Monday, February 20, 2012


Here is the diagnostic criteria for the DSM-IV:

Diagnostic Criteria for 299.00 Autistic Disorder

[The following is from Diagnostic and Statistical Manual of Mental Disorders: DSM IV]
(I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)
(A) qualitative impairment in social interaction, as manifested by at least two of the following:
1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
4. lack of social or emotional reciprocity ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids )
(B) qualitative impairments in communication as manifested by at least one of the following:
1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:
1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects
(II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
(A) social interaction
(B) language as used in social communication
(C) symbolic or imaginative play
(III) The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder

Here is the criteria for the DSM-V:

DSM-V Autistic Disorder 299.00 Diagnostic Criteria

by MELISSA on FEBRUARY 25, 2010
The American Psychiatric Association has published the proposed draft revisions for the DSM-V, which is scheduled to be published in 2013. Included in the proposed changes is a new set of diagnostic criteria for Autistic Disorder – 299.00

The term “Autism Spectrum Disorder”, which is commonly used by parents and autism professionals, will also be used as a synonym for Autistic Disorder.

The following is the proposed revision diagnostic criteria for Autistic Disorder in the DSM-V:

Must meet criteria 1, 2, and 3:

1. Clinically significant, persistent deficits in social communication and interactions, as manifest by all of the following:

a.  Marked deficits in nonverbal and verbal communication used for social interaction:
b.  Lack of social reciprocity;
c.  Failure to develop and maintain peer relationships appropriate to developmental level

2.  Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:

a.  Stereotyped motor or verbal behaviors, or unusual sensory behaviors
b.  Excessive adherence to routines and ritualized patterns of behavior
c.  Restricted, fixated interests

3.  Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

The social and communication deficits used to diagnose autism spectrum disorders with the DSM-IV have been merged into a social/communication deficit domain. It is important to note that a statistically significant delay in language will no longer be needed in order for an individual to be diagnosed with autistic disorder using the DSM-V.

To help differentiate between what was once Asperger’s Syndrome, PDD-NOS, and autistic disorder, the American Psychiatric Association (APA) will propose severity criteria. These criteria are currently unavailable.

The APA has listed two rationale for the proposed changes:

Differentiation of autism spectrum disorder from typical development and other “nonspectrum” disorders is done reliably and with validity; while distinctions among disorders have been found to be inconsistent over time, variable across sites and often associated with severity, language level or intelligence rather than features of the disorder.
Because autism is defined by a common set of behaviors, it is best represented as a single diagnostic category that is adapted to the individual’s clinical presentation by inclusion of clinical specifiers (e.g., severity, verbal abilities and others) and associated features (e.g., known genetic disorders, epilepsy, intellectual disability and others.) A single spectrum disorder is a better reflection of the state of knowledge about pathology and clinical presentation; previously, the criteria were equivalent to trying to “cleave meatloaf at the joints”.

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