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What Will the DSM5 Cost Your Child?
Potentially Everything Says Leading Psychiatrist
Will your child lose his or her health insurance, school placement, Medicaid or other services when the Diagnostic and Statistical Manual, Fifth Edition (DSM5) is published by the American Psychiatric Association in May? Dr. Allen Frances, the psychiatrist who headed the development of the current DSM4, thinks so.
Frances has led the criticism of the DSM5 for the last three years. And he puts his criticism in a nutshell in this recent article from Psychology Today:
There has been a heated controversy about the DSM-5 proposal to redefine autism. Will its dramatic changes in definition result in dramatic changes in who gets diagnosed and will this cause a big reduction in the overall rate of autism? The DSM-5 folks claim their changes will have minimal impact. My prediction has been that they will have a major impact.
Dr. Lynn Waterhouse, an autism researcher for more than thirty years, has weighed in on the issue in her recently published book, Rethinking Autism: Variation and Complexity. Dr. Waterhouse believes the DSM-5 criteria are seriously flawed and will reduce the number of diagnoses. She sent this email:
"Dr. Catherine Lord, head of the DSM-5 autism group, recently cited a data analysis she performed as conclusive evidence that DSM-5 criteria for Autism Spectrum Disorder (ASD) will "not change the number of children with clinical diagnoses."
I disagree. First off, Dr Lord did find that using the new DSM-5 criteria caused about a 10% reduction in ASD diagnoses. That's a lot of kids who will no longer qualify for the diagnosis and who will not get services.
And Dr Lord's 10% estimate is almost certainly way too low because two of her study's three data sets were not really representative of the typical children assessed for ASD. It is a very good bet that her results won't generalize very accurately to real world settings where a much larger percentage of kids would lose the diagnosis.
Other (admittedly smaller) studies tell a radically different story- one that should inspire a lot more caution in the DSM-5 group than it has. Mattila found only 46% of those given a DSM-IV diagnosis met criteria for DSM-5 ASD. Taheri and Perry found only 63% of DSM-IV patients met DSM-5 criteria. And McPartland found only 60% diagnosed with ASD under DSM-IV would get a DSM-5 ASD diagnosis.
These studies all suggest that, contrary to Dr Lord's assertion, DSM-5 will likely have a radical impact on autism diagnosis and qualification for school and mental health services.
Read the rest of the article at this link:http://www.psychologytoday.com/node/111377