(CNN) - Starting next year, the process of diagnosing autism may see drastic changes following the revision of the official guide to classifying psychiatric illnesses.
After years of reviewing and refining criteria used by psychiatrists and other experts to diagnose mental health disorders, the American Psychiatric Association board of trustees on Saturday approved major changes to the manual, better known as DSM-5.
The approval of the changes in the Diagnostic and Statistical Manual of Mental Disorders came during a meeting in Arlington, Virginia.
The DSM is considered the "bible" of psychiatry because it's the criteria mental health professionals use to diagnose their patients.
It is also used by insurance companies, schools and other agencies responsible for covering or creating special provisions for individuals with developmental or mental disorders.
Whether someone receives the death penalty or a lesser sentence can rise or fall depending on criteria for a mental health disorder as defined in the DSM.
Autism diagnoses will see significant changes in how patients are labeled.
Under the current manual, called the DSM-IV, children who meet the criteria for having autism a re diagnosed with and told they have autistic disorde r (also known as 'classic' autism) or Asperger's Syndrome or PDD-NOS, which stands for "Pervasive Developmental Disorder - Not Otherwise Specified."
In the new "DSM-5" manual, "the criteria will incorporate several diagnoses from DSM-IV including autistic disorder, Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder (not otherwise specified) into the diagnosis of autism spectrum disorder for DSM-5 to help more accurately and consistently diagnose children with autism," according to an APA statement Saturday.
When the new guidebook goes into effect in May, a child who has symptoms of Asperger's Syndrome, (problems with social interaction and unusual interests or behaviors but less likely to have problems with language or intellectual ability), will no longer be told he has Asperger's but rather "autism spectrum disorder (ASD)." The same goes for a child meeting the criteria for PDD-NOS or classic autism.
"I'm feeling quite good about the series of recommendations that were made in that area. It will help us diagnose these children in a more consistent way," said Dr. David J. Kupfer, who chairs the DSM-5 Task Force.
New research has led experts to have a better hand on social and communicative disorders as well as repetitive behaviors, he said.
Over the past few years, the APA has posted possible revisions of criteria, inviting comments from the other researchers and the public.
But these incremental revisions raised concerns among some researchers and advocacy groups who feared the new criteria would result in many children losing their autism diagnosis and much-needed services.
For example, in March, a study presented by Yale autism expert Dr. Fred Volkmar suggested only 60% of those meeting current criteria for autism would still be diagnosed with the disorder under the proposed criteria.
A recent, larger study found 9% of people might lose services, according to Autism Speaks, a research and advocacy group for people with autism.
Geraldine Dawson, chief science officer for Autism Speaks, said she was worried some people would be excluded by the new definitions and not receive the services they need.
"The concern is we really don't know yet how these changes are going to affect people in real world settings," she said.
Kupfer agrees that some children might fall off the autism spectrum, but he believes maybe 5% to 10% of patients will no longer meet the criteria for autism. He says he welcomes experts and advocacy groups to be vigilant and notify the APA if many more children lose their diagnoses.
But Dr. Bryan King says it's too early to say if children will be excluded.
King has been working on revising the autism diagnosis criteria since 2007 and also treats children with autism and other developmental disorders as the director of the Seattle Children's Autism Center .
He believes the new diagnostic criteria could be more inclusive and lead to more children being diagnosed with ASD. King says there are at least three big changes that could potentially open up the door for more (not less) children being diagnosed with autism:
1. A patient's history.
If, for instance, a teenager shows social impairments and sensory sensitivities (criteria for autism), but at the time of evaluation no longer lines up toys and is preoccupied with spinning wheels (other signs of autism), this history of repetitive behavior could be included to make an autism diagnosis. That's not possible under DSM-IV criteria.
2. Softening the criteria of the age of onset of symptoms.
Under the current guidelines for diagnosing a child with autism, symptoms have to occur before age 3. However, in some children, the impairment from autism may not be seen until a later age,
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