DSM-5 changes for Autism Spectrum Disorders – What about people with pragmatic language issues?

The American Psychiatric Association (APA) has officially approved changes to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The changes include new – and hotly debated — criteria for the diagnosis of individuals on the Autism Spectrum.
The DSM-5 changes will impact many in the Autism community. Who and how many people will be impacted is the source of endless discussion. While the goal of the changes is to prevent the over diagnosis of individuals with Autism Spectrum Disorders, many are concerned that the new criteria might leave some behind.
One group at high risk of being overlooked are those in the high functioning end of the Spectrum whose challenges in communication involve the use of pragmatic language, which is the ability to vary speech based on different conversation contexts — knowing what to say, how to say it, when to say it, and where to say it. Pragmatic language skills include the ability to recognize sarcasm, take turns in conversations, stay on topic and engage in small talk.
The exact changes aren’t posted on the APA website and until the changes are put into effect, there is little to do beyond keeping a watchful eye on how they’re applied. Hopefully, the criteria will be applied in a way that remains true to a requirement that is listed late but should be treated as a first principal in appropriately diagnosing Autism Spectrum Disorders. It simply reads as follows: “Symptoms together limit and impair everyday functioning.”

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