The role of prenatal, obstetric and neonatal factors in the development of autism.

Abstract: The American Psychiatric Association has revised the diagnostic criteria for their DSM-5 manual. Important changes have been made to the diagnosis of the current (DSM-IV) category of Pervasive Developmental Disorders. This category includes Autistic Disorder (autism), Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The DSM- 5 deletes Asperger’s Disorder and PDD-NOS as diagnostic entities. This change may have unintended consequences, including the possibility that the new diagnostic framework will adversely affect access to developmental interventions under Individuals with Disabilities Education Act (IDEA) programs, Early Intervention (for birth to 2 years olds) and preschool special education (for 3 and 4 years olds). Changing the current diagnosis of PDD-NOS to a “Social Communication Disorder” focused on language pragmatics in the DSM-5 may restrict eligibility for IDEA programs and limit the scope of services for affected children. Young children who meet current criteria for PDD-NOS require more intensive and multi-disciplinary services than would be available with a communication domain diagnosis and possible service authorization limited to speech-language therapy. Intensive behavioral interventions, inclusive group setting placements, and family support services are typically more available for children with an autism spectrum disorder than with diagnoses reflecting speech-language delay. The diagnostic distinction reflective of the higher language and social functioning between Asperger’s Disorder and autism is also undermined by eliminating the former as a categorical diagnosis and subsuming it under autism. This change may adversely affect treatment planning and misinform parents about prognosis for children who meet current criteria for Asperger’s Disorder. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Subjects: *American Psychological Association; *Diagnostic and Statistical Manual; *Pervasive Developmental Disorders; Diagnosis

PsycINFO
Classification: Developmental Disorders & Autism (3250)

Title: The role of prenatal, obstetric and neonatal factors in the development of autism.

Authors: Dodds, Linda, Perinatal Epidemiology Research Unit, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada, l.dodds@dal.ca
Fell, Deshayne B., Perinatal Epidemiology Research Unit, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
Shea, Sarah, Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
Armson, B. Anthony, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
Allen, Alexander C., Perinatal Epidemiology Research Unit, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada