Does the DSM-5 Threaten Autism Service Access?

Abstract

The present paper addressed the question: how will the DSM-5 revisions  impact access to autism services? While media commentators posited a  straightforward link between DSM-5 changes and service access, we should  consider the different strength of couplings between a DSM diagnosis and  entitlement access by investigating the factors that result in a diagnoses translation  into service access. The Article began by outlining the pre DSM-5 policy  background for autism entitlements. This background helps contextualize the policy  environment into which the DSM-5 changes entered. Rather than examining autism  medical and educational services in isolation, we should conceive of these services  as interdependent, and investigate how changes to the uptake or depth of medical  service access affect changes to the uptake or depth of educational service access. Taking this interdependent perspective, the Article showed how the passage of  private insurance mandates for autism services has led to more rapid uptake of  special education services for autism, showing how one entitlement that creates a close DSM diagnosis-service link (an insurance mandate) increases uptake of  another entitlement with a looser DSM diagnosis-service link (special education  services). This shows that if DSM-5 revisions undermine access to medical entitlements there will be a corresponding impact on access to educational  entitlements.