title: DSM Criteria that Best Differentiate Intellectual Disability from Autism Spectrum Disorder.
abstract: Clinical characteristics of autism spectrum disorder (ASD) and intellectual disability (ID) overlap, creating potential for diagnostic confusion. Diagnostic and statistical manual of mental disorders (DSM) criteria that best differentiate children with ID and some ASD features from those with comorbid ID and ASD were identified. Records-based surveillance of ASD among 8-year-old children across 14 US populations ascertained 2816 children with ID, with or without ASD. Area under the curve (AUC) was conducted to determine discriminatory power of DSM criteria. AUC analyses indicated that restricted interests or repetitive behaviors best differentiated between the two groups. A subset of 6 criteria focused on social interactions and stereotyped behaviors was most effective at differentiating the two groups (AUC of 0.923), while communication-related criteria were least discriminatory. Matching children with appropriate treatments requires differentiation between ID and ASD. Shifting to DSM-5 may improve differentiation with decreased emphasis on language-related behaviors.
authors: Department of Psychology and Child Development, California State University, Stanislaus, One University Circle, Turlock, CA, 95382, USA. apedersen1@csustan.edu.
authors: Anita L
authors: AL
authors: Pedersen
authors: Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
authors: Sydney
authors: S
authors: Pettygrove
authors: Statistical Consulting Laboratory, Bio5 Institute, The University of Arizona, Tucson, AZ, USA.
authors: Zhenqiang
authors: Z
authors: Lu
authors: Department of Pediatrics, College of Medicine, The University of Arizona, Tucson, AZ, USA.
authors: Jennifer
authors: J
authors: Andrews
authors: Department of Pediatrics, College of Medicine, The University of Arizona, Tucson, AZ, USA.
authors: F John
authors: FJ
authors: Meaney
authors: Department of Genetics and Developmental Pediatrics, College of Medicine, The University of Arizona, Tucson, AZ, USA.
authors: Margaret
authors: M
authors: Kurzius-Spencer
authors: Department of Epidemiology and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Li-Ching
authors: LC
authors: Lee
authors: Department of Population Health Sciences and Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
authors: Maureen S
authors: MS
authors: Durkin
authors: Division of Medical Genetics, Weill Cornell Medical College, New York, NY, USA.
authors: Christopher
authors: C
authors: Cunniff
mesh_terms: D000067877:Autism Spectrum Disorder / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D012919:Social Behavior; D013239:Stereotyped Behavior / Q000502:physiology
keywords: Autism spectrum disorder; DSM; Differential diagnosis; Intellectual disability; Restricted interests/repetitive behaviors