With potential changes to the definition of autism in the newest (fifth) edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), due to be published in May, clinicians and researchers must recognize that children who fall under the diagnostic umbrella of autism spectrum disorder are as varied as those who carry the diagnosis of cancer, says autism expert Jennifer Pinto-Martin, MPH, MD, of the University of Pennsylvania School of Nursing. Some who work in the field have coined the word “autisms” to represent the many faces of the disorder.

The DSM, from the American Psychiatric Association, is the standard reference for the diagnosis of mental disorders and has an important influence on insurance coverage and access to educational support and therapeutic services, as well as research.

The new, more restrictive criteria would combine three subgroups on the autism spectrum into one category and require a child to display more pronounced symptoms to qualify for a diagnosis. The effect may be that it is harder for some more mildly affected children to qualify for insurance to cover therapeutic and educational support services.