Understanding Autism Spectrum Disorder (ASD) Diagnostic Criteria
Dr. Danish frequently works with patients who have Autism Spectrum Disorder (ASD) and collaborates with Chris Smith, who heads the Autism treatment program at Philadelphia Integrative Psychiatry. This handout is designed to break down the diagnostic criteria for ASD, based on research. While it is not exhaustive, it is intended to foster discussion between patients and their healthcare providers.
Two Main Categories of Symptoms
ASD is characterized by two primary categories of symptoms:
Social Communication and Interaction Deficits: These involve challenges in social communication and interaction.
Restricted and Repetitive Behaviors: These include limited, repetitive patterns of behavior, interests, or activities.
These symptoms are considered a disorder because they are pervasive, affecting various settings and aspects of life, and they impair everyday functioning.
Onset and Course of Symptoms
According to the DSM-5, the symptoms of ASD must be present from early childhood. However, they might not be noticeable until social demands increase, revealing limitations in social communication and interaction. These symptoms might not be evident during an evaluation but can be identified through historical accounts. Over time, specific symptoms may change, or individuals may develop strategies to mask them.
A. Social Communication and Interaction Deficits
For a diagnosis of ASD, there must be deficits in three key areas:
Social-Emotional Reciprocity: This includes abnormal social approaches, failure in back-and-forth conversations, reduced sharing of interests or emotions, and failure to initiate or respond to social interactions. Other examples include impaired joint attention, lack of spontaneous sharing, and not seeking comfort when distressed.
Nonverbal Communicative Behaviors: Deficits here include poorly integrated verbal and nonverbal communication, abnormal eye contact and body language, and a lack of facial expressions. Individuals may have difficulty interpreting or conveying meaning through tone of voice and gestures.
Developing, Maintaining, and Understanding Relationships: Challenges in this area include difficulty adjusting behavior to suit different social contexts, sharing imaginative play, making friends, and understanding social nuances like "white lies" or jokes.
B. Restricted and Repetitive Patterns of Behavior, Interests, or Activities
At least two of the following must be present for an ASD diagnosis:
Stereotyped or Repetitive Movements, Use of Objects, or Speech: Examples include motor stereotypies, lining up toys, echolalia, and idiosyncratic phrases.
Insistence on Sameness and Routines: This includes extreme distress at small changes, rigid thinking patterns, and a need for consistent routines.
Highly Restricted, Fixated Interests: These are interests that are abnormal in intensity or focus, such as strong attachments to unusual objects.
Sensory Reactivity: This includes hyper- or hyporeactivity to sensory input, such as indifference to pain, adverse responses to specific sounds, or fascination with lights or movement.
Getting in Touch with Dr. Danish and His Team
At Philadelphia Integrative Psychiatry, we are committed to practicing the subtle nuances of psychiatry, a field often prone to misdiagnoses and inaccurate assessments. Our holistic and integrative approach ensures comprehensive care, considering all aspects of well-being. If you or a loved one needs support for ASD or similar conditions, please text or call 610-999-6414 to learn how we can help.
For more on this topic and related subjects, check out these blogs:
This blog looks at the role sensory processing concerns play in many patients with ADHD.
This blog looks at ARFID, which is a subtype of sensory processing disorder.
This blog looks at PDA, or Pathological Demand Avoidance, which can lead to rage and regular outbursts in patients who do not fit criteria for ASD.
This blog dives further into sensory processing disorder including research that backs up both diagnosing and treating it.
