Question

2. Review the diagnostic criteria for autism spectrum disorders and discuss the diagnostic criteria and why it is considered a “spectrum disorder.”

Answer 1

• The current DSM diagnostic taxonomy places Autism Spectrum Disorders (ASDs) in the category of pervasive developmental disorders (PDDs). The class of PDDs includes five disorders, with the term, ASD, applied to Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), excluding Rett’s syndrome and Childhood Disintegrative Disorder.
• Diagnosis of Autistic Disorder requires a minimum of six behavioral criteria, at least two from the domain of social impairment and one from each of the other two areas of impairment (communication and restricted/repetitive behaviors).
• Contrasting the disorder from more general intellectual impairment, these social and communicative deficits are considered with respect to overall developmental level.
• Diagnostic Criteria:-
• 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 absence of interest in peers.
• Specify current severity:-
• Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
• 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 stereotypes, 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 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 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).
• Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
• 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.
• Autism spectrum disorder (ASD) is a neurological and developmental disorder that begins early in childhood and lasts throughout a person's life. It affects how a person acts and interacts with others, communicates, and learns.
• It includes what used to be known as syndrome and pervasive developmental disorders.
  It is called a "spectrum" disorder because people with ASD can have a range of symptoms. People with ASD might have problems talking with you, or they might not look you in the eye when you talk to them.
• They may also have restricted interests and repetitive behaviors. They may spend a lot of time putting things in order, or they may say the same sentence again and again. They may often seem to be in their "own world."
• 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 autism spectrum disorder.
• 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.