Frontline Initiative Autism Spectrum Disorder

The DSM-IV-TR and DSM-5:
A primer for DSPs

Since the mid-20th Century, the American Psychiatric Association (APA) has published a tool to describe and differentiate various mental disabilities and their characteristics. This tool is the Diagnostic Statistical Manual of Mental Disorders (DSM). The DSM is periodically revised as society’s understanding of disorders advances. The DSM-IV-TR is the fourth edition with text revisions, thus the IV-TR in its title. It was released in 2000. The DSM-5 is the fifth edition of the APA’s classification system and will be released in the spring of 2013. When the DSM-5 is released, the language and definitions from the DSM-IV-TR will still be in the records of the individuals you support. Many people may still use terms from the DSM-IV-TR during the transition to the DSM-5. Given that you will likely come across both conceptualizations of autism, it is important to have an understanding of both the old and the new definitions. The DSM-5 will include 3 major changes related to autism. The 3 major changes are —

  • The five subcategories of autism will be eliminated and included under the umbrella term Autism Spectrum Disorder (ASD).
  • Severity levels of characteristics from mild to severe will be based on the amount of support needed (as opposed to a simple yes or no of presence of the characteristic).
  • Instead of the three deficit areas used in the DSM-IVTR (communication, social, and behaviors/routines), the DSM-5 will instead utilize two deficit areas: 1) social communication and interaction, and 2) restrictive, repetitive patterns of behavior, interests, or activities.

The APA has confirmed that all individuals who currently have an autism diagnosis under the DSM-IV-TR criteria will be able to retain the diagnosis. This means that no one with a current diagnosis will lose their diagnosis (or corresponding services) because of the changes in the DSM-5. However, individuals who currently hold these diagnoses may receive a different diagnosis when reevaluated.

A person or family you support may be concerned about the DSM changes. You can help by sharing this article and more information from The American Psychiatric Association .