DSM-5

Apparently this week or sometime here recently, a study was done on how the DSM5 is going to affect the world of Autism. Basically the study showed that a huge majority of those dx on the spectrum will no longer be considered to have Autism. I had reviewed the changes earlier last year but didn't really go over all the details. This worried me a bit so I took a closer look. In some ways, the new criteria will be *better* for Michael, but there is one criteria that has to be met which I'm worried about. When Michael was dx past July, one of the main reasons he was dx with PDD-NOS and not Autism was due to the fact he *does* make eye contact. However, it's mostly with those close to him. The speech therapist noted in her records that his eye contact is poor.
 
This, however is the exact requirement and the only one I'm afraid the doc might say he doesn't meet which would completely boot him off the spectrum:

 2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

I'm not an expert on nonverbal communication in young kids so other than the eye contact, I don't know what they would be looking for!

Here are the full proposed changes. I'll bold the ones that I KNOW he meets.

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:

A.    Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,

2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people

B.    Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following:

1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases). 

2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C.    Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D.         Symptoms together limit and impair everyday functioning.

It seems a bit insane to me that he would completely lose his dx based on a simple thing as him giving me eye contact. That basically downplays the real meat of his issues!