Autism Spectrum Disorder
This post is about the diagnostic criteria of autism. In the past autism was broken up into different types however with the DSM-5 the various types now fall under the same disorder, autism spectrum disorder.
Direct quotes from the DSM-5 will be written in italics
Criterion A
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
For the individual being diagnosed with this disorder there aren’t communicating or interacting at the same level as their peers.
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
The individual approaches social interactions with difficulty. They are unable to have a “normal” back-and-forth conversations. They may be unable to share the emotions needed for social context or the interests involved. They may also be unable to initiate or respond to conversation in the typical fashion.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to total lack of facial expressions and nonverbal communication.
The individual has difficulty with the nonverbal behaviors that may arise during communication with others. The range of difficulty would go from poor verbal and nonverbal communication, difficulty maintain eye contact and difficult utilizing body language properly to express themselves to complete lack of facial expressions and nonverbal communication
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
The individual has difficulty in creating, maintaining and understanding relationships. The range of difficulty is between adjusting their behavior for various social situations to difficulty in utilizing imagination for play scenarios and making friends to a complete lack of interest in making friends or long-standing relationships.
Criterion B
Restricted repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive, see text):
For this criterion there is a repetitive nature in terms of their behavior, interests or activities in a restrictive way. Two of the four following examples need to be evident for this criterion to be met.
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
The individual has repeated movements, use of objects or speech, the examples listed provide a good picture of this type of behavior.
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
The individual would have difficulty changing certain routines that they’ve become accustomed to and will get upset or have difficulty changing those behaviors such as the example above pointed out, eating the same food daily.
Highly restricted, fixated interests that are abnormal in intensity and focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
The individual would have an intense level of focus on specific interests that some may deem unusual for the interest itself
Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
The individual would either be hyper or hyporeactive (meaning either high response or minimal response) to stimuli within their environment or interests when it comes to the senses. So like the examples state they may be indifferent to pain/temperature (hyporeactive), adverse response to specific sounds or textures (meaning depending on the response, it is not how someone would typically response to this stimuli), excessive smelling or touching of objects (hyperreactive) and visual fascination with lights or movement (hyperreactive).
Criterion C
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capabilities, or may be masked by learned strategies in later life)
For this criterion to be met the symptoms must have been apparent during the early developmental period. It does state that it may not fully manifest until the social demands for a specific developmental stage exceed the individuals capabilities or certain learned behaviors helped them mask the deficit.
Criterion D
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning
The above symptoms cause significant difficulty in social, occupational and other important areas of functioning
Criterion E
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
For this specific diagnosis to hold true, the symptoms that the individual is experiencing can’t be better described to be intellectual developmental disorder or global developmental delay. It is important to note that there is a possibility for an individual to be diagnosed with both autism spectrum disorder and intellectual developmental disorder and to do that the social communication should be below the expected level for “normal” developmental level of that individual.
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