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![The 5th edition, published in 2013, set out to simplify and modernise the nosology of autism-related disorders, replacing the DSM-IV’s cluster of Pervasive Developmental Disorders (PDDs) — Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Disorder[1] and PDD-Not Otherwise Specified (PDD-NOS) — with a single diagnosis: Autism Spectrum Disorder (ASD). The intent was, in principle, laudable: a spectrum captures gradation and avoids splits between “high-” and “low-functioning” labels. In practice, DSM-5 produced a conceptual flattening by collapsing important distinctions and introduced criteria so under-specified they undermine diagnostic coherence – creating a set of internal contradictions that have done more to muddy than to clarify diagnosis.](https://static.wixstatic.com/media/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png/v1/fill/w_333,h_250,fp_0.50_0.50,q_35,blur_30,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.webp)
![The 5th edition, published in 2013, set out to simplify and modernise the nosology of autism-related disorders, replacing the DSM-IV’s cluster of Pervasive Developmental Disorders (PDDs) — Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Disorder[1] and PDD-Not Otherwise Specified (PDD-NOS) — with a single diagnosis: Autism Spectrum Disorder (ASD). The intent was, in principle, laudable: a spectrum captures gradation and avoids splits between “high-” and “low-functioning” labels. In practice, DSM-5 produced a conceptual flattening by collapsing important distinctions and introduced criteria so under-specified they undermine diagnostic coherence – creating a set of internal contradictions that have done more to muddy than to clarify diagnosis.](https://static.wixstatic.com/media/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png/v1/fill/w_305,h_229,fp_0.50_0.50,q_95,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.webp)
When a Spectrum Becomes a Vacuum: How DSM-5 Broke Autism Diagnosis and Fed a Diagnostic Epidemic
A Simplification That Simplifies Nothing The 5 th edition, published in 2013, set out to simplify and modernise the nosology of autism-related disorders, replacing the DSM-IV’s cluster of Pervasive Developmental Disorders (PDDs) — Autistic Disorder, Asperger’s Disorder, Childhood Disintegrative Disorder, Rett’s Disorder [ 1 ] and PDD-Not Otherwise Specified (PDD-NOS) — with a single diagnosis: Autism Spectrum Disorder (ASD). The intent was, in principle, laudable: a spectrum
5 days ago8 min read


Diagnostic Stability of Autism Before the Concept of Spectrum
The question of how stable an autism diagnosis is over time has long been debated. While many families and clinicians view an autism diagnosis as lifelong, research suggests that diagnostic stability—how consistently a diagnosis persists over time—depends heavily on which diagnostic framework is used. Emerging evidence indicates that before the introduction of the broader ASD category in the DSM-5 (APA 2013), autism diagnoses were more stable and predictable. Before DSM-5: D
Nov 73 min read


In Memory of Donna Williams (1963-2017)
12 October 2025 would have been Donna Williams’ 62 nd birthday — a day to remember not only an extraordinary woman but also a mind...
Oct 133 min read


Camouflage and Autism (1): Beyond the Autism-Specific Narrative
Over the past two decades, research on autism has expanded at an extraordinary pace. Studies on prevalence, lived experience, and...
Sep 217 min read


Autism Diagnosis Today (2): Dediagnosing
In the past two decades, our societies have become more fluent in the language of mental health. Public campaigns encourage people to...
Sep 55 min read


The Prevalence Inflation Hypothesis and Autism Overdiagnosis
Over the past decade, mental health awareness campaigns have expanded significantly across the Western world. These efforts, ranging from...
Aug 285 min read


Autism Diagnosis Today (1): Overdiagnosis
Autism has undergone a remarkable transformation in recent decades. Once thought of as a rare and narrowly defined childhood condition,...
Aug 205 min read


Regression in Autism (3):
In most cases, ASD is diagnosed between 15 and 30 months. Some children exhibit typical early development, only to lose acquired language and social skills between 15 and 30 months. These cases qualify as regressive autism.
However, there are instances of late onset autism where individuals appear to develop typically until adolescence or even adulthood before displaying symptoms consistent with autism. In such cases, an identifiable neurological insult, such as, e.g, herpes
Jul 107 min read


Regression in Autism (2):
Regression in autism, often seen within the first two years of life, represents a distinct subtype of autism that has sparked considerable scientific interest. While the exact causes of regression are still not fully understood, current research points to a combination of genetic, environmental, metabolic, immune, and neurological factors.
Jul 45 min read
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