title: Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders.
abstract: OBJECTIVE
  Substantial revisions to the DSM-IV criteria for autism spectrum disorders (ASDs) have been proposed in efforts to increase diagnostic sensitivity and specificity. This study evaluated the proposed DSM-5 criteria for the single diagnostic category of autism spectrum disorder in children with DSM-IV diagnoses of pervasive developmental disorders (PDDs) and non-PDD diagnoses.
  
  
  METHODS
  Three data sets included 4,453 children with DSM-IV clinical PDD diagnoses and 690 with non-PDD diagnoses (e.g., language disorder). Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) and clinical observation instrument (Autism Diagnostic Observation Schedule) were matched to DSM-5 criteria and used to evaluate the sensitivity and specificity of the proposed DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses.
  
  
  RESULTS
  Based on just parent data, the proposed DSM-5 criteria identified 91% of children with clinical DSM-IV PDD diagnoses. Sensitivity remained high in specific subgroups, including girls and children under 4. The specificity of DSM-5 ASD was 0.53 overall, while the specificity of DSM-IV ranged from 0.24, for clinically diagnosed PDD not otherwise specified (PDD-NOS), to 0.53, for autistic disorder. When data were required from both parent and clinical observation, the specificity of the DSM-5 criteria increased to 0.63.
  
  
  CONCLUSIONS
  These results suggest that most children with DSM-IV PDD diagnoses would remain eligible for an ASD diagnosis under the proposed DSM-5 criteria. Compared with the DSM-IV criteria for Asperger's disorder and PDD-NOS, the DSM-5 ASD criteria have greater specificity, particularly when abnormalities are evident from both parents and clinical observation.
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, USA. mah2046@med.cornell.edu
authors.forename: Marisela
authors.initials: M
authors.lastname: Huerta
authors.forename: Somer L
authors.initials: SL
authors.lastname: Bishop
authors.forename: Amie
authors.initials: A
authors.lastname: Duncan
authors.forename: Vanessa
authors.initials: V
authors.lastname: Hus
authors.forename: Catherine
authors.initials: C
authors.lastname: Lord
mesh_terms: D000293:Adolescent; D020817:Asperger Syndrome / Q000175:diagnosis; D001321:Autistic Disorder / Q000175:diagnosis; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis*; D002675:Child, Preschool; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D012680:Sensitivity and Specificity