title: The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis?
abstract: The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20-47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When applying a mild level of impairment (cutoff: 1 SD below the mean on the VABS), 88 % of the cases fulfilled the impairment criterion. Sixty-nine percent fulfilled the impairment criterion at a moderate level (1.5 SDs) and 33 % at a severe level (2 SDs). Findings indicate that a strict application of the new DSM-5 impairment criterion might compromise early diagnosis of ASD.
authors.affiliation: Pediatric Neuropsychiatry Unit, Department of Children's and Women's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden. eric.zander@ki.se.|Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden. eric.zander@ki.se.
authors.forename: Eric
authors.identifier: http://orcid.org/0000-0002-2267-5813
authors.initials: E
authors.lastname: Zander
authors.affiliation: Pediatric Neuropsychiatry Unit, Department of Children's and Women's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden.|Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
authors.forename: Sven
authors.initials: S
authors.lastname: Bölte
mesh_terms: D000367:Age Factors; D000067877:Autism Spectrum Disorder / Q000175:diagnosis*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012737:Sex Factors
keywords: Adaptive functioning; Assessment; Classification; Neurodevelopmental disorders; Psychiatry