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These findings are consistent with previous research on the psychological consequences of adverse childhood experiences (ACEs) in the general population (Anda et al. Preliminary findings indicate that people with ASD may be at high risk for experiencing stressful and traumatic life events, the sequelae of which can negatively impact mental health through the development of comorbid psychopathology and/or worsening of the core symptoms of ASD (Mehtar and Mukaddes 2011 Taylor and Gotham 2016). Since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association 2013), the symptomatic features and risk factors associated with comorbidity in individuals with ASD have emerged as important new areas of research. However, high rates of comorbidity between ASD and other psychological disorders indicate that standard behavior therapies are not adequately addressing issues related to mental health and wellbeing. Research indicates that such interventions are effective in improving educational outcomes and fostering various types of skill development (Fonagy et al. Particularly in North America, professionals, including social workers, are taught to support people with autism spectrum disorder (ASD) and their families through primarily behavioral interventions (Keenan et al.
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Future directions for research to better understand the nature of childhood stress and trauma and improve mental health in this population are also discussed. Mounting evidence for stress and trauma as a risk factor for comorbidity and the worsening of core ASD symptoms may intimate a shift in the way clinical social workers and other clinical practitioners conceptualize and approach work with this population to include trauma-focused assessment strategies and clinical interventions. Research emerging since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is advancing our understanding of the nature of childhood stress and trauma in people with ASD and its subsequent impact on mental health and wellbeing.
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However, high rates of comorbidity between ASD and other psychological disorders, including depression and anxiety, indicate that standard behavioral approaches are not adequately addressing issues related to mental health in this population. As our mechanistic understanding of autism improves, diagnoses based on behavioral parameters will continue to provide opportunities for interventions targeting the behaviors, while etiological diagnoses will provide opportunities for interventions tailored to etiology.Research findings suggest that behavioral interventions are effective in improving educational outcomes and fostering skill development in people with autism spectrum disorder (ASD). We support the evidence-based changes to autism diagnosis found in DSM-5, and look forward to further studies on the autism phenotype as this has implications for diagnosis and treatment. The commentaries go on to discuss the positive aspects of these changes and raise some areas of potential concern. In addition, DSM-5 collapses social and communication domains into a single combined domain. Both commentaries note how DSM-5 collapses the earlier diagnostic categories of the pervasive developmental disorders into a single category of autism spectrum disorder. We are fortunate to have invited commentaries from the laboratories of Dr Cathy Lord and Dr Fred Volkmar offering their perspectives on the new Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for the autism spectrum.