> It seems in the DSM 5 the definition was narrowed
I think it may have been narrowed in theory, but often not in practice.
Here in Australia, making DSM-5 ASD a shortcut to getting funded by our national disability insurance scheme (NDIS) caused a lot of pressure to broaden the diagnosis in practice - if clinicians have to stretch the diagnosis to get someone the support they need, they feel ethically obliged to engage in that stretching, since it is in the best interests of their client (who are experiencing real challenges, even if those challenges map poorly to the official diagnostic criteria).
And Australia is not unique in providing funding pressures for ASD diagnosis, although NDIS is arguably a global outlier in the scale of that pressure. Apart from funding, growing popular and clinical mindshare of the diagnosis creates independent pressure to broaden its definition.
So a theoretical narrowing coexists with a practical broadening - and the latter is arguably what really counts
I think it may have been narrowed in theory, but often not in practice.
Here in Australia, making DSM-5 ASD a shortcut to getting funded by our national disability insurance scheme (NDIS) caused a lot of pressure to broaden the diagnosis in practice - if clinicians have to stretch the diagnosis to get someone the support they need, they feel ethically obliged to engage in that stretching, since it is in the best interests of their client (who are experiencing real challenges, even if those challenges map poorly to the official diagnostic criteria).
And Australia is not unique in providing funding pressures for ASD diagnosis, although NDIS is arguably a global outlier in the scale of that pressure. Apart from funding, growing popular and clinical mindshare of the diagnosis creates independent pressure to broaden its definition.
So a theoretical narrowing coexists with a practical broadening - and the latter is arguably what really counts