What are the criteria for diagnosing autism spectrum disorder according to the Fifth Diagnostic Manual – DSM-5?
In 2013, The American Psychiatric Association has released the fifth edition of its Diagnostic and Statistical Manual of Developmental Disorders (DSM-5).
The DSM-5 is now the standard reference that health care providers use to diagnose developmental and behavioral disorders, including autism spectrum disorder.
Diagnostic criteria for autism spectrum disorder – (DSM-5)
a. Persistent and persistent deficits in social skills, communication, and social interaction across multiple contexts (examples here are illustrative and not exhaustive):
1- Deficiencies in social and emotional skills such as, Inability to conduct normal conversation, how to start or end a conversation, and failure to form or respond to relationships and social interactions.
2- Deficiencies in non-verbal communicative behaviors used in social interaction such as, Integrated verbal and non-verbal communication, inability to make sustained eye contact, deficiencies in body language and gestures, deficiencies in facial expressions and non-verbal communication.
3- Deficiencies in developing, maintaining and understanding relationships, such as: Inappropriate behavior in different social contexts, difficulty engaging in imaginative play or making friends, and lack of interest in peers.
When determining current severity, severity is based on poor social communication and limited and repetitive behavior patterns (see table below).
B. Limited and repetitive patterns of behavior or limited interests and activities and must include at least two of the following (examples here are illustrative and not exhaustive):
1- Stereotyped, repetitive movements or using objects and speech in a stereotypical manner (such as: repetitive stereotyped movements, arrangement of games, Stirring things echo, Repeat some phrases.
2- Insistence on order, inflexible adherence to routine, adherence to routine rituals, or verbal and non-verbal behavior (e.g. Anger at small changes, Facing difficulties when moving from one place to another and having to take the same path, Eat the same food every day).
3- Very specific interests that are abnormal in intensity and focus (eg: Strong attachment, interest, and preoccupation with things that are extremely or mildly unusual.
4- Sensory input or abnormal interests in sensory aspects of the environment (such as: Lack of sensation of pain and temperature, And the opposite response to sounds, Excessive smelling and touching, Optical focus with lights).
When determining current severity, severity is based on poor social communication and limited and repetitive behavior patterns (see table below).
T. Symptoms should be present in early childhood (but may not fully appear until social demands have passed or may be triggered by later learned strategies).
C. Skill deficiencies may cause significant impairment in social, occupational, or other important areas of current functioning.
Dr.. These disorders may not be explained accurately, such as intellectual disability (intellectual developmental disorder) or developmental delay, Intellectual disability and autism spectrum disorder can occur at the same time, and until the coexisting diagnoses of autism spectrum disorder and intellectual disability are made, social communication must be less than expected for a normal level of development.
note: Individuals with an established DSM-IV diagnosis of autism spectrum disorder, Asperger’s disorder, or other developmental disorders should be diagnosed with autism spectrum disorder. Therefore, individuals who have significant deficits in social communication should be evaluated.
It should be determined whether a diagnosis of autism spectrum disorder is accompanied by certain:
- To be with or without an accompanying intellectual disability
- May be with or without accompanying language impairment
- It must be related to another neurological, mental, or behavioral disorder
- It must be linked to a medical or genetic condition or linked to a known environmental factor
Here is a table showing the risk levels for autism spectrum disorder:
|
Risk level |
Social Media |
Limited and repetitive behaviors |
|
Level 3 “It needs a lot of support.” |
Severe deficiency in verbal and non-verbal social communication skills causes severe impairment in performance and lack of response to the social interactions of others, for example, An individual with few words rarely initiates interaction and when he does he takes up the conversation solely to meet his needs and only responds to direct speech directed at him. |
Inconsistency of behavior, extreme difficulty coping with change in routine, and other limited/repetitive behaviors that significantly interfere with performance in all areas. |
|
Level 2 “It needs a lot of support” |
A clear deficiency in verbal and non-verbal social communication skills, even with the presence of means of support, social interactions are limited and there is a lack of social responses to others, for example, An individual who speaks in simple sentences and whose interaction is limited to his or her interests has significantly less nonverbal interaction. |
Behavioral inconsistency or difficulty coping with change in routine and other limited/repetitive behaviors may appear frequently enough to be obvious to the observer and may interfere with performance in a variety of domains. |
|
Level 1 “Needs support” |
With no support, Deficiencies in social communication cause difficulty initiating social interactions and little interest in social interactions. For example, A person who is able to speak complete sentences in communication, but some failure may occur when conversing with others, and his attempts to form some friendships are usually unsuccessful. |
Inconsistency in behavior may lead to significant interference with performance in one or more areas, difficulty switching between activities, and some problems of organization and planning may hinder the individual’s independence. |
Social communication disorder
Criteria for diagnosing social communication disorder
a. Persistent difficulties in social communication and verbal and non-verbal communication in:
1- Deficiencies in social communication such as, Greeting and exchanging information in a manner appropriate to the social context.
2- Inability to conduct a conversation that suits the context or the needs of the listener, such as, Talk differently to a child and an adult, Avoid using too much formal language.
3- Difficulties in following the rules of conversation and storytelling such as, roles in conversation, And rephrase when you hear it incorrectly, And know how to use verbal and non-verbal cues.
4- Difficulty in understanding the metaphorical or ambiguous meanings of language, for example, Slang, humor, metaphorical expressions, Multiple meanings that depend on the context of interpretation.
B. Deficiencies in social interaction and deficiencies in social participation, social relationships, academic achievement, or professional performance, individually or collectively.
C- Deficiencies begin to appear in the early developmental period (but the deficiencies may not fully appear until they exceed the demands of social communication).
Dr.. When deficiencies appear, they may not be viewed as a medical or neurological condition or a decrease in abilities in some area. Deficiencies are best not explained by autism spectrum disorder, intellectual disability, developmental delay, or some other mental disorder.
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