The increased use and acceptance of the Autism diagnosis began to rise dramatically in the early 2000s. Much of the focus has been on children on the spectrum and the supports which are needed for them to have the greatest quality in life. In 2020, clinicians are now faced with the growing number of adults who have been given a ASD diagnosis. While there are some programs with funding to assist this population, this country is not prepared to economically or physically support the percentage of people who will need these services. The attached article discusses concerns for ASD patients and employment. There are similar discussions surrounding housing and health care. Clinicians will be faced with providing therapy and supports to individuals who are ASD but do not have access to programs. How can we utilize behavioral therapy as a support for these individuals? What steps can be taken to promote high rates of employment and housing stability for these individuals? What argument can be made for a shift in the thought process of how we can assist individuals aging with Autism?
This week we are going to review the neurodevelopmental disorder, autism spectrum disorder. Please read the entire section on the Neurodevelopmental Disorders (pp. 31-86) in the DSM-5 (2013) so that you start to have an understanding how these disorders relate. Here is an excerpt written by the American Psychological Association(2013) that describes the development of the criteria for Autism Spectrum Disorder (ASD):
The Neurodevelopmental Work Group, led by Susan Swedo, MD, senior investigator at the National Institute of Mental Health, recommended the DSM-5 criteria for ASD to be a better reflection of the state of knowledge about autism. The Work Group believes a single umbrella disorder will improve the diagnosis of ASD without limiting the sensitivity of the criteria, or substantially changing the number of children being diagnosed.
People with ASD tend to have communication deficits, such as responding inappropriately in conversa-tions, misreading nonverbal interactions, or having difficulty building friendships appropriate to their age. In addition, people with ASD may be overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items. Again, the symptoms of people with ASD will fall on a continuum, with some individuals showing mild symptoms and others having much more severe symptoms. This spectrum will allow clinicians to account for the variations in symptoms and behaviors from person to person.
Under the DSM-5 criteria, individuals with ASD must show symptoms from early childhood, even if those symptoms are not recognized until later. This criteria change encourages earlier diagnosis of ASD but also allows people whose symptoms may not be fully recognized until social demands exceed their capacity to receive the diagnosis. It is an important change from DSM-IV criteria, which was geared toward identifying school-aged children with autism-related disorders, but not as useful in diagnosing younger children.
The DSM-5 criteria were tested in real-life clinical settings as part of DSM-5 field trials, and analysis from that testing indicated that there will be no significant changes in the prevalence of the disorder. More recently, the largest and most up-to-date study, published by Huerta, et al, in the October 2012 issue of American Journal of Psychiatry, provided the most comprehensive assessment of the DSM-5 criteria for ASD based on symptom extraction from previously collected data. The study found that DSM-5 criteria identified 91 percent of children with clinical DSM-IV PDD diagnoses, suggesting that
most children with DSM-IV PDD diagnoses will retain their diagnosis of ASD using the new criteria. Sev-eral other studies, using various methodologies, have been inconsistent in their findings.(DSM-5 Autism Spectrum Disorder fact sheet, 2013).
American Psychiatric Association (2013). Autism Spectrum Disorder, DSM-5 Collection, retrieved from: www.psychiatry.org.