Diagnosing Autism

The definition of autism is based on the diagnostic criteria provided in the American Psychiatric Association’s Diagnostic and Statistical manual of Mental Disorders – Fourth Edition (DSM-IV). Autism is included under DSM-IV’

s Pervasive Developmental Disorders. This is a category of disorders in which many basic areas of infant and child psychological development are affected at the same time, and to a severe degree. The disorder has three major hallmarks: qualitative impairment in social interaction, qualitative impairment in communication, and restricted, repetitive and stereotypical pattern behaviors, interests and activities. Onset in delays is very early; prior to three years of age. To meet DSM-IV diagnostic criteria for autism, children will display impairment in social interaction in at least two ways, impairment in communication in at least one way, and restricted, repetitive and stereotypical patterns of behavior, interests and activities in at least one way. According to DSM-IV, impairment in social interaction is manifested in at least two of the following ways:

Eye Contact1. Marked impairment in the use of
multiple nonverbal behaviors
such as eye-to-eye gaze,
facial expression, body postures,
and gestures to regulate
social interaction.

Friends Playing2. Failure to develop peer
relationships appropriate
to developmental level.
Girl Sharing Enjoyment3. A lack of spontaneous
seeking to share enjoyment,
interests or achievement
with other people.

Imitation, Playing games, patty cake4. Lack of social or
emotional reciprocity.

Impairment in communication is 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.
  2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain 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.

Restricted, repetitive and stereotyped patterns of behavior, interests and activities are manifested by at least one of the following:

  • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
  • Apparently inflexible adherence to specific, non-functional routines or rituals; stereotyped and repetitive motor mannerisms, such as hand or finger flapping, or complex whole body movement.
  • Persistent preoccupation with parts of objects.

(DSM-IV, 1994);