Autism - diagnosis

autism; Autism Spectrum Disorders; Asperger syndrome; disorder; communication; intellectual disability; early intervention; developmental disorder; echolalia; savant;

Classification of autistic disorder - from the Diagnostic and Statistical Manual of Mental Disorders,
4^th Edition (DSM IV), American Psychiatric Association, 1994.

See also the topics:

• Autism
• Autism - resources
• Autism Spectrum Disorder
• Communication difficulties

DSM IV

1. A total of 6 (or more) items from (1), (2) and (3), with at least 2 from (1) and one each from (2) and (3).

1. qualitative impairment in social interaction, as manifested by at least two of the following:

1. marked impairment in the use of multiple non-verbal behaviours such as eye to eye gaze, facial expression, body postures and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interest or achievements with other people (eg by a lack of showing, bringing or pointing out objects of interest).

2. qualitative impairment in communication as manifested by at least one of the following:

1. 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)
2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

3. restrictive, repetitive and stereotyped patterns of behaviour, interests and activities, as manifested by at least one of the following:

1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific non-functional routines or rituals
3. stereotyped and repetitive motor mannerisms (eg hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects.

2. 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.

By comparison, the DSM IV listing for Asperger's Disorder (also called Asperger Syndrome) has similar criteria of qualitative impairment in social interaction, and of restrictive repetitive and stereotyped patterns of behaviour, interest and activities, plus the following criteria:

3. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
4. There is no clinically significant general delay in language (eg single words by 2 years, communicative phrases used by age 3 years).
5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behaviour (other than in social interaction), and curiosity about the environment in childhood.
6. Criteria not met for another pervasive developmental disorder or schizophrenia.

 

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