In this paper we review the impact of DSM-III and its successors on the field of autism--both in terms of clinical work and research. We summarize the events leading up to the inclusion of autism as a "new" official diagnostic category in DSM-III, the subsequent revisions of the DSM, and the impact of the official recognition of autism…

The autism mental status exam is an eight-item observational assessment that structures the way we observe and document signs and symptoms of ASD. Investigations of test performance indicate strong sensitivity and specificity using gold-standard assessment as reference standard. This study aims to explore potential sex differences in AMSE test…

The relationship between autism spectrum disorders (ASD) and psychotic disorders (PD) is a focus of continued interest. There are substantial conceptual and clinical difficulties associated with diagnosing comorbid PD in individuals who have ASD. In this case series, we report on five cases where adolescents with previously diagnosed ASD were also…

A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and…

In an earlier investigation, the authors assessed the reliability of the ADI-R when multiple clinicians evaluated a single case, here a female 3 year old toddler suspected of having an autism spectrum disorder (Cicchetti et al. in "J Autism Dev Disord" 38:764-770, 2008). Applying the clinical criteria of Cicchetti and Sparrow ("Am J…

The authors assessed the reliability of the Autism Diagnostic Interview (ADI-R). Seven Clinical Examiners evaluated a three and one half year old female toddler suspected of being on the Autism Spectrum. Examiners showed agreement levels of 94-96% across all items, with weighted kappa (K[subscript w]) between 0.80 and 0.88. They were in 100%…

The Autism Behavior Checklist was evaluated with 94 autistic and 63 nonautistic subjects. Although the two groups differed significantly in ratings of pathology both false positive and false negative diagnostic classifications occurred. The test appears to have merit as a screening instrument but should not be used alone to establish a diagnosis…

In a field trial addressing revisions to autism criteria in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV), information on 977 cases (454 with autism, 240 with "autistic-like" conditions, and 283 with nonpervasive developmental disabilities disorders) was rated. DSM-IV criteria were compared with the International…

The concurrent validity of the original and revised versions of the Leiter International Performance Scale was examined with 26 children (ages 4-16) with autism. Although the correlation between the two tests was high (.87), there were significant intra-individual discrepancies present in 10 cases, two of which were both large and clinically…

This paper compared clinicians' diagnosis and DSM-III (Diagnostic and Statistical Manual), DSM-III-R (Revised), and ICD-10 (International Classification of Diseases) diagnoses of 52 individuals with autism and 62 nonautistic, developmentally disordered individuals. The DSM-III-R system overdiagnosed the presence of autism, and ICD-10 closely…

This paper presents evidence regarding the validity of the diagnostic concept of "autistic-like" childhood disintegrative disorder, also known as Heller syndrome or as disintegrative psychosis. Its inclusion in the DSM-IV (Diagnostic and Statistical Manual) is supported, and proposed criteria and narrative description are provided.…

Data on 52 individuals with and 62 individuals without autism were analyzed to assess developmental aspects of the DSM-III-R (Diagnostic and Statistical Manual III, Revised) diagnostic system. Findings indicate that DSM-III-R criteria are more developmentally oriented and more behaviorally specific than previous criteria, but the diagnostic…

Autism Behavior Checklists were completed for 52 autistic individuals (ages 2-31) and 62 nonautistic individuals, and data were analyzed using signal detection methodology. A single item (looks "through" people) combined with one of five other items discriminated as well as the sum scores, and further combinations did not improve…

This study examined the inter-rater reliability of clinician-assigned diagnosis of autism using or not using the criteria specified in the Diagnostic and Statistical Manual IV (DSM-IV). For experienced raters there was little difference in reliability in the two conditions. However, a clinically significant improvement in diagnostic reliability…

This paper examines the validity of Asperger syndrome as a condition apart from high-functioning autism. Potential differences between Asperger syndrome and autism is possible if both are strictly defined. The importance of genetic factors in Asperger syndrome is stressed. Research on the nosological validity of this condition and its relationship…