DSM-IV Autism vs. ICD-10 Autism

Attribute	DSM-IV Autism	ICD-10 Autism
Definition	Autistic Disorder, Asperger's Disorder, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)	Autistic Disorder
Age of Onset	Before 3 years of age	Before 3 years of age
Symptoms	Impairments in social interaction, communication, and restricted, repetitive behaviors	Impairments in social interaction, communication, and restricted, repetitive behaviors
Severity Levels	Not specified	Mild, Moderate, Severe
Diagnostic Criteria	Based on a checklist of symptoms	Based on a checklist of symptoms

Definition and Diagnosis

DSM-IV Autism, also known as Autistic Disorder, was characterized by qualitative impairments in social interaction, communication, and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. In contrast, ICD-10 Autism, referred to as Childhood Autism, emphasized impairments in social interaction and communication, as well as restricted and repetitive behaviors. Both diagnostic criteria required the presence of symptoms before the age of three, but DSM-IV Autism included a specific criterion for delays or abnormal functioning in social interaction, language used in social communication, or symbolic or imaginative play.

Symptoms and Criteria

DSM-IV Autism had six main criteria, including qualitative impairments in social interaction, qualitative impairments in communication, restricted repetitive and stereotyped patterns of behavior, delays or abnormal functioning in social interaction, language used in social communication, or symbolic or imaginative play, and the disturbance was not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder. ICD-10 Autism had similar criteria, such as qualitative impairments in reciprocal social interaction, qualitative impairments in communication, and restricted, repetitive, and stereotyped patterns of behavior, but did not include specific criteria for delays or abnormal functioning in social interaction, language, or play.

Subtypes and Specifiers

DSM-IV Autism included several subtypes, such as Autistic Disorder, Asperger's Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). Each subtype had specific criteria and characteristics that differentiated them from one another. In contrast, ICD-10 Autism did not have subtypes but included specifiers for the presence of language impairment, age of onset, and associated medical conditions. These specifiers helped clinicians further describe the individual's presentation of autism within the ICD-10 diagnostic framework.

Global Use and Acceptance

DSM-IV Autism was widely used in the United States and other countries that followed the American Psychiatric Association's diagnostic guidelines. It provided a comprehensive framework for diagnosing autism spectrum disorders and was accepted by clinicians, researchers, and insurance companies. On the other hand, ICD-10 Autism was used globally as part of the World Health Organization's International Classification of Diseases. It offered a different perspective on autism diagnosis and classification, aligning with the broader ICD system used for all medical conditions and disorders.

Updates and Revisions

Both DSM-IV Autism and ICD-10 Autism underwent updates and revisions to improve diagnostic accuracy and clinical utility. The release of DSM-5 in 2013 replaced DSM-IV Autism with Autism Spectrum Disorder (ASD), which combined several subtypes into a single diagnostic category. The criteria for ASD were updated to reflect current research and understanding of autism spectrum disorders. Similarly, ICD-11, released in 2018, introduced changes to the classification of autism, aligning with the latest scientific evidence and clinical practice.

Impact on Research and Treatment

The differences between DSM-IV Autism and ICD-10 Autism had implications for research studies and treatment approaches. Researchers had to consider the diagnostic criteria used in their studies to ensure consistency and comparability across different populations. Clinicians had to adapt their treatment strategies based on the diagnostic framework they followed, considering the specific criteria and subtypes outlined in DSM-IV or the broader classification in ICD-10. Overall, the impact of these diagnostic systems on research and treatment highlighted the importance of clear and standardized diagnostic criteria for autism spectrum disorders.