Autism, Language Disorder, and Social (Pragmatic) Communication Disorder: DSM-V and Differential Diagnoses

Mark D. Simms; Xing Ming Jin

doi:10.1542/pir.36-8-355

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Mark D. Simms, MD, MPH*
Xing Ming Jin, MD^†

^*Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
^†Department of Pediatrics, Jiao Tong University School of Medicine, Shanghai, Peoples Republic of China.

AUTHOR DISCLOSURE
Drs Simms and Jin have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Educational Gap

The recent revision of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V) included refinements to the diagnostic criteria for autism spectrum disorders and language disorders and introduced a new entity, social (pragmatic) communication disorder. Clinicians should become familiar with these changes and understand how to apply this new knowledge in clinical practice.

Objectives

After completing this article, readers should be able to:

Know the revised criteria for autistic spectrum disorders and language disorders and the diagnostic criteria for social (pragmatic) communication disorder.
Understand the clinical similarities and difference of these disorders.
Know the differences in the long-term prognosis of these disorders.
Be familiar with some relatively common “nonspecific” behaviors that should not be confused with specific developmental disorders.

Introduction

The past decade has witnessed an explosion in public and professional awareness of autism and autistic spectrum disorders (ASDs). Once considered to be a rare disorder, ASD now has a reported prevalence rate of slightly more than 1% among United States children. (1) Although the cause of this increased prevalence is not certain, greater awareness has likely resulted in improved recognition. This has been accompanied by increased research on autism focused on its cause and effective interventions for young children. Autism treatment programs are now widely available in school and community settings.

At the same time, childhood language disorders, which are more common than ASDs, have remained relatively unknown publicly and professionally. At kindergarten entry, approximately 7% to 8% of children have evidence of a language impairment (2) and are at significant risk for difficulty with language-based learning tasks and social adaptation as they progress through school. The most …