As knowledge and understanding of the spectrum evolves the criteria for diagnosis are subject to review and refinement. Since publication of DSM V the Scottish Intercollegiate Guidelines Network (SIGN) have reviewed and drawn up a new guideline, SIGN145
The new guideline covers all ages and replace previous guideline that only covered children and young people. They also acknowledge that autism can present differently in women and girls.
Other changes in DSM V incorporated in the new guideline include;
- the previously separate subcategories including Asperger syndrom and PDD-NOS, will beincluded in the broad term autism spectrum disorder (ASD).
- Instead of three areas (social impairment, language/communication impairment and repetitive/restricted behaviors), two categories will be used: social communication impairment and restricted interests/repetitive behaviors.
- diagnosis will require a person to exhibit three deficits in social communication and at least two symptoms in the category of restricted range of activities/repetitive behaviors. Within the second category, a new symptom will be included: hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment.
A diagnosis of autism can:
- help signpost appropriate support
- help provide an understanding of the challenges and impact of these for the individual
- help an individual understand the difficulties they have been having
- signpost further training needs
- provide useful information to other agencies
- come with co-existing diagnosis
- use a variety of terminology
- be a lengthy process
- involve a number of agencies
Support in school should not depend on a diagnosis if difficulties are recognised. Staff concerns should be discussed with parents with view to referral to psychologist, Speech and Language Therapist or GP for further assessment. However it is often parents who will have initiated a referral for diagnosis.
Often autism comes with a co-existing diagnosis, the most common being Attention deficit hyperactivity disorder (ADHD), Dyslexia, Dyspraxia, Epilepsy and, In recent years, Pathological Demand Avoidance Syndrome (PDA) has been increasingly recognised as part of the autism spectrum.
It is also increasingly recognised that young people with A.S.D may have co-existing mental health disorders such as anxiety and depression.