Autism Spectrum Disorder and DSM-5: Spectrum or Cluster?

Within the new DSM-5, the currently differentiated subgroups of Autistic Disorder (299.0), Asperger's Disorder (299.80) and Pervasive Developmental Disorder (299.80) are replaced by the more general Autism Spectrum Disorder': With regard to a patient-oriented and expedient advising therapy planning, however, the issue of an empirically reproducible and clinically feasible differentiation into subgroups must still be raised. Based on two Autism-rating-scales (ASDS and FSK), an exploratory two-step cluster analysis was conducted with N = 103 children (age: 5-18) seen in our social-pediatric health care centre to examine potentially autistic symptoms. In the two-cluster solution of both rating scales, mainly the problems in social communication grouped the children into a cluster with communication problems (51 % and 41 %), and a cluster without communication problems. Within the three-cluster solution of the ASDS, sensory hypersensitivity, cleaving to routines and social-communicative problems generated an autistic subgroup (22 %). The children of the second cluster (communication problems, 35 %) were only described by social-communicative problems, and the third group did not show any problems (38 %). In the three-cluster solution of the FSK, the autistic cluster of the two-cluster solution differentiated in a subgroup with mainly social-communicative problems (cluster 1) and a second subgroup described by restrictive, repetitive behavior. The different cluster solutions will be discussed with a view to the new DSM-5 diagnostic criteria, for following studies a further specification of some of the ASDS and FSK items could be helpful.