What is the DSM-5?

Background:

In May 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released by the American Psychiatric Association (APA). The publication is used by master's and doctoral level psychologists, psychiatrists, and other mental health clinicians in both public and private practice. The DSM-5 serves as the desk reference for practitioners who are engaged in making clinical diagnoses for mental disorders. The previous edition of the DSM, the DSM-IV-TR (Fourth Edition, Text Revision) was released in 1994, nearly 20 years prior to the DSM-5.

In my work with parents and teachers, I'm often engaged in conversations which outline specific conditions listed in the DSM. Outside of these conversations, the DSM does not generally guide or influence the individualized educational plans or curriculum for students in public schools. Except in very rare circumstances, the DSM is not used within the school building in working with students with educational disabilities.

Nonetheless, the students with whom I work often do come to school with a clinical diagnosis from the DSM. In schools, we are mandated by federal education laws, which do not require the use of DSM in consideration for special education and related services. The DSM information may be considered as a part of the process of special education evaluation, but it is not a required element. For a good review of this how the DSM-5 and special education relate, I encourage you to read the guidance from this page.

It's common for parents to not understand why their child may have a clinical diagnosis from the DSM, but not be found eligible for special education services within the school. Our school teams work with parents to explain what intervention and tiered support systems are available. When a DSM diagnosis is present, but special education is not warranted, schools may consider enacting an educational 504 plan to support the student's mental health needs.

Criticisms:

The DSM-5 is perhaps the most controversial revision of the DSM.

    1. Several autism support groups and advocates have expressed concerns about the proposed changes to the autism diagnosis within the DSM-5.

    2. This Psychology Today post warns that nearly anyone would be able to diagnosed with some condition found within its pages, and warns that these changes may be especially damaging for children.

    3. A third major criticism is that the manual is designed based on the identification of symptoms, not on biology or science. Many claim that the identification of a disorder by looking at the expressed symptoms is a backward approach to diagnosis.