How is Defined ASD in the DSM-5

24 April 2019 Posted by Kenny Oliva Autism , No Comments

The DSM (Diagnostic and Statistical Manual of Mental Disorders) as its name says, is a diagnostic and statistical manual of mental disorders, edited by the American Psychiatric Association (APA). The purpose of this manual is to classify mental disorders as well as provide clear descriptions of the different categories in which these are, so it can be useful for different clinicians and researchers in the health sciences fields. The latest edition is the DSM-5, and what its intended with its implication is that it becomes more dynamic when it comes to incorporating new scientific discoveries. This is very useful when it comes to making a medical diagnosis, studying one of the different disorders in it or sharing information to treat them.

The autistic spectrum disorder in the DSM-5

First of all, it is necessary to point out that the previous version of the DSM defined autism and its associated disorders as “pervasive developmental disorders” (PDD), while in the recent version (DSM-5) the term definition has been substituted for “autism spectrum disorder” (ASD), and has been included in the neurodevelopmental disorders category.

This said, below you’ll find detail information about the diagnostic criteria for autism spectrum disorder, provide by the American Psychiatric Association:

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history.
1. 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.
2. Deficits in nonverbal communicative behaviors 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.
3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to the absence of interest in peers.

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history.
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, ritualized patterns or verbal-nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take the same route or eat food every day).
3. 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 interest).
4. Hyper or hyporeactivity to sensory input or unusual interests 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).

C. 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).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

NOTE: individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder or pervasive developmental disorder not otherwise specified should be given the diagnosis of ASD. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.

The DSM-5 has also included a table that shows different severity levels for autism spectrum disorder as well as the help required for each level, these are:

Level 1: “Requiring support.”
Level 2: “Requiring substantial support.”
Level 3: “Requiring very substantial support.”

Autism is a complex neurobehavioral condition, therefore, is understandable that information about this condition is constantly being updated, but what’s really important about these updates, is that with each one we learn how to help people with autism in better ways, so it’s essential to keep up with the DSM information about ASD.

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