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Diagnosis and classification in autism

L Waterhouse1, R Morris, D Allen

  • 1Trenton State College, New Jersey 08650-4700, USA.

Journal of Autism and Developmental Disorders
|February 1, 1996
PubMed
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This study compared autism diagnostic systems and social subgroups in preschool children. Findings support two overlapping continua within Pervasive Developmental Disorder (PDD).

Area of Science:

  • Developmental Psychology
  • Child Psychiatry
  • Autism Spectrum Disorder Research

Background:

  • Autism Spectrum Disorder (ASD) diagnosis relies on various systems, including DSM-III, DSM-III-R, DSM-IV, and ICD-10.
  • Previous research suggests heterogeneity within ASD, necessitating further investigation into distinct subgroups.
  • Understanding social interaction patterns is crucial for differentiating ASD from other Pervasive Developmental Disorders (PDD).

Purpose of the Study:

  • To compare the diagnostic utility of four major classification systems (DSM-III, DSM-III-R, DSM-IV, ICD-10) for autism.
  • To examine the relationship between these diagnostic systems and two empirically derived autism taxa.
  • To investigate the association between diagnostic systems, taxa, and three distinct social subgroups (Aloof, Passive, Active-but-Odd) in preschool children with social impairment.

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Main Methods:

  • A cohort of 194 preschool children exhibiting significant social impairment was assessed.
  • Children were evaluated using four diagnostic systems: DSM-III, DSM-III-R, DSM-IV, and ICD-10.
  • Comparisons were made with two empirically derived autism taxa and three social subgroups: Aloof, Passive, and Active-but-Odd.

Main Results:

  • Significant differences in behavior and IQ were observed between autistic and other-PDD groups across all four diagnostic systems.
  • A significant association was found between Taxon B, autism diagnoses, and the Aloof social subgroup.
  • Conversely, Taxon A, other-PDD diagnoses, and the Active-but-Odd subgroup showed a significant association.

Conclusions:

  • The findings provide empirical support for the existence of two major, overlapping continua within idiopathic Pervasive Developmental Disorder.
  • This research highlights the importance of considering social interaction patterns alongside diagnostic criteria for a more nuanced understanding of ASD and related disorders.
  • The study underscores the utility of integrating diagnostic systems with empirically derived taxa and behavioral subgroups for improved diagnostic accuracy and classification.