1. Denis J. O’Keefe, LCSW New York University
DSM 5 and Autistic Spectrum Disorders: Conceptual Analysis and Review of Tests of Specificity and Sensitivity
Denis J. O’Keefe, LCSW
New York University

2. APA’s Primary objectives in DSM-5 ASD Criteria
Increasing Specificity
Clarifying distinctions between ASD and non-ASD disorders
Research consistently shows that practitioners interpretation of criteria can vary even when our perception of the symptoms is in agreement.
Research has firmly established key identifying features of ASD
DSM-5 adds features such as sensory integration problems and difficulties with non-verbal social cues.
Stabilizing rising rates of ASD and ending “runaway diagnostic inflation”
Maintaining Sensitivity

3. Changes in diagnostic domains

5. Controversies: Is there really an autistic spectrum?
Does the DSM-5’s focus on increasing Specificity compromise Sensitivity?
What is the role of Social Communication Disorder?

6. Review of recent research on ASD Specificity and Sensitivity

7. DSM-IV vs DSM-5 diagnostic criteria for toddlers with Autism 2,721 children ages 17-36 months
DSM IV ASD v DSM 5 ASD = 52.2% qualify for ASD
DSMIV AD v DSM 5 ASD= 74.72%
DSM IV PDD v DSM 5 ASD= 21.06%
Matson, J.L., Kozlowski, A.M., Hattier, M.A., Horovitz, M., & Sipes, M. (2012). DSM-IV vs DSM-5 diagnostic criteria for toddlers with Autism. Developmental Neurorehabilitation,

8. How does relaxing the algorithm for autism affect DSM-5 Prevalence Rates
DSM-5: Results in 52.26% of DSM-IV sample
Modification 1: Required 2 of 3 criteria in deficits in social communication and interaction % of DSM-IV Sample
Modification 2: Required 2 of 3 deficits in social communication and interaction and 1 of 4 impairments in restricted, repetitive behavior % of DMS- IV sample
Matson, J.L., Hattier, M.A., & Williams, L.W. (2012). How does relaxing the algorithm for Autism affect DSM-V prevalence rates? Journal of Autism and Developmental Disorders,

9. Social Communication Disorder

10. References
Gibbs, V., Aldridge, F., Chandler, F., Witzlsperger, E. & Smith, K. (2012). Brief report: An exploratory study comparing diagnostic outcomes for Autism Spectrum Disorders under DSM-IV-TR with the proposed DSM-5 revision. Journal of Autism and Developmental Disorders,
Huerta, M., Bishop, S.L., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 criteria for Autism Spectrum Disorder to three samples of children with DSM-IV diagnoses of Pervasive Developmental Disorders. American Journal of Psychiatry,
Mandy, W.P.L., Charman, T. & Skuse, D.H. (2012). Testing the construct validity of proposed criteria for DSM-5 Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry,
Matson, J.L., Kozlowski, A.M., Hattier, M.A., Horovitz, M., & Sipes, M. (2012). DSM-IV vs DSM-5 diagnostic criteria for toddlers with Autism. Developmental Neurorehabilitation,
Matson, J.L., Hattier, M.A., & Williams, L.W. (2012). How does relaxing the algorithm for Autism affect DSM-V prevalence rates? Journal of Autism and Developmental Disorders,  
McPartland, J.C., Reichow, B. & Volkmar, F.R. (2012). Sensitivity and specificity of proposed DSM-5 diagnostic criteria for Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry,  
Taheri, A. & Perry, A. (2012). Exploring the proposed DSM-5 criteria in a clinical sample. Journal of Autism and Developmental Disorders,
Via, E., Radua, J., Cardoner, N., Nappe, F. & Mataix-Cols, D. (2011). Meta-analysis of gray matter abnormalities in Autism Spectrum Disorder. Archives of General Pscychiatry,