Exploring the proposed DSM-5 criteria in a clinical sample.

Azin and coworkers looked at kids who already had an autism label under the old DSM-IV rules. They asked how many would still qualify under the new DSM-5 checklist.

The team used a small clinic sample. They scored each child again with the stricter DSM-5 rules for autism spectrum disorder.

Only 63 out of every 100 kids kept the ASD label. Kids whose old label was classic Autistic Disorder mostly stayed in, but kids with the PDD-NOS label mostly dropped out.

In plain numbers, 81 percent of Autistic Disorder cases still fit, while only 17 percent of PDD-NOS cases did.

Yaylaci et al. (2017) ran almost the same check and got the same one-fifth drop, so the early warning held up.

Whitehouse et al. (2014) and Heald et al. (2020) pooled many studies and still found a one-third cut, showing the 2012 signal was not a fluke.

Rispoli et al. (2011) helps explain why PDD-NOS kids lose the label. They showed PDD-NOS is mostly social-communication problems without repetitive behaviors, and DSM-5 now requires both.

If you reassess a teen who carries an old PDD-NOS diagnosis, do not assume automatic eligibility under DSM-5. Re-score with the new criteria and document repetitive behaviors. If the child no longer meets ASD, plan for alternative codes like Social Communication Disorder so services stay in place.