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Annual research review: re-thinking the classification of autism spectrum disorders
Open accessAbstract
Background: The nosology of autism spectrum disorders (ASD) is at a critical point in history as the field seeks to better define dimensions of social‐communication deficits and restricted/repetitive behaviors on an individual level for both clinical and neurobiological purposes. These different dimensions also suggest an increasing need for quantitative measures that accurately map their differences, independent of developmental factors such as age, language level and IQ. Method: Psychometric measures, clinical observation as well as genetic, neurobiological and physiological research from toddlers, children and adults with ASD are reviewed. Results: The question of how to conceptualize ASDs along dimensions versus categories is discussed within the nosology of autism and the proposed changes to the DSM‐5 and ICD‐11. Differences across development are incorporated into the new classification frameworks. Conclusions: It is crucial to balance the needs of clinical practice in ASD diagnostic systems, with neurobiologically based theories that address the associations between social‐communication and restricted/repetitive dimensions in individuals. Clarifying terminology, improving description of the core features of ASD and other dimensions that interact with them and providing more valid and reliable ways to quantify them, both for research and clinical purposes, will move forward both practice and science.
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“More specifically, individuals with ASD with low nonverbal IQs, compared to those with greater cognitive abilities, show increased repetitive behaviors (Gabriels et al. 2005) and greater social–communication difficulties (Lord and Jones 2012).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Lord and Jones 2012
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“Language ability has also been linked to outcomes, such that individuals with minimal verbal abilities often show more severe ASD symptoms (Lord and Jones 2012) and greater intellectual impairment (Luyster et al. 2008).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Lord and Jones 2012
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“The major rationale behind these changes is to improve reliability [3].”
From Subgrouping the Autism Spectrum: Reflections on DSM-5 (2013) · cites this paper as [3]
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“Many argue that categorical and dimensional approaches are fluid, such that dimensions can become categories by defining thresholds, and categories can become dimensions by combining constructs to allow for common core features with accompanying variation, as is seen in the transition from DSM-IV to DSM-5 (see Fig. 1; Pickles and Angold 2003; Lord and Jones 2012).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Lord and Jones 2012
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“While the relationship between IQ and symptom severity is unsurprising given individuals with lower cognitive abilities likely possess fewer strategies to compensate for ASD-specific deficits (Lord and Jones 2012), it is important to consider these associations when disentangling the effects of ASD and IQ on phenotypic profiles.”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Lord and Jones 2012
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“The age at which caregivers recognize symptoms is often different from the age at which professionals diagnose ASD, which are both often different from the age at which the symptoms may actually emerge (Lord and Jones 2012).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Lord and Jones 2012
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“Notably, however, while conceptualized through clinical observation, the DSM-5 and ICD-11 criteria included within each domain are not empirically-defined dimensions (Lord and Jones 2012).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Lord and Jones 2012
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Metadata
- Authors
- Lord, C., & Jones, R. M.
- Affiliations
- Weill Cornell Medicine (US)
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2012-04-04
- Volume
- 53
- Issue
- 5
- Pages
- 490-509
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC3446247
- OpenAlex
- W2109246429
- Cited by
- 290
- References
- 182
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 9 · 2023: 10 · 2022: 12 · 2021: 18 · 2020: 18 · 2019: 20 · 2018: 18 · 2017: 22 · 2016: 30 · 2015: 24 · 2014: 34 · 2013: 39 · 2012: 17
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5rc1mh089721-02)
- U.S. Public Health Service (UA3-MC-1055)
- National Institute of Mental Health (MH 081873, RC1 MH-089721, R01MH078165, MH 081757, MH 089721, R01MH081757, R01MH081873, MH078165)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, disease classification, DSM-5, ICD-11, social communication deficits, restricted and repetitive behaviors, quantitative indicators, developmental differences, diagnostic criteria
- MeSH terms
- Adult, Child, Child Development Disorders, Pervasive, Child Psychiatry, Child, Preschool, Humans, Psychometrics, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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