By Emily Bourke
Thousands of Australian children with autism could miss out on government-funded support and services because of changes to the way autism is diagnosed.
The manual of medical disorders known as the DSM 5, used by psychiatrists around the world, is being updated.
The updated American guidebook for mental disorders is expected to be released in May next year, but already it has many people nervous.
Experts say the creation of a new category for "social communication disorder" will mean more than 20 per cent of children who now qualify as having a form of autism would fail to meet the new criteria.
Nicole Rogerson from Autism Awareness Australia said not meeting the criteria for autism could see thousands of children miss out on government funded programs.
"Well it's going to have a huge impact on those children, their outcomes, their families, but let's not be silly here," she said.
"It's going to drop off that particular pot of funding and it's going to have to be dealt with in a particular later pot of funding when that child isn't being very successful at school.
"So by putting off early intervention and indeed taking the early out of early intervention just means that child's problems aren't going to miraculously go away, they're just not going to be dealt with adequately, particularly by families who have limited resources, and the system is going to have to deal with that child when they become older or indeed as a teenager or an adult.
"So pretending like it's not happening isn't going to make things better."
Some American field studies suggest the new criteria will not affect the number of patients receiving care for autism.
But Vicki Gibbs from Autism Spectrum Australia's diagnostic service said Australian research has found a significant number of autistic children would fail to meet the new criteria.
"What our study found was of the 120-odd children that we assessed, about 23 per cent of those children who would have got a diagnosis under the existing DSM 4, we would not have been able to give a diagnosis under DSM 5, just because they didn't have enough of the symptoms," the clinical psychologist said.
"I don't think any parent would feel particularly bad about the fact that their child didn't have enough symptoms to meet the new criteria and perhaps met this other diagnosis, if it meant that they would continue to get support.
"So I think it's really about getting help for children that need help rather than I want my child to have an autism diagnosis."
The DSM 5 might offer clarity and simplicity on one level, but it creates another problem in that the World Health Organisation has not said whether it plans to update its diagnostic manual known as the ICD10.
'Sad state of affairs'
Cheryl Dissanayake is the director of the Olga Tennison Autism Research Centre at La Trobe University.
She said the changes in diagnosis may lead to complications.
"What you're going to get is that then in different parts of the world where now you're using different systems and that is going to be a nightmare, both clinically and for research," she said.
Ms Dissanayake said the ICD10 is revised periodically but there is no indication from the World Health Organisation whether it will be revised in accordance with the DSM 5 criteria, and she said that is of real concern.
A spokesperson for Community Services Minister Jenny Macklin says Government support for children with autism is based on the best advice from Australian health experts and that the DMS 5 will not automatically be adopted in Australia as a diagnostic tool for autism.
But for some the fears about the future are irrelevant because of the current state of services for autistic children.
Nicole Rogerson said it is important to look at how funding is distributed.
"Well at the moment, as part of the helping children with autism package, a child on the autism spectrum is allocated 20 speech pathology visits. That's over their lifetime," she said.
"So if you have a child like mine with a severe language disorder that accompanies their autism, 20 visits over the lifetime of a child is actually wasting the money, we're not actually doing anything meaningful with it, we're just spending it as a kind of make-ourselves-feel-better.
"The truth of the fact is children with autism who are receiving services are the ones who have parents that can either afford it or are mortgaging themselves to the hilt to be able to do it and that's a sad state of affairs in a country that prides itself on universal healthcare."
from http://www.abc.net.au/news/2012-09-03/autism-funding-cuts/4240064 , http://www.abc.net.au/news/2012-09-03/fears-autistic-kids-miss-out-on-se... and