ASD - Diagnosis

Autism Spectrum Disorder (ASD) Diagnosis Overview

Introduction to ASD

• Introduced into the DSM-III in 1980 as a "pervasive developmental disorder."
• Eligible for special education services starting in 1990.
• Asperger’s Syndrome included in the DSM in 1994.

Changes in Diagnostic Criteria

• The DSM-5 (2013) replaces previous specific conditions with the broader term Autism Spectrum Disorder (ASD):
  • High functioning autism
  • Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
  • Asperger’s Disorder

Diagnostic Criteria

Criterion #1: Social Communication and Interaction

• ASD is characterized by persistent deficits in social communication and social interaction across multiple contexts, evidenced by all of the following:
  • Deficits in social reciprocity: Difficulty in back-and-forth conversations, lack of shared interest.
  • Limited non-verbal communication: Challenges with body language, eye contact, and gestures.
  • Difficulty in relationships: Challenges in understanding, establishing, and maintaining relationships.

Criterion #2: Restricted and Repetitive Behaviors

• At least two of the following must be present:
  • Stereotyped, repetitive movements or speech: Hand-flapping, echolalia.
  • Insistence on sameness: Difficulty with changes in routine or environment.
  • Restricted, fixated interests: Intense focus on specific subjects or objects, such as trains or numbers.
  • Hyper- or hypo-reactivity: Over- or under-sensitivity to sensory input (sounds, textures).

Specifiers for ASD Diagnosis

• Severity Levels for Criteria 1 & 2:
  • Very substantial support (Level 3)
  • Substantial support (Level 2)
  • Support needed (Level 1)
• Language impairment: Potential delays or deficits in language skills.
• Medical concerns: Including gastrointestinal problems, sleep issues, or seizure disorders.
• Comorbid conditions: Other neurodevelopmental, psychological, or behavioral disorders may accompany ASD.
• Intellectual impairment: Possible co-occurring cognitive delays or disabilities.