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Diagnostic Criteria from DSM-V


A. Persistent deficits in social communication and social interaction across multiple contexts, as

manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):

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 absence of interest in



B. Restricted repetitive patterns of behavior, interests, or activities, as manifested by at least two

    of the following, currently or by history (examples are illustrative, not exhaustive; see text):

    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, or ritualized patterns of  

               verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with  

               transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same

               food everyday 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 interests).

    4. Hyper- or hyporeactivity 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).


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 co-occur; to make comorbid diagnoses of autism spectrum disorder and   

    intellectual disability, social communication should be below that expected for general     

    developmental level.

Additional Information:

National Institute of Mental Health (NIMH), HHS, US.Gov; Autism

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