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The Criteria for a Diagnosis of Autism

Autistic disorder is classified in the Diagnostic and Statistical Manual, a reference published by the American Psychiatric Association, as having 6 or more symptoms from a list of 12 possible symptoms. The manual groups these symptoms of autism into three areas: social interaction, communication, and behavior. The DSM is revised regularly, and so are the categories. The next edition, the DSM 5, will likely be released in 2013 with significant changes in how diagnostic criteria for autism are defined and used. One good aspect is that it appears that sensory issues will become part of the defining criteria.

Your child must have at least six symptoms, with at least two symptoms indicating social-interaction deficits and one symptom in each of the communication and behavior categories. A child who has most of the symptoms — up to 12, according to the American Psychiatric Association — will usually be diagnosed as autistic, or sometimes called classic autism. Others who have only a few symptoms may be classified as developmentally disabled, with autistic-like features. If you’re thinking this sounds imprecise, you’re right. Researchers are still debating which disorders belong on the autism spectrum.

Asperger Syndrome is also listed on the autism spectrum. Diagnosticians for Asperger's focus on the social and behavioral categories for this part of the spectrum, due to the lack of significant clinical delay in verbal communication in people with Asperger Syndrome.

Here are the 12 symptoms listed within their respective categories:

  • Social interaction:

    • Marked impairment in the use of multiple nonverbal behaviors

    • Failure to develop age-appropriate peer relationships

    • Lack of spontaneous seeking to share interests and achievements with others

    • Lack of social or emotional reciprocity

  • Communication:

    • Delay in or lack of spoken language development (with no compensation through alternative modes of communication) in verbal persons

    • Marked impairment in conversational skills

    • Stereotyped and repetitive use of language

    • Lack of spontaneous age-appropriate make-believe or social-imitative play

  • Behavior:

    • Preoccupation with at least one stereotyped and restricted pattern of interest to an abnormal degree

    • Inflexible adherence to nonfunctional routines or rituals

    • Repetitive motor mannerisms and preoccupation with parts of objects

    • Persistent preoccupation with parts of objects

Besides showing at least six of these symptoms, your child also needs to show a delay in social interaction, social communication, or symbolic or imaginative play. The Diagnostic and Statistical Manual and most medical professionals agree that these symptoms generally must occur before the child is 3 years old. A diagnosis of autism can occur later (even up to old age) if it’s clear that the symptoms began before the age of three.

After looking at the symptoms, criteria, and the vague labels attached, you may begin to think that autism isn’t a very informative label. However, the diagnosis is a starting point for getting treatment. Although the Food and Drug Administration (FDA) hasn’t approved any medical treatments for autism itself, it has approved treatments for related problems that may occur, such as irritable bowel syndrome, anxiety, vitamin deficiencies, and other physical conditions from which autistic people frequently suffer. When you treat those health issues, you can reduce or even eliminate many symptoms.

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