Knowledge Gaps in ASD Research: Short and Long Term Implications for Policy.

Most researchers and practitioners speak about the gap between research and practice; fewer researchers and practitioners speak about the gap between research and policy, which is arguably much greater, much more significant, and much more likely to be overlooked. A handful of articles each year shed some light on this gap, and one of these appears in a recent issue of the Journal. In the paper, Barton et al. (2015) reviewed state-level practices and policies surrounding educational assessment and identification, and explored the relation between these practices and the proportion of children identified with ASD within the school system in each state. Their findings offer insights into the potential sources, extent, and impacts of these gaps between research and policy. In many respects, the trajectory of ASD research over the past 30 years has followed the evolution of the DSM. The converging consensus surrounding the diagnosis of ASD is truly remarkable given its complexity, and is absolutely essential to any efforts to compare results across different research samples. At the same time, recent changes in the DSM-5 (with a new emphasis on autism spectrum, the ‘grandfathering’ in of cases with previous DSM-IV diagnoses) and the advent of both R-Doc and eventually ICD-11 may contribute to some degree of confusion despite the essential consensus on the central diagnostic features of autism (Volkmar and McPartland 2014). The findings of Barton and her colleagues raise questions about the likelihood of agreement between educational identification and current conceptualizations of ASD. For example, more than 80 % of the states simply adopt the federal statute, which has not been significantly amended since 1990, and which references many features that do not clearly align with the DSM-IV let alone the DSM-V (Doehring and Winterling 2011). It can be argued that we should not seek any alignment between educational and medical definitions of ASD as captured in the DSM-V: for example, medical diagnosis functions to group individuals together whose difficulties might stem from a common biological cause, something of less concern to educators. Medical diagnosis and educational classification do share, however, the most important function: to group individuals together who might benefit from similar programs of intervention, particularly in the US. To the extent that many medical diagnoses and educational interventions focus on observable behavior and skill deficits, an updated federal policy that clearly aligns educational definitions with relevant DSM criteria would group children meaningfully for purposes of educational planning. The lack of alignment between the federal definition and the DSM over at least the past 15 years has hindered the ability of many different professionals to provide ASD services to individuals who do not also have a co-occurring intellectual disability, such as those identified with Asperger’s Disorder under the DSM-IV. The current federal definition specifies that autism cannot be considered in the absence of an intellectual disability, if the individual’s disabilities are explained by an emotional disorder. It is our experience that confusion regarding diagnostic practice, & Peter Doehring pfd35@drexel.edu