Seventy years autism：from Kanner to DSM-V / 临床儿科杂志

ABSTRACT

The diagnostic criteria for autism was revised in the 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅴ) in 2013. This year also marks the 70th anniversary of psychiatrist Leo Kanner’s ifrst clinical description of autism. The great changes in the diagnostic criteria within the 70 years relfect the challenge and dififculty of the diagnostics of autism. In DSM-Ⅴ, autism spectrum disorder is under the category of neurodevelopmental disorder, with the cancellation of the deifnition of pervasive developmental disorder;“persistent impairment in social communication and social interaction”plus“restricted, repetitive patterns of behavior”;the symptoms have to be present in the early development period. Compared with DSM-Ⅳ, DSM-Ⅴis justiifed to remove the“discrete”sub-categories including autistic disorder, Asperger disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified in DSM-Ⅳ, and the deleted ones are absorbed into a single category, autism spectrum disorder;the numbers of general items of diagnostic criteria are reduced to 7, while the number of minimal items for diagnostics are decreased to 5. The concept of DSM-Ⅴdeifning autism spectrum disorder as a single category will profoundly result in changes of prevalence, diagnostics, intervention, prognosis, and other related regions of autism.