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Retrospective Review of Children's Diagnostic Assessments for Autism Spectrum Disorder in British Columbia: Are we
April L Christiansen1,2, Isobel Fishman2,3, Sarah M Hutchison4
1University of Toronto, Faculty of Medicine, Toronto, ON, Canada.
Objectives:
Since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013, a dual diagnosis of autism spectrum disorder (ASD) and developmental coordination disorder (DCD) has been permitted. This study assessed the prevalence of DCD in children with ASD and whether DCD diagnosis increased after the publication of the DSM-5.
Methods:
We retrospectively reviewed data from 19,307 children (≤19 years) assessed for ASD in the province of British Columbia in Canada between 2010 and 2019 (N = 19,307). Data from 2010 to 2013 (DSM-4 in place, n = 6532) and 2014 to 2019 (after publication of DSM-5, n = 12,775) were analyzed separately.
Results:
From 2010 to 2013, only 1.1% (37/3261) of children diagnosed with ASD received a co-diagnosis of DCD. Children who were assessed for ASD but not given a diagnosis, 2.4% (62/2559) received a DCD diagnosis. After the publication of the DSM-5 (2014-2019), diagnosis of DCD in children diagnosed with ASD showed a modest increase to 2.8% (172/6152). For children without an ASD diagnosis, 2.9% (99/3396) were given a DCD diagnosis.
Conclusion:
This study demonstrates consistently low rates of DCD diagnosis across 2 periods: before and after the publication of the DSM-5. Despite a modest increase, the prevalence of ASD + DCD co-diagnoses after the introduction of DSM-5, DCD rates remain significantly lower than reported in the literature. This discrepancy suggests significant and persistent underdiagnosis of DCD in children with ASD in British Columbia.
