![]() ![]() The second viewpoint is that autism symptoms represent a category, with qualitative differences in symptom levels between ASD-affected and unaffected individuals. 15, 16 This evidence points toward the need to include a dimensional conceptualization of autism symptoms in its diagnosis. 12 Also compelling are possible genetic heterogeneity of symptom domains 13, 14 and the substantial variability of autism symptoms among identical twins. 8 This perspective is supported by the observations from population and family studies of a broad distribution of observed autism symptoms in the population, 9 elevated levels of autism traits in siblings and other family members of affected cases, 10, 11 and shifting toward greater autism symptoms in children whose parents both show sub-threshold autism traits. The first viewpoint proposes that autism symptoms are best represented dimensionally, with differences between typical and ASD symptom levels being a matter of degree (ie. 7 The present study evaluates an important aspect of this controversy - symptom continuity between individuals with Asperger’s disorder and other ASD cases - by explicitly testing conflicting views of the nature of autism symptom structure. 6 Yet, to date, there is little evidence that Asperger’s disorder is qualitatively distinct from other autism diagnoses at the symptom level or that the new criteria will under-identify high functioning ASD. This proposed change has generated considerable apprehension from patients and their families, who are concerned that individuals diagnosed with Asperger’s disorder will be orphaned or receive inappropriate service provision. 4, 5 The most remarkable change was combining specific DSM-IV-TR diagnoses into a single broad Autism Spectrum Disorder (ASD). DSM-5 Field Trials have recently begun evaluating new diagnostic criteria that contain several important modifications relative to DSM-IV-TR. 1 The importance of accurately identifying individuals with autism has never been greater, particularly given the growing prevalence, 2 considerable family and societal costs, 3 and recognized importance of early diagnosis and intervention. Autisms are a highly heterogeneous set of disorders with wide variations in symptom severity, intellectual level, and functional disability.
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