Final Decision for DSM-VPosted December 4, 2012
Dear friends and colleagues,
Lucy Jane Miller, PhD, OTR
Miller, L. J., McIntosh, D. N., McGrath, J., Shyu, V., Lampe, M., Taylor, A. K., Tassone, F.,
On behalf of the Sensory Processing Disorder Foundation, I want to personally thank you for taking action. We asked and you responded!
Thank you for posting comments on the DSM-5 website by the June 15, 2012 deadline. We know the website’s comment posting process was complicated, but you persevered! Your emails, phone calls, Facebook postings, tweets, blogs, and other displays of public support were also great!
When I started the SPD Foundation in 1979, few people had even heard of “Sensory Processing Disorder.” Today, Sensory Processing Disorder is being talked about worldwide. The progress made over the past 35 years is phenomenal! Individuals who previously would have been misdiagnosed or told it is “all in your head” are now receiving accurate diagnosis and treatment.
We hope that SPD will be included in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) as a “Novel Diagnosis in Need of Further Research”, which would result in better worldwide recognition of the disorder and funding for additional research and treatment.
Regardless of the DSM-5 outcome, the SPD Foundation will continue on with our mission: To improve the lives of children with Sensory Processing Disorder (SPD) and their families by conducting research, educating caregivers, pediatric professionals, and educators, and empowering scientists throughout the world to study the diagnosis and treatment of SPD.
We will keep you updated regarding the status of having Sensory Processing Disorder included in DSM-5.
Thank you again and again for your support.
Lucy Jane Miller, PhD, OTR
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Update on Status of DSM-5 Applications
We were recently contacted by the head of the APA committee requesting a clearer description of Sensory Processing Disorder with specific diagnostic criteria along with strong evidence that SPD exists in the absence of other mental health disorders.
We submitted new definitions and diagnostic criteria, rewritten with the consultation of a committee of experts. We also submitted studies from two of our scientific work group members, Dr. Alice Carter and Dr. Hill Goldsmith. Both have evidence showing that SPD exists in groups of children that were followed from birth. Among the children with SPD, 50%-70% did not have any other psychopathology or mental health diagnoses. This is truly groundbreaking research and a huge step forward!
Although we still donít know whether or not SPD will be recognized as a new or novel diagnosis, we believe it is quite likely, that two of the SPD subtypes (Sensory Over-Responsivity and Sensory Under-Responsivity) will be included as an associated feature of Autistic Spectrum Disorders. This will be extremely helpful in getting sensory-based services for that group of children.
Although it appears that SPD will not be included as a separate diagnosis in the 2013 edition of the DSM-5, there has been a tremendous amount of discussion about SPD and many people on the APA committees were supportive of its inclusion.
This is very positive news! We will continue to share new information as it is received.
SENSORY PROCESSING DISORDER STILL IN THE RUNNING!
Preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses have been released for the 2013 revision of the Diagnostic and Statistical Manual (DSM-5). The DSM is the source for diagnoses of mental health disorders and many developmental disorders. The American Psychiatric Association (APA), which publishes the DSM, has also identified several disorders still under consideration for diagnostic recognition.
Sensory Processing Disorder is among the conditions still under consideration!
A final decision about recognizing any of these conditions will be made after assessment of evidence supporting their inclusion in DSM-5 is completed. This assessment includes consideration of public comments about recognizing Sensory Processing Disorder. To see the conditions proposed by outside sources still being considered for diagnostic recognition in DSM-5, visit the APA site.
We know many of you are interested in Autism Spectrum Disorder and Asperger's Disorder also. Here is the official word regarding those conditions:
A single diagnostic category, "autism spectrum disorders" that will incorporate the current diagnoses of autistic disorder, Asperger's disorder, childhood disintegrative disorder, and pervasive developmental disorder (not otherwise specified).
The American Psychiatric Association provided the following explanation for the above:
The recommended DSM-5 draft criteria for autism spectrum disorders include a new assessment of symptom severity related to the individual's degree of impairment. The draft criteria also specify deficits in two categories: 1) social interaction and communication (e.g., maintaining eye-to-eye gaze, ability to sustain a conversation and peer-relations) and 2) the presence of repetitive behaviors and fixated interests and behaviors. Additionally, in recognition of the neurodevelopmental nature of the disorder, the criteria require that symptoms begin in early childhood. Clinicians must take into account an individual's age, stage of development, intellectual abilities and language level in making a diagnosis.
"The recommendation of a new category of autism spectrum disorders reflects recognition by the work group that the symptoms of these disorders represent a continuum from mild to severe, rather than being distinct disorders," said Dr. Cook. In addition to specifying a range of severity of ASD, the criteria will include description of the individual's overall development, course (e.g. regression), and language. "We expect that the proposed changes will improve the sensitivity and specificity of the criteria for autism spectrum disorders, so that clinicians may be able to more accurately diagnose these disorders."
DSM-5 initiative - summary
The American Psychiatric Association's Diagnostic and Statistical Manual, currently in its 4th edition and often called simply DSM-IV, is the standard diagnostic tool used by mental health professionals worldwide to promote reliable research, accurate diagnosis, and appropriate treatment of cognitive and mental health conditions. Currently, Sensory Processing Disorder is not included in the DSM. This absence limits awareness of SPD, contributes to the misdiagnosis and inappropriate therapeutic treatment of children, and reduces funding for research. Insurance companies often rely upon the DSM-IV diagnoses and may not cover treatment of SPD because it is not listed in the DSM.
Since 2000, the SPD Foundation has spearheaded an intense campaign for recognition of Sensory Processing Disorder in the revised DSM-5, which will be published in 2013. The SPDF has invested heavily in research and has facilitated complementary studies at premier research institutions across the country and internationally. In January 2007, the SPD Foundation submitted its first-stage application to the DSM-5 committee of the American Psychiatric Association. Because we completed or published so much additional research in 2007, we prepared and submitted a supplement to our original application in March 2008. This assured that the DSM committee members have the most current data before them as they deliberate.
In April 2008, we received a lengthy and extremely detailed letter from the chair of the DSM committee. In it, he indicated a significant number of additional studies we needed to submit before SPD could be recognized. We began those studies immediately. At the same time, we remained in close communication with the DSM committee. In June 2009, we received word that SPD is "on the list" of "novel diagnostic entities" being considered for the DSM-5. We also were informed that field trials for new diagnoses under consideration would begin in August 2009, five months earlier than we anticipated. We submitted additional requested data by that deadline.