?

The new definition of ASD now includes the characteristics of autistic disorder, Asperger’s syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), and childhood disintegrative disorder. Going forward, a person will be diagnosed as having autism spectrum disorder Level 1, Level 2 or Level 3.

2) Why did they revise this area of the DSM?

Understanding and knowledge of autism and autism-related disorders has grown extensively since DSM-IV introduced the term autism spectrum disorder 20 years ago. The above change was suggested since it is understood that the four previous conditions are, indeed, levels of autism.

3) What does this change mean for families?

First of all, the new definition of autism spectrum disorder allows for earlier diagnosis in pre-school children. The previous definition was really geared towards the school-aged child. It is a great advantage to have an earlier diagnosis in preparation for school.

Secondly, this change also provides a more detailed definition of autism. Up until now, the definition of “autistic” varied from state to state. This meant that children diagnosed with PDD-NOS, childhood disintegrative disorder or Asperger’s syndrome would not be able to receive the same treatment or educational assistance from one state to the other, or be eligible for individual education plans in schools.

Thirdly, it is hoped that providing the new diagnosis of ASD would also open up insurance coverage for treatments or therapies that had been previously available only to those with an ASD diagnosis. (3)

To read more on how the changes to the definition of Autism Spectrum Disorder go to Autism changes in the DSM V: A step toward clarifying a confusing diagnosis by Melissa Nishawala, MD.

You can also check out The proposed DSM-5 changes with regard to ASD by Michelle Garcia Winner.


1. Highlights of Changes from DSM-IV-TR to DSM-5. American Psychiatric Association. Web. Accessed: Jan 27, 2014.
http://www.dsm5.org/Documents/changes from dsm-iv-tr to dsm-5.pdf

2. Autism Spectrum Disorder. American Psychiatric Association. Web. Accessed: Jan 27, 2014.
http://www.dsm5.org/Documents/Autism Spectrum Disorder Fact Sheet.pdf

3. The proposed DSM-5 changes with regard to ASD. Winner, Michelle Garcia. Autism Support Network. Web. Accessed: Jan 28, 2014.

4. Updates to the APA in DSM-V – What do the changes mean to families living with Autism? Compart, Pamela. Autism Research Institute. Web. Accessed: Jan 27, 2014.

5. Autism changes in the DSM V: A step toward clarifying a confusing diagnosis. Nishawala, Melissa. NYU Langone Medical Center The Child Study Center. Web. Accessed: Jan 27, 2014.

Reviewed January 29, 2014
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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