TY - JOUR
T1 - DSM Criteria that Best Differentiate Intellectual Disability from Autism Spectrum Disorder
AU - Pedersen, Anita L.
AU - Pettygrove, Sydney
AU - Lu, Zhenqiang
AU - Andrews, Jennifer
AU - Meaney, F. John
AU - Kurzius-Spencer, Margaret
AU - Lee, Li Ching
AU - Durkin, Maureen S.
AU - Cunniff, Christopher
N1 - Funding Information:
Data collection for this study was supported by cooperative agreements with the Center for Disease Control and Prevention (UR3 DD000090).
Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Clinical characteristics of autism spectrum disorder (ASD) and intellectual disability (ID) overlap, creating potential for diagnostic confusion. Diagnostic and statistical manual of mental disorders (DSM) criteria that best differentiate children with ID and some ASD features from those with comorbid ID and ASD were identified. Records-based surveillance of ASD among 8-year-old children across 14 US populations ascertained 2816 children with ID, with or without ASD. Area under the curve (AUC) was conducted to determine discriminatory power of DSM criteria. AUC analyses indicated that restricted interests or repetitive behaviors best differentiated between the two groups. A subset of 6 criteria focused on social interactions and stereotyped behaviors was most effective at differentiating the two groups (AUC of 0.923), while communication-related criteria were least discriminatory. Matching children with appropriate treatments requires differentiation between ID and ASD. Shifting to DSM-5 may improve differentiation with decreased emphasis on language-related behaviors.
AB - Clinical characteristics of autism spectrum disorder (ASD) and intellectual disability (ID) overlap, creating potential for diagnostic confusion. Diagnostic and statistical manual of mental disorders (DSM) criteria that best differentiate children with ID and some ASD features from those with comorbid ID and ASD were identified. Records-based surveillance of ASD among 8-year-old children across 14 US populations ascertained 2816 children with ID, with or without ASD. Area under the curve (AUC) was conducted to determine discriminatory power of DSM criteria. AUC analyses indicated that restricted interests or repetitive behaviors best differentiated between the two groups. A subset of 6 criteria focused on social interactions and stereotyped behaviors was most effective at differentiating the two groups (AUC of 0.923), while communication-related criteria were least discriminatory. Matching children with appropriate treatments requires differentiation between ID and ASD. Shifting to DSM-5 may improve differentiation with decreased emphasis on language-related behaviors.
KW - Autism spectrum disorder
KW - DSM
KW - Differential diagnosis
KW - Intellectual disability
KW - Restricted interests/repetitive behaviors
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U2 - 10.1007/s10578-016-0681-0
DO - 10.1007/s10578-016-0681-0
M3 - Article
C2 - 27558812
AN - SCOPUS:84983438818
SN - 0009-398X
VL - 48
SP - 537
EP - 545
JO - Child Psychiatry and Human Development
JF - Child Psychiatry and Human Development
IS - 4
ER -