The controversies surrounding the DSM-5

Quit constantly trying to put us into boxes and categories. We are human, we are not boxes nor categories.

The DSM-5 autism support levels are categories that indicate an individuals needed support in order to properly handle their disability needs. Instead of the outdated autism spectrum which left many autistics feeling unheard and unseen the autism support levels is used as a guide for individuals, families, teachers and clinicians to understand how to provide appropriate interventions and support. But, what exactly are the controversies surrounding the DSM-5?

Revision to Diagnostics

There have been several revisions to the DSM-5 since the original diagnosis criteria was formulated. The last revision was made in May 2013. This edition marked significant changes from the previous DSM-IV-TR (published in the year 2000). The new DSM-5 combined several previously separate diagnoses into one singular diagnostic of Autism Spectrum Disorder, with the aim of improving diagnosis clarity and consistency. However, these changes raised concerns about individuals who may no longer meet the criteria and thus lose access to necessary services.

The DSM-5 introduced severity levels for ASD in it’s last revision, which categorises the level of support needs for individuals. Many have argued that these levels can be too subjective and may not accurately reflect an individual’s needs over time, and is not broad enough to represent varying contexts and abilities.

Social Communication Disorder (SCD)

The DSM-5 introduced a new diagnosis, that being Social Communication Disorder (SCD). It was created in order to address difficulties in social communication without the repetitive behaviours characterised by Autism. Some professionals worry that this distinction may have created further issues as it could lead to confusion and misdiagnosis, as the boundaries between SCD and ASD can be rather blurry.

Removal of the Asperger Label

In one of it’s latest revisions the previous diagnosis once known as Asperger Syndrome was eliminated from the DSM-5 and merged into the Autism Spectrum diagnosis. This was done due to major controversies surrounding the Asperger's label that originated in the second World War by Hans Asperger. Both Hans and the Asperger label are both deeply embedded within Nazi history. After many concerns had been raised over this matter The American Psychiatric Association (APA) finally removed the label from it’s classifications (and rightfully so).

Neurodivergent Community

The Neurodiversity Movement emerged in the late 1990s and early 2000s as a social and civil rights movement that advocates for the recognition and acceptance of neurological differences as natural variations of the human genome, rather than as pathologies or disorders to be cured. This movement includes, but is not limited to, conditions such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), dyslexia, and other neurodevelopmental conditions. The Neurodiversity Movement views Autism as a part of the natural diversity of human cognition and functioning. This perspective emphasises that Autistic traits are part of an individual’s identity, rather than a defect or illness that needs to be eradicated.

Instead of focusing solely on the deficits and impairments associated with Autism, the neurodiversity perspective highlights the strengths and unique abilities that many autistic individuals possess. These can include intense focus, attention to detail, and innovative thinking. The language used in diagnostic manuals like the DSM-5 often frames Autism in terms of deficits, impairments, and deviations from the norm. The Neurodiversity Movement challenges this pathologizing language, suggesting it perpetuates stigma and negative stereotypes. By defining Autism as a disorder, these manuals imply that Autistic individuals are inherently flawed or deficient, which can further affect how they are perceived and treated by society, as well as the way in which they may see themselves.

References & Further Reading

• Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508-520. doi:10.1016/S0140-6736(18)31129-2.

• 
  

• Norbury, C. F. (2014). Practitioner review: Social (pragmatic) communication disorder conceptualization, evidence, and clinical implications. Journal of Child Psychology and Psychiatry, 55(3), 204-216. doi:10.1111/jcpp.12154.

• 
  

• Silberman, S. (2015). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. New York: Avery.

• 
  

• Evans, B. (2013). How autism became autism: The radical transformation of a central concept of child development in Britain. History of the Human Sciences, 26(3), 3-31. doi:10.1177/0952695113484320.

• 
  

• Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37-70. doi:10.1177/1529100614531398.