I was watching a new video released by the American Psychiatric Association, on the changes to the autism criteria, when something that was said made me rewind and replay it, because it was a game-changer that I hadn’t heard mentioned before. The video can be found here, but I’ll provide a transcript of the relevant part:
Susan Swedo, the chair of the Neurodevelopmental Disorders Work Group, begins by discussing that the social communication aspects of the new autism diagnosis, are “impairing and life-long, persistent.” But then she goes on to discuss the second group of autism symptoms: the restrictive repetitive behaviours. She says that some patients may – through training and development – come to have less obvious manifestations of these behaviours in later life, so “that criterion can be met on the basis of history alone.”
This is new, as far as I can tell. I’ve had a re-read of the original proposed criteria and see no mention about some symptoms not having to be present at the time of diagnosis, or (and very importantly) not having to be present in later years. This would seem to be a major twist, since it means talk about “outgrowing autism” could only be relevant in regards to the social communication criterion: If you no longer meet all the criterion, that is to say you no longer have the repetitive restrictive behaviours, it appears you would still be considered autistic because you had such behaviours historically, as long as you still had social communication challenges.
This reflects the current understanding that autism remains and affects a person, even though they may have found a way to “pass” as neurotypical. This also puts an interesting spin on claims of curing autism and outgrowing autism.
I have tried to find the final confirmed diagnostic criteria for autism in the DSM-5, the one that would illustrate this change, but every search I do just turns up the proposed criteria or a request for me to buy the DSM-5 for myself. I would very much like someone to confirm if Swedo’s summary is reflected in the precise wording of the new criteria, and whether I have correctly understood her statement and its implications.
I haven’t had much time to reflect further on what seems to me to be quite a big and important change to what we previously understood about the proposed criteria, so perhaps you see something here that I haven’t yet. As always, I would love to hear your thoughts.