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.