The Diagnostic and Statistical Manual of Mental Disorders, or DSM, has long been the tool most often used to render a diagnosis of autism in the United States. The upcoming version of the DSM is already drawing criticism in regard to the diagnosis of Asperger's Syndrome (AS). The current proposal will group all of the autistic disorders under one umbrella term, Autism Spectrum Disorders (ASDs), which would be accompanied by a severity scale. Though a strong argument can be made for considering AS a separate diagnostic category, as the needs of persons with it are different than the needs for those more severely affected, AS is already considered an ASD and the proposed change will likely have little impact.
Perhaps the most pressing concern about the DSM is that the reliability of diagnoses rendered by different clinicians is often poor. For ASDs, and many other mental health disorders, structured tools have been developed to aid in rendering valid diagnoses. The best diagnostic tool for diagnosing autism is thought to be the Autism Diagnostic Observation Schedule (ADOS). Administering the ADOS consists of exposing a child to a series of tasks and a diagnosis is rendered based upon how the child performs on these tasks. There are clear guidelines for scoring the child's performance on these tasks and, in general, the ADOS is considered a reliable means of obtaining a valid diagnosis. Using the ADOS is far superior to a clinician's use of the DSM. That said, the ADOS is still a clinician's impression that is translated into a diagnosis.
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