44 Work since DSM-IV appeared suggests that before age 3 the diagnosis is less stable than after this age.45 Often children who go on to have autism by age 3 have the social and communication features of the disorder before that time, but the “restricted interests” criteria are slower to develop, in their most robust form being preceded by odd but not diagnostic sensory interests.44 For most younger children with a question of Inhibitors,research,lifescience,medical autism, the issue is typically a move from autistic disorder to PDD-NOS or vice versa. For Asperger’s disorder, a number of concerns have

been raised about the stringency (or lack thereof) of the DSM-IV diagnostic criteria.46,47 Due to dissatisfaction with the original description, the entire written narrative was replaced in DSM-IV-TR, but no changes Inhibitors,research,lifescience,medical were made to the wording of actual diagnostic criteria.48 Several different approaches to the diagnosis of this condition are in common use, with more stringent criteria sets more likely to

yield differences in neuropsychological profiles, family history, and comorbid psychiatric conditions in probands.49-51 For Childhood Disintegrative Disorder, concerns have centered around issues such as the reliability of Inhibitors,research,lifescience,medical parental report of regression and the issue of whether or not the condition is sufficiently distinctive to merit inclusion in its own right (rather than as part of the a broader autism “spectrum”).52-55 Part of the Belnacasan source of this disagreement Inhibitors,research,lifescience,medical relates to the nature of methods used to assess regression. In a study from our center about 20% of a large sample of parents with children with autism reported regression, but only a small fraction of these could clearly be shown to have had such a regression.56 Somewhat surprisingly for Rett’s disorder the discovery of an etiological Inhibitors,research,lifescience,medical gene has raised another problem—should single-gene disorders be considered ”psychiatric“? For the broader PDD-NOS group the increased awareness of the many different genes potentially contributing to autism has increased interest

in seeing PDD-NOS as one part of the broader autism continuum or spectrum (the broader autism phenotype).43,57 Unfortunately this DSM-IV subgroup has been the least well studied, and is undoubtedly the most heterogeneous.20 no The fifth edition of the DSM is scheduled for publication in May 2013. The diagnostic criteria and taxonomic structure of the Pervasive Developmental Disorders are expected to change in several regards.58 First, the current diagnostic subcategories are replaced by a single broad category of ASD would replace the term PDD. Second, the current three symptom domains (ie, social, communication, and atypical behaviors) would be reduced to two. Currently distinct domains representing social interaction and communicative behavior would be remapped into a single domain (Social/Communicative Deficits).