For the 61 percent of children with severe language, communications and social deficits, and clearly repetitive behavior -- all classic signs of autism -- there was good consistency among the various centers in the autism diagnosis, according to the report in the Nov. 7 online issue of the Archives of General Psychiatry.
But for the 39 percent of children with milder problems, there were large inconsistencies in whether the child was labeled with autism, Asperger or PDD-NOS, the investigators found.
"The second most important predictor of which diagnosis the clinician made was where they worked, not any characteristic of the child, which is not good," said Lord.
Geraldine Dawson, chief science officer for Autism Speaks, agreed that it may be time do away with diagnosing specific autism subtypes and instead use the broader, and more reliable, autism spectrum disorder.
"Given the subtle distinctions among the subtypes of autism spectrum disorder, it is not surprising that clinicians were not consistent in how they applied these diagnoses," Dawson said. "In the future, it is likely that we will no longer attempt to classify individuals in the autism spectrum into different subtypes."
Furthermore, whether a child is diagnosed with Asperger or autism doesn't change the treatment.
There are several possible reasons for the discrepancies among autism centers. Parents may want to hear that their child has Asperger rather than autism, and health professionals may be influenced by that, Lord said.
On the other hand, in some regions, kids can only get certain services if they have autism, so those centers may apply that term more broadly.
Generally speaking, children with significant impairments in language, communications
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