DSM-5 ASD moves forward into the past.
The old autism subtypes still show real skill gaps, so don’t throw away your Asperger and PDD-NOS checklists yet.
01Research in Context
What this study did
The authors read 162 studies that compared autistic disorder, Asperger’s disorder, and PDD-NOS.
They asked: do the three old groups really look the same on ability, language, and daily living skills?
This was a narrative review, so they counted how many papers found differences instead of running new stats.
What they found
Most studies still saw clear gaps among the subtypes in IQ, speech, and adaptive behavior.
The team says the evidence is too strong to squash everyone into one DSM-5 label.
How this fits with other research
Edgin et al. (2017) later tracked real kids and agreed: DSM-5 catches classic autism but misses many former Asperger and PDD-NOS cases.
Sharma et al. (2012) looked only at Asperger studies and also doubted the split, yet their worry was overlap, not loss of mild cases.
Zander et al. (2015) adds toddlers to the story: two-thirds who once qualified would fail DSM-5’s stricter impairment rule.
Together the papers extend the same warning—DSM-5 may drop the very clients who need supports.
Why it matters
Keep your older tools—ADOS modules, ADI-R algorithms, or GARS subscale scores—handy when you assess bright or verbose clients.
Document both DSM-5 criteria and the older subtype profile; it helps justify services if payers question severity.
Watch for quiet girls, articulate teens, or any child who once carried an Asperger label—they remain at risk of under-identification today.
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02At a glance
03Original abstract
The fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) (APA in diagnostic and statistical manual of mental disorders, Author, Washington, 2013) has decided to merge the subtypes of pervasive developmental disorders into a single category of autism spectrum disorder (ASD) on the assumption that they cannot be reliably differentiated from one another. The purpose of this review is to analyze the basis of this assumption by examining the comparative studies between Asperger's disorder (AsD) and autistic disorder (AD), and between pervasive developmental disorder not otherwise specified (PDDNOS) and AD. In all, 125 studies compared AsD with AD. Of these, 30 studies concluded that AsD and AD were similar conditions while 95 studies found quantitative and qualitative differences between them. Likewise, 37 studies compared PDDNOS with AD. Nine of these concluded that PDDNOS did not differ significantly from AD while 28 reported quantitative and qualitative differences between them. Taken together, these findings do not support the conceptualization of AD, AsD and PDDNOS as a single category of ASD. Irrespective of the changes proposed by the DSM-5, future research and clinical practice will continue to find ways to meaningfully subtype the ASD.
Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-013-1870-3