Before diving straight into the breaking down of the criteria let’s look at what the criteria are for those
unfamiliar. There are two diagnostic manuals. The Diagnostic and Statistical Manual of Mental Disorders
(DSM) and the International Classification of Diseases (ICD).
Criteria From The DSM 5 TR
Persistent deficits in social communication and social interaction across multiple contexts, as
manifested by all of the following, currently or by history (examples are illustrative, not exhaustive;
see text):
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and
failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect;
to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviours used for social interaction, ranging, for example, from
poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body
language or deficits in understanding and use of gestures; to a total lack of facial expressions and
nonverbal communication.
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from
difficulties adjusting behaviour to suit various social contexts; to difficulties in sharing
imaginative play or in making friends; to absence of interest in peers.
Restricted, repetitive patterns of behaviour, interests, or activities, as manifested by at least two of
the following, currently or by history (examples are illustrative, not exhaustive; see text):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies,
lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualised patterns of verbal or
nonverbal behaviour (e.g., extreme distress at small changes, difficulties with transitions, rigid
thinking patterns, greeting rituals, need to take same route or eat same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment
to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper- or hypo- reactivity to sensory input or unusual interest in sensory aspects of the environment
(e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures,
excessive smelling or touching of objects, visual fascination with lights or movement).
Symptoms must be present in the early developmental period (but may not become fully manifest until
social demands exceed limited capacities, or may be masked by learned strategies in later life).
These disturbances are not better explained by intellectual developmental disorder (intellectual
disability) or global developmental delay. Intellectual developmental disorder and autism spectrum
disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual
developmental disorder, social communication should be below that expected for general developmental
level.
These disturbances are not better explained by intellectual developmental disorder (intellectual
disability) or global developmental delay. Intellectual developmental disorder and autism spectrum
disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual
developmental disorder, social communication should be below that expected for general developmental
level.