What does it mean to have an ASD? The new Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) which defines all known medical disorders for the purposes of diagnosis, describes six characteristics of ASDs. To qualify for a diagnosis, a person must have a total of six or more items from (1), (2), and (3), with at least two from (1) and one each from (2) and (3):
1. Qualitative impairment in social interaction, manifest by at least two of the following:
- A. Marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, body postures and gestures, to regulate social interaction
- B. Failure to develop peer relationships appropriate to developmental level
- C. Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by lack of showing, bringing, or pointing out objects of interest)
- D. Lack of social or emotional reciprocity
Qualitative impairment in communication, as manifest by at least one of the following:
- A. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
- B. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
- C. Stereotyped and repetitive use of language, or idiosyncratic language
- D. Lack of varied, spontaneous make-believe, or social imitative play appropriate to developmental level
3. Restrictive repetitive and stereotypic patterns of behavior, interests, and activities, as manifested by at least one of the following:
- A. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
- B. Apparently inflexible adherence to specific nonfunctional routines or rituals
- C. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
- D. Persistent preoccupation with parts of objects.
Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
- 1. Social interaction
- 2. Language as used in social communication
- 3. Symbolic or imaginative play
The disturbance is not better accounted for by Retts Disorder or childhood disintegrative disorder.
Sources:
Autism Spectrum Disorders (Pervasive Developmental Disorders). 2004: National Institute for Mental Health (NIMH) 2004.
