![]() These included the consistency of the diagnosis of Asperger's disorder, frequently labeled as high-functioning autistic disorder the adequacy of the use of the diagnosis of PDD-NOS for mild neurodevelopmental disorder and Asperger's disorder for individuals with unusual behaviors but not severe autistic features. Despite text corrections on the PDD-NOS section in the subsequent DSM-IV revision (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, DSM-IV-TR) ( 5), several major shortcomings were identified in the implementation of DSM-IV/DSM-IV-TR criteria ( 6). The category also included childhood disintegrative disorder and Rett syndrome, the latter a genetic disorder with initial descriptions of prominent autistic features ( 4). The category under which disorders with severe autistic features were grouped, pervasive developmental disorders included three disorders (i.e., autistic disorder, Asperger's disorder, PDD-NOS) with substantial clinical overlap. ![]() DSM-IV tried to systematize the different clinical entities associated with autistic features, including recently identified disorders, such as Rett syndrome ( 4). The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was released in 1994, at a time in which new knowledge on ASD was rapidly emerging. From DSM-IV to DSM-5: Diagnosis of Autism Spectrum Disorder ![]() The simplified diagnosis of ASD, which merged previous diagnoses into a single disorder, has led to its use in plural (autism spectrum disorders) for different purposes. While the revisions to the diagnostic criteria introduced a few years ago into DSM-5 ( 1) updated ASD from the conceptual and practical perspectives, some persistent confusion regarding terminology and the diagnosis of the condition in individuals with intellectual disability remains. Genetic syndromes, defined mutations, and de novo copy number variations are reported to account for almost 10% to 20% of cases within ASD ( 3). Though the DSM and ICD are quite useful in determining whether a given individual's behavior is consistent with a given diagnosis, it does not speak to the etiology or impact of co-occurring conditions on the behavioral phenotype or presentation. The diagnosis of ASD is based on observations and assessments of behavior using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) ( 1) or International Classification of Diseases, 11th Edition (ICD-11) criteria ( 2). Autism spectrum disorder (ASD) is a behaviorally defined complex neurodevelopmental disorder.
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