A 4-year-old child fails to respond to his name, makes no eye contact, has not developed any words, engages in repetitive hand-flapping, and insists on rigid routines. There is no history of regression after normal development. He scores in the severe range on the Autism Diagnostic Observation Schedule (ADOS-2). Which DSM-5 change is MOST relevant to this case?
- A Asperger's disorder is now a separate diagnosis in DSM-5
- B DSM-5 requires regression of skills after normal development for ASD diagnosis
- C DSM-5 added a separate Social Communication Disorder category only for children without language delay
- D DSM-5 collapsed the previous subtypes (Autistic Disorder, Asperger's, PDD-NOS) into a single diagnosis: Autism Spectrum Disorder ✓
Explanation
A major DSM-5 change was merging the DSM-IV subtypes—Autistic Disorder, Asperger's Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder–Not Otherwise Specified—into a single unified diagnostic category: Autism Spectrum Disorder (ASD). ASD is diagnosed based on two core domains: (1) persistent deficits in social communication and interaction, and (2) restricted, repetitive patterns of behavior/interests/activities. Severity specifiers (levels 1–3) replace the old subtypes. Social Communication Disorder is a new DSM-5 diagnosis for those with pragmatic language deficits without restricted repetitive behaviors.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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Written and medically reviewed by the StethoPrep medical team.