Colton McKee

DSM-5 Reflection #1 - Low Incidence Exceptionalities (Autism Spectrum

Disorder)

In what follows I attempt to parse the changes present in the Ministrys

Special Education manual, which gleans its diagnostic protocol from
the DSM IV and the document titled Autism Spectrum Disorder (DSM5, 2013). What is more, in an attempt to analyze the implications of
shifting diagnostic requirements, this paper comprehensively explores
what said changes in diagnostic policy may mean form my professional
practice.
In analyzing the two documents already mentioned, the
immediate fairly significant change is the DSM-5 subsumes autistic
disorder, Asperger's disorder, childhood disintegrative disorder, and
pervasive developmental disorder not otherwise specified (PDD-NOS)
all distinct exceptionalities in DSM-IVinto one category called autism
spectrum disorder (ASD). The overarching premise that underwrites
this divergent modus operandi is that insofar as the abovementioned
conditions all have similar or analogous symptoms, the need to
classify each exceptionality into separate categories is unnecessary
and perhaps even counter-productive. Instead, the DSM-5 places each
condition along a continuum.
Broadly speaking, the diagnostic criteria for autistic disorder in
DSM-IV, learners must demonstrate 6/12 symptoms, which are further
divided into three groups: deficits in social interaction; deficits in
communication; and repetitive and restricted behaviours and interests.
Contrastingly, the DSM-5 designates seven symptoms of ASD into two
central categories: 1) deficits in social communication and social

Colton McKee
DSM-5 Reflection #1 - Low Incidence Exceptionalities (Autism Spectrum
Disorder)

interaction; 2) and restricted, repetitive behaviours and interests. For

example, on page 2 of the document Autism Spectrum Disorder (DSM5, 2013), the text describes the central criteria for diagnosing ASD:
The essential features of autism spectrum disorder are
persistent impairment in reciprocal social
communication and social interaction (Criterion A), and
restricted, repetitive patterns of behavior, interests, or
activities (Criterion B). These symptoms are present
from early childhood and limit or impair everyday
functioning (Criteria C and D).
What is more, the DSM-5 adds a severity ranking of level 1, 2 or 3. As
such this rating ostensibly advises parents and teachers as to the level
of support the learner with ASD requiresthat to say, some learners
will have mild ASD symptoms, while others will have more severe
symptoms. Additionally, the creation of Disruptive Mood Disorder (for
those students who demonstrate persistent irritability and recurrent
episodes of behavioural disruptions or outbursts 3x per week for more
than a year ) could create the space for over diagnosing DMD.
Let me turn now to the implications such changes in policy will
have on my professional practice. Firstly, if a student was diagnosed
with DSM-IV their IEP will (or should) not change. Notwithstanding the
likelihood that some students will be diagnosed under new diagnostic
protocols, their educational needs will remain the same. That is, IEPs
are designed to meet the learning needs of each individual student and
is not contingent on their exceptionality. Secondly, there is one area of
concern generated from the changes in diagnosing ASD that could
have profound implications on school funding and support staff; viz.
the new proposed diagnosis of Social Communication Disorder. That is

Colton McKee
DSM-5 Reflection #1 - Low Incidence Exceptionalities (Autism Spectrum
Disorder)

to say, given that the DSM-5 has a seemingly more rigid set of
diagnostic criteria for ASD, it to also creates other exceptionalities like
SCD. Thus, those students (and the schools they attend) who are
ineligible for an ASD diagnosis under the DSM-5, may run into
challenges in terms of special education funding and educational
assistant staffing. Thirdly, the uniqueness of key indicators such as
higher language and social functioning of Aspergers in comparison to
autism is seemingly undermined by jettisoning the former and
subsuming it into the broader diagnosis that is ASD. In short, I raise
this concern because of the potential for students who are
symptomatic of what the DSM-4 labelled as Aspergers disorder being
unable to reach their potential because of policy that could shift
teachers practice to meet the needs of the more general ASD
diagnosis.

But in its efforts to make diagnosis more accurate, the APA may have
raised the bar for autism a little too high, neglecting autistic people
whose symptoms are not as severe as others. The studies also point
out, however, that minor tweaks to the DSM-5 criteria would make a
big difference, bringing autistic people with milder symptoms or sets of
symptoms that differ from classic autism back into the spectrum

Colton McKee
DSM-5 Reflection #1 - Low Incidence Exceptionalities (Autism Spectrum
Disorder)
British Columbia Ministry of Education (2016). Special education services: A
manual of policies, procedures, and guidelines
(http://www.bced.gov.bc.ca/specialed/ppandg.htm)