Journal
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
Volume 53, Issue 5, Pages 500-508Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jaac.2013.12.021
Keywords
ASD; SCD; DSM-IV; DSM-5; prevalence
Categories
Funding
- Autism Speaks Pilot Research Grant
- Brain Research Foundation
- Simons Foundation [137032 M134793]
- National Institute for Mental Health (NIMH) [5K01MH079317-02, K23MH082883]
- National Institute of Environmental Health Sciences (NIEHS) [R01 ES021462-01]
- Korean Health Technology Research and Development Project, Ministry of Health and Welfare [HI12C0021, HI12C0245-A120029]
- Jean Young and Walden W. Shaw Foundation
- Daniel X. and Mary Freedman Foundation
- Dukyoung Foundation
- [7996]
- Korea Health Promotion Institute [HI12C0245000013] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Objective: Changes in autism diagnostic criteria found in DSM-5 may affect autism spectrum disorder (ASD) prevalence, research findings, diagnostic processes, and eligibility for clinical and other services. Using our published, total-population Korean prevalence data, we compute DSM-5 ASD and social communication disorder (SCD) prevalence and compare them with DSM-IV pervasive developmental disorder (PDD) prevalence estimates. We also describe individuals previously diagnosed with DSM-IV PDD when diagnoses change with DSM-5 criteria. Method: The target population was all children from 7 to 12 years of age in a South Korean community (N = 55,266), those in regular and special education schools, and a disability registry. We used the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening. Parents of screen-positive children were offered comprehensive assessments using standardized diagnostic procedures, including the Autism Diagnostic Interview Revised and Autism Diagnostic Observation Schedule. Best-estimate clinical diagnoses were made using DSM-IV PDD and DSM-5 ASD and SCD criteria. Results: DSM-5 ASD estimated prevalence was 2.20% (95% confidence interval = 1.77-3.64). Combined DSM-5 ASD and SCD prevalence was virtually the same as DSM-IV PDD prevalence (2.64%). Most children with autistic disorder (99%), Asperger disorder (92%), and PDD-NOS (63%) met DSM-5 ASD criteria, whereas 1%, 8%, and 32%, respectively, met SCD criteria. All remaining children (2%) had other psychopathology, principally attention-deficit/hyperactivity disorder and anxiety disorder. Conclusion:. Our findings suggest that most individuals with a prior DSM-IV PDD meet DSM-5 diagnostic criteria for ASD and SCD. PDD, ASD or SCD; extant diagnostic criteria identify a large, clinically meaningful group of individuals and families who require evidence-based services.
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