Teaching Students w/ASD 1.2: DSM IV vs. DSM V and the Importance of Early Diagnosis

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What is Autsim?

Autism is a complex condition that affects brain development and results in differences in social interaction, communication, interests and behaviour. (British Columbia Ministry of Health, n.d.)

Three domains affected: Social interactions, communication, and interests and behavior in the DSM IV and now only 2 areas observed for diagnosis: social impairment and ritualistic behaviour. (Alder et. al, 2014)

Importance

An ASD diagnosis is highly important for early intervention which leads to overall better outcomes for a child, access to funding and services, and comfort in understanding one’s neurodiversity.  Early diagnosis has shown to be successful, according to Adler et al,  in improving cognitive scores, social interactions, and adaptive behavior as well as improved communication skills. (2014) Diagnosis also provides patients and caregivers with access to funds for medical services.

In British Columbia, the importance of early diagnosis is evident in the funding model. There is a large amount of funding, up to $22,000,  per year available for children with ASD under 6 years old, which plummets to up to $6000 per year from ages 6 to 18. This large amount of funding for under 6 years of age is for intense intervention like a behavioral intervention plan, access to specialists, and training for caregivers. (BC Ministry of Children and Family Development, 2017, p. 10-11) In a way, it’s sad that the funding drops so much, especially as we see most children are diagnosed at school age. 

The diagnosis is also important for individuals and their families because individuals with ASD finally have answers explaining how and why they may think and do things differently and so do caregivers. 

Challenges

Challenges that exist in getting diagnosed include the possible stigma and discrimination to the individual receiving the diagnosis and well as financial barriers in the U.S. since private health insurance companies include ASD in pre-existing conditions increasing the cost for insurance for those with the diagnosis. We're we have access to subsidized healthcare here in British Columbia, but I imagine the cost for specialists would be exorbitant.

Additional challenges are present in the diagnosis process itself since there are so many variables “including parent reports, the provider of testing, their educational background, standardized objective measures, evaluation process, and the patient’s involvement,” in addition to the diversity of traits of patients. (Adler et al., 2014, p. 15) 

I found it particularly interesting that the attire a clinician wears during an examination could also interfere -I hadn’t thought about how something I might perceive as mundane could have such an impact. 

References:

Adler et al. (2014). Evolution of Autism: From Kanner to the DSM-V: In J. Taxton, Handbook of Early Intervention for Autism Spectrum Disorders (pp.3-19)

British Columbia Ministry of Health. (n.d.). What is autism?. Retrieved from https://www2.gov.bc.ca/gov/content/health/managing-your-health/child-behaviour-development/special-needs/autism-spectrum-disorder/about-autism

BC Ministry of Children and Family Development. (2017). A parents handbook: your guide to autism programs. Victoria, BC., (pp. 10-11)