Autism

The American Psychiatric Association, in its Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition (DSM-5, APA, 2013) provides diagnostic guidelines that are used internationally.

 

DSM 5 Diagnostic Criteria for Autism Spectrum Disorder

 

To meet diagnostic criteria for Autism Spectrum Disorder according to DSM-5, a person must have persistent deficits in each of three areas of A. social communication and interaction, plus at least two of four types of B. restricted, repetitive behaviours. These symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life). The symptoms together limit and impair everyday functioning and these disturbances are not better explained by Intellectual Disability or Global Developmental Delay.

 

The DSM-5 diagnostic criteria for Autism Spectrum Disorder:

A.  Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following (currently or in history):

1.  Deficits in social emotional reciprocity (ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions or affect, to failure to initiate or respond to social interactions)

2.  Deficits in nonverbal communicative behaviours used for social interaction (ranging from poorly integrated verbal and nonverbal communication, through abnormalities in eye contact and body language, or deficits in understanding and use of gestures, to total lack of facial expression or nonverbal communication)

3. Deficits in developing, maintaining and understanding relationships (ranging from difficulties adjusting behaviour to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in peers)

B.  Restricted, repetitive patterns of behaviour, interests, or activities as manifested by at least two of the following (currently or in history):

1.  Stereotyped or repetitive speech, motor movements, or use of objects (such as simple motor stereotypies, lining up toys or flipping objects, echolalia, repetitive use of objects, or idiosyncratic phrases)

2. Inflexible adherence to routines, ritualised patterns of verbal or nonverbal behaviour, or excessive resistance to change (such as rigid thinking patterns, greeting rituals, insistence on same route or food, difficulties with transitions or extreme distress at small changes)

3.Highly restricted, fixated interests that are abnormal in intensity or focus (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests)

4. Hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment (such as apparent indifference to pain/heat/cold; adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or movement)

C.  Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life)

D.  Symptoms together limit and impair everyday functioning

E. These disturbances are not better explained by Intellectual Disability or Global Developmental Delay

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If you think you or your child may have autism, you can use one of our free screening questionnaires to help you to consider whether a full diagnostic assessment may benefit you. 

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