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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_1332,h_1000,fp_0.50_0.50,q_35,blur_30,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png)
![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_1364,h_1024,fp_0.50_0.50,q_95,enc_avif,quality_auto/904f97_7ed4d390f69f44a3bee34406e457dba0~mv2.png)
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
Nov 238 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
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
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