06 Mar Autism Spectrum Disorder and the DSM-5

The DSM-5 is the Diagnostic Statistics Manual, Fifth Edition (DSM-5) written for healthcare providers to diagnose various mental health disorders or conditions. All healthcare providers use the DSM as a way to standardise diagnoses worldwide, and identify possible treatment plans.

For an individual to be diagnosed with autism spectrum disorder they need to meet certain criteria. An individual must have challenges with communication and social interaction, as well as problems with restrictive and repetitive patterns or behaviours.

Social communication and interaction:

Social communication refers to any communication process between people, while social interaction is one’s ability to recognize that others are social beings. All verbal and non-verbal communication forms part of social interactions.

1. Deficits in social-emotional reciprocity
   1. Lack of normal back-and-forth conversation
   2. Trouble sharing with others
   3. Challenges understanding own and others’ emotions
   4. Difficulty initiating social interactions with others
2. Deficits in nonverbal communicative behaviours used for social interaction
   1. Poorly integrated verbal and nonverbal communication
   2. Limited eye contact and body language
   3. Insufficient understanding and use of gestures
   4. Minimal facial expressions
3. Deficits in developing, maintaining, and understanding relationships
   1. Difficulties adjusting behaviour to suit various social contexts
   2. Difficulties in imaginative play or in making friends
   3. Limited interest to play in groups or with others
   4. Difficulty understanding the ‘rules of the game”

Restrictive, repetitive behaviours, interests or activities:

Restrictive and repetitive behaviours are actions that are constantly repeated by an individual. And they must be performed in order for the individual to continue with their day.

1. Stereotyped or repetitive motor movements, use of objects, or speech
   1. Lining up toys
   2. Flipping objects
   3. Echolalia
2. Insistence on sameness, inflexible conforming to routines, or ritualized patterns of verbal or nonverbal behaviour
   1. Changing between different activities
   2. Moving between spaces
3. Highly restricted, obsessive interests that are abnormal in intensity or focus
   1. Fixated interest with a character or movie
   2. Obsessive behaviour with a type of toy or random item
4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
   1. Challenges brushing teeth
   2. Trying new foods
   3. Wearing shoes or walking barefoot
   4. Blocking of ears

The abovementioned signs must be present in the early developmental period and must cause clinically significant impairment in social, occupational, or other important areas of current functioning in order to be diagnosed.