Autism Diagnosis Criteria: DSM-5

The DSM-5 is the standard reference that healthcare providers use to diagnose autism. Click here to find out how autism is diagnosed using DSM-5 criteria. Skiptomaincontent AutismSpeaks MyAutismGuide Walk Donate Walk Donate AboutUs Events COVID-19 SetYourLocation WhatIsAutism? LearntheSigns SymptomsofAutism WhatCausesAutism? AspergerSyndrome AutismStatisticsandFacts LearnaboutScreening ScreeningQuestionnaire FirstConcerntoAction AutismDiagnosisCriteria:DSM-5 NewlyDiagnosed AssociatedConditions SensoryIssues Interventions AccessServices Insurance CaregiverSkillsTraining(CST) Help&Information InformationbyTopic Directory ResourceGuide AutismResponseTeam OurWork OurMission OurGrantmaking ResearchPrograms GetInvolved Fundraise Walk TeamUp KindnessCampaign SocialFundraising WaystoGive Memorial&Tributes Stocks WorkplaceGiving Shop Advocate CorporateSupport BecomeaSupporter WaystoEngage MeetourSupporters ¿Queeselautismo? 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AutismDiagnosisCriteria:DSM-5 WhataretheDSM-5diagnosticcriteriaforautism? In2013,theAmericanPsychiatricAssociationreleasedthefiftheditionofitsDiagnosticandStatisticalManualofMentalDisorders(DSM-5).  TheDSM-5isnowthestandardreferencethathealthcareprovidersusetodiagnosementalandbehavioralconditions,includingautism.  ByspecialpermissionoftheAmericanPsychiatricAssociation,youcanreadthefull-textofthenewdiagnosticcriteriaforautismspectrumdisorderandtherelateddiagnosisofsocialcommunicationdisorderbelow. Alsosee:AnswerstofrequentlyaskedquestionsaboutDSM-5criteriaforautism DSM-5AutismDiagnosticCriteria A.Persistentdeficitsinsocialcommunicationandsocialinteractionacrossmultiplecontexts,asmanifestedbythefollowing,currentlyorbyhistory(examplesareillustrative,notexhaustive,seetext): Deficitsinsocial-emotionalreciprocity,ranging,forexample,fromabnormalsocialapproachandfailureofnormalback-and-forthconversation;toreducedsharingofinterests,emotions,oraffect;tofailuretoinitiateorrespondtosocialinteractions. Deficitsinnonverbalcommunicativebehaviorsusedforsocialinteraction,ranging,forexample,frompoorlyintegratedverbalandnonverbalcommunication;toabnormalities in eyecontactandbodylanguageordeficitsinunderstandinganduseofgestures;toatotallackoffacialexpressionsandnonverbalcommunication. Deficitsindeveloping,maintaining,andunderstandingrelationships,ranging,forexample,fromdifficultiesadjustingbehaviortosuitvarioussocialcontexts;todifficultiesin sharingimaginativeplayorinmakingfriends;toabsenceofinterestinpeers. Specify currentseverity:Severityisbasedonsocialcommunicationimpairmentsandrestrictedrepetitivepatternsofbehavior. (Seetablebelow.) B.Restricted,repetitivepatternsofbehavior,interests,oractivities,asmanifestedbyatleasttwoofthefollowing,currentlyorbyhistory(examplesareillustrative,notexhaustive;seetext): Stereotypedorrepetitivemotormovements,useofobjects,orspeech(e.g.,simplemotorstereotypies,lininguptoysorflippingobjects,echolalia,idiosyncraticphrases). Insistenceonsameness,inflexibleadherencetoroutines,orritualizedpatternsorverbalnonverbalbehavior(e.g.,extremedistressatsmallchanges,difficultieswithtransitions,rigidthinkingpatterns,greetingrituals,needtotakesamerouteoreatfoodeveryday). Highlyrestricted,fixatedintereststhatareabnormalinintensityorfocus(e.g,strongattachmenttoorpreoccupationwithunusualobjects,excessivelycircumscribedorperseverativeinterest). Hyper-orhyporeactivitytosensoryinputorunusualinterestsinsensoryaspectsoftheenvironment(e.g.,apparentindifferencetopain/temperature,adverseresponsetospecificsoundsortextures,excessivesmellingortouchingofobjects,visualfascinationwithlightsormovement). Specify currentseverity:Severityisbasedonsocialcommunicationimpairmentsandrestricted,repetitivepatternsofbehavior. (Seetablebelow.) C.Symptomsmustbepresentintheearlydevelopmentalperiod(butmaynotbecomefullymanifestuntilsocialdemandsexceedlimitedcapacitiesormaybemaskedbylearnedstrategiesinlaterlife). D.Symptomscauseclinicallysignificantimpairmentinsocial,occupational,orotherimportantareasofcurrentfunctioning. E.Thesedisturbancesarenotbetterexplainedbyintellectualdisability(intellectualdevelopmentaldisorder)orglobaldevelopmentaldelay.Intellectualdisabilityandautismspectrumdisorderfrequentlyco-occur;tomakecomorbiddiagnosesofautismspectrumdisorderandintellectualdisability,socialcommunicationshouldbebelowthatexpectedforgeneraldevelopmentallevel. Note: Individualswithawell-establishedDSM-IVdiagnosisofautisticdisorder,Asperger’sdisorder,orpervasivedevelopmentaldisordernototherwisespecifiedshouldbegiventhediagnosisofautismspectrumdisorder.Individualswhohavemarkeddeficitsinsocialcommunication,butwhosesymptomsdonototherwisemeetcriteriaforautismspectrumdisorder,shouldbeevaluatedforsocial(pragmatic)communicationdisorder. Specify if: Withorwithoutaccompanyingintellectualimpairment Withorwithoutaccompanyinglanguageimpairment (Codingnote: Useadditionalcodetoidentifytheassociatedmedicalorgeneticcondition.) Associatedwithanotherneurodevelopmental,mental,orbehavioraldisorder (Codingnote: Useadditionalcode[s]toidentifytheassociatedneurodevelopmental,mental,orbehavioraldisorder[s].) Withcatatonia  Associatedwithaknownmedicalorgeneticconditionorenvironmentalfactor Table:Severitylevelsforautismspectrumdisorder Severitylevel Socialcommunication Restricted,repetitivebehaviors Level3 "Requiringverysubstantialsupport” Severedeficitsinverbalandnonverbalsocialcommunicationskillscausesevereimpairmentsinfunctioning,verylimitedinitiationofsocialinteractions,andminimalresponsetosocialoverturesfromothers.Forexample,apersonwithfewwordsofintelligiblespeechwhorarelyinitiatesinteractionand,whenheorshedoes,makesunusualapproachestomeetneedsonlyandrespondstoonlyverydirectsocialapproaches Inflexibilityofbehavior,extremedifficultycopingwithchange,orotherrestricted/repetitivebehaviorsmarkedlyinterferewithfunctioninginallspheres.Greatdistress/difficultychangingfocusoraction. Level2 "Requiringsubstantialsupport” Markeddeficitsinverbalandnonverbalsocialcommunicationskills;socialimpairmentsapparentevenwithsupportsinplace;limitedinitiationofsocialinteractions;andreducedor abnormalresponsestosocialoverturesfromothers.Forexample,apersonwhospeakssimplesentences,whoseinteractionislimited tonarrowspecialinterests,andhowhasmarkedlyoddnonverbalcommunication. Inflexibilityofbehavior,difficultycopingwithchange,orotherrestricted/repetitivebehaviorsappearfrequentlyenoughtobeobvioustothecasualobserverandinterferewithfunctioningin avarietyofcontexts.Distressand/ordifficultychangingfocusoraction. Level1 "Requiringsupport” Withoutsupportsinplace,deficitsinsocialcommunicationcausenoticeableimpairments.Difficultyinitiatingsocialinteractions,andclearexamplesofatypicalorunsuccessfulresponsetosocialoverturesofothers.Mayappeartohavedecreasedinterestinsocialinteractions.Forexample,apersonwhoisabletospeakinfullsentencesandengagesincommunicationbutwhoseto-and-froconversationwithothersfails,andwhoseattemptstomakefriendsareoddandtypicallyunsuccessful. Inflexibilityofbehaviorcausessignificantinterferencewithfunctioninginoneormorecontexts.Difficultyswitchingbetweenactivities.Problemsoforganizationandplanninghamper independence. Social(Pragmatic)CommunicationDisorder DiagnosticCriteria A.Persistentdifficultiesinthesocialuseofverbalandnonverbalcommunicationasmanifestedbyallofthefollowing: Deficitsinusingcommunicationforsocialpurposes,suchasgreetingandsharinginformation,inamannerthatisappropriateforthesocialcontext. Impairmentoftheabilitytochangecommunicationtomatchcontextortheneedsofthelistener,suchasspeakingdifferentlyinaclassroomthanontheplayground,talkingdifferentlytoachildthantoanadult,andavoidinguseofoverlyformallanguage. Difficultiesfollowingrulesforconversationandstorytelling,suchastakingturnsinconversation,rephrasingwhenmisunderstood,andknowinghowtouseverbalandnonverbalsignalstoregulateinteraction. Difficultiesunderstandingwhatisnotexplicitlystated(e.g.,makinginferences)andnonliteralorambiguousmeaningsoflanguage(e.g.,idioms,humor,metaphors,multiplemeaningsthatdependonthecontextforinterpretation). B.Thedeficitsresultinfunctionallimitationsineffectivecommunication,socialparticipation,socialrelationships,academicachievement,oroccupationalperformance,individuallyorincombination. C. Theonsetofthesymptomsisintheearlydevelopmentalperiod(butdeficitsmaynotbecomefullymanifestuntilsocialcommunicationdemandsexceedlimitedcapacities). D.Thesymptomsarenotattributabletoanothermedicalorneurologicalconditionortolowabilitiesinthedomainsorwordstructureandgrammar,andarenotbetterexplainedbyautismspectrumdisorder,intellectualdisability(intellectualdevelopmentaldisorder),globaldevelopmentaldelay,oranothermentaldisorder. Formoreinformation DSM-5andAutism:FrequentlyAskedQuestions