DSM 5 Criteria Explained
The DSM 5 is the current diagnostic manual used by social workers, therapists, and psychologists to diagnose neurodevelopmental and mental health conditions. Because it is intended for professionals, the language in it is often difficult to understand. In this post, or series of posts, I will go through each of the diagnostic criteria for Autism Spectrum Disorder.
Category A in the criteria addresses persistent deficits in social communication and interactions with others. To qualify, these deficits must be present across multiple contexts like school and home. Each of the following must be present in some capacity:
1. Deficits in social exchanges
Examples: starting conversations inappropriately or not at all, failure to maintain conversation, reduced sharing of interests or emotions, and failure to respond to social interactions in the expected way
2. Deficits in nonverbal communication
Examples: reduced or nonexistent eye contact, not understanding/using social gestures, lack of expected facial expressions, and struggles combining verbal and nonverbal communication
3. Deficits in developing and maintaining relationships
Examples: struggles to adapt behavior to different social contexts, difficulty making friends, not being interested in making friends, and difficulty cognitively understanding relationships
Category B in the criteria addresses repetitive movements, behaviors, and interests. To qualify, two of the following must be met currently or historically.
1. Repetitive motor movements, use of objects, or speech
Examples: simple motor behaviors, repeatedly lining up toys, echoing speech or sounds, and scripting responses to situations or socializations
2. Insistence on sameness or routines
Examples: extreme distress at small changes, difficulties with transitions, rigid thinking patterns, and doing things the same way
3. Restricted interests
Examples: strong attachment to unusual objects, only talking about one topic or interest, and choosing to play with a single category of toys
4. Under or overreaction to sensory input
Examples: apparent indifference to pain or temperature, adverse responses to specific sounds/lights/textures, fascination with certain stimuli, and using sensory stimuli to self-regulate
Category C addresses the fact that signs of autism must be present early in development, even if they don’t fully manifest until later. It also addresses how people can be taught to mask their symptoms, especially as they get older. Unmasking might be required for someone to get an accurate diagnosis.
Category D simply states that the symptoms the person is experiencing must make it difficult to function in relationships, work, school, and/or other areas of functioning.
Category E states that, to be diagnosed with autism, the symptoms are not better explained by another condition. This category is to remind the person doing the diagnosis to check for other conditions that can influence scores on autism screenings, such as an intellectual disability.
