Diagnosing ASD with the DSM-5

As a parent of a child with autism, feeling judged by others is a common occurrence. Many people may not understand the unique challenges that come with raising a child with autism. And this can take a toll on both you and your child, leading to feelings of isolation or frustration.

In this article, we walk you through the diagnostic criteria for a child with autism according to the DSM-5. We’ll also give you some tips on how to handle judgment from others.

What is the DSM-5?

“DSM-5” stands for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. It was developed by the American Psychiatric Association. The manual is a reference material used by medical practitioners to identify and diagnose mental and behavioral conditions, including ASD (Autism Spectrum Disorder).

DSM-5-TR Criteria for Autism Spectrum Disorder Diagnosis

For a child to be diagnosed with autism spectrum disorder, he or she must have shown the following:

  • Difficulties and/or differences from what’s typical in ‘social communication’
  • Restricted, repetitive, and/or sensory behaviors.

They must have had the characteristics from early childhood, even if these aren’t picked up until later in childhood.

Difficulties in Social Communication

Signs of difficulties in social communication can include:

  • Rarely using language to communicate with other people
  • Not speaking at all
  • Rarely responding when spoken to
  • Not sharing interests or achievements with parents
  • Rarely using or understanding gestures like pointing or waving
  • Using only limited facial expressions to communicate
  • Not showing an interest in friends
  • Having difficulties making friends
  • Rarely engaging in imaginative play.

Restricted, Repetitive, and Sensory Behavior or Interests

Signs of restricted, repetitive, and sensory behavior or interests can include:

  • Repeatedly lining up toys in a particular way
  • Frequently flicking switches or spinning objects
  • Speaking in a repetitive way
  • Having very narrow or intense interests
  • Needing things to always happen in the same way
  • Having trouble with changes to their schedule or when changing from one activity to another
  • Showing signs of sensory sensitivities like becoming distressed by every day sounds like hand dryers, not liking the feel of clothes labels, or licking or sniffing objects.

Severity Levels

Autism spectrum disorder can be categorized into three different levels of severity, as shown in the table below:

  1. Level 1: Support is required
  2. Level 2: Substantial support is required
  3. Level 3: Very substantial support is required.

These levels are determined based on the severity of the child’s social communication and restricted, repetitive behaviors.

Severity Level Social communication Restricted, Repetitive Behaviors
Level 3

“Requiring very substantial support”

Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others.

 

An example is a child with few words of intelligible speech who rarely initiates interaction. When he initiates interactions, he makes unusual approaches to meet needs only and responds to only very direct social approaches

 

  • Inflexibility of behavior
  • Great distress or difficulty changing focus or action
  • Extreme difficulty coping with change
  • Restricted or repetitive behaviors markedly interfere with functioning in all spheres
Level 2

“Requiring substantial support”

  • Marked deficits in verbal and nonverbal social communication skills
  • Social impairments apparent even with support in place
  • Limited initiation of social interactions
  • Reduced or abnormal responses to social overtures from others.

 

An example is a child who speaks simple sentences, whose interaction is limited to narrow special interests, or who has markedly odd nonverbal communication.

  • Inflexibility of behavior
  • Difficulty coping with change
  • Restricted or repetitive behaviors appear frequently enough to be obvious to the casual observer. It also interferes with functioning in a variety of contexts.
Level 1

“Requiring support”

Without support in place, deficits in social communication cause noticeable impairments, including:

 

  • Difficulty initiating social interactions
  • Atypical or unsuccessful responses to social overtures of others.
  • May appear to have decreased interest in social interactions.

 

An example is a child who can speak in full sentences and engages in communication but whose to-and-fro conversation with others fails. Their attempts to make friends could also be odd and unsuccessful.

  • Inflexibility of behavior causes significant interference with functioning in one or more contexts.
  • Difficulty switching between activities.
  • Problems of organization and planning hamper independence.

Asperger’s Syndrome and the DSM-5

For many people, the term “Asperger syndrome” is part of their day-to-day vocabulary and identity. It is understandable that there are concerns around the removal of Asperger syndrome as a distinct category from DSM-5.

However, everyone who currently has a diagnosis on the autism spectrum, including those with Asperger syndrome, will retain their diagnosis. No one will ‘lose’ their diagnosis because of the changes in DSM-5.

Dealing With Judgment From Others

Here are a few tips to help you handle judgment from others regarding your child with autism.

  • Educate others: Often, people who are judgmental towards children with autism simply do not understand the condition. You may want to educate them about what autism is and how it affects your child. This will help them understand where you’re coming from.
  • Explain your child’s behavior: Sometimes, your child’s behavior may seem strange or unusual to others. You may want to explain why your child is behaving in a certain way and how it is related to their autism. This can be helpful at places you frequently visit with your child.
  • Be patient: It can be frustrating when others don’t understand or accept your child’s condition. However, remain patient and understanding and don’t take people’s comments or criticisms to heart. It’s always best to keep a cool head so you can keep your child safe.
  • Seek support: If possible, you should seek support from other parents of children with autism or from support groups. You will find comfort in knowing that others are going through similar experiences.

The Bottom Line

Handling criticism from people concerning your autistic child can be difficult at times. As a parent, you may feel frustrated or isolated since your child is unique. However, taking time to understand your child’s condition and educating your peers can help reduce the judgment surrounding having a child with autism.

 

If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.