The Three Criteria for Diagnosing Autism
It’s really hard to get away from a diagnosis of autism if you have it… All it takes is basically saying “yes” to these three distinctive criteria:
- Impairment in social interaction
- Impairment in communication
- Restricted interest
Sounds familiar? Reminds you of anybody you know? Read on further for more details. The reason I say that is because the earlier the diagnosis (preferably in early childhood), the better the prognosis. Autism may not be cured, but with an early intervention program and a special education plan throughout school, a child who has autism will be able to grow into their full potential and enjoy a full and happy life.
First of all, let me define these three criteria and how they are used in the process of diagnosis. It is obviously more complex than I presented it in the first sentence of this article (I like to exaggerate sometimes…). A person requires a total of six or more characteristics from the above criteria, with at least two from A and B, and at least one from C. There are also additional criteria for diagnosing autism which I will refer to in the end of this article. The following is adapted from the DSM-IV as per this site, with additional notes from my own experience and from other online resources. I am not trying to break any news here, just compile together a list for reference.
A. IMPAIRMENT IN SOCIAL INTERACTION
Qualitative impairment in social interaction. If a person has at least two of the following characteristics that might raise a red flag:
- Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction. Examples:
- Laughing, crying, showing distress for reasons not apparent to others
- Little or no eye contact
- Not responsive to verbal cues; acts as if deaf although hearing tests in normal range.
- Failure to develop peer relationships appropriate to developmental level
a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people. Examples:
- lack of showing, bringing, or pointing out objects of interest to other people
- Autistic children may find it difficult to interact with their own age group and may prefer to interact with adults (or less commonly – with babies).
- Lack of social or emotional reciprocity. Examples:
- Not actively participating in simple social play or games
- Difficulty in mixing with others
- May not want to cuddle or be cuddled
- Repetition of own message and responses that are inappropriate to the messages communicated from the people involved in the interaction
- preferring solitary activities, or involving others in activities only as tools or "mechanical" aids, i.e.:
- Prefers to be alone; aloof manner
- Choose solitary activities that do not require interaction with others (i.e.: puzzles, beading)
B. IMPAIRMENT IN COMMUNICATION
Qualitative impairments in communication as manifested by at least one of the following:
- Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
- Repeating words or phrases in place of normal, responsive language
- Difficulty in expressing needs; uses gestures or pointing instead of words
- May also lead the person to what they want instead of using gestures (hold the person’s hand and bring them to where they wan to show them something)
- Unresponsive to normal teaching methods
- In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
- Stereotyped and repetitive use of language or idiosyncratic language
- Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
C. RESTRICTED INTEREST
Now that’s where the fun begins. While the other behaviours may also be common to other conditions, such as language or developmental delay, this is where all the cliché autisistic beahaviours show off the most. Each individual will of course have their own restricted interest, and these can change throughout the years. But nevetheless, this is what makes autism look so special to the laymen. From the outside, these could even be perceived as charming egocentric personality traits. In reality, they are a method in which the autistic person is trying to make their own life a bit more stable, and put order in an otherwise extremely chaotic world. The restricted interest bring a sense of order and predictability, which is calming and centering.
Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following is a reason to be paying close attention and seeking help or diagnosis for your child:
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
- Extreme interest in particular subject busses, trains, birthday cakes, pumpkins, etc.
- Obsessive counting or spelling
- Inappropriate attachments to objects
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
a. Insistence on sameness; resistance to change
b. Repeat the same behaviour over and over again
c. Sustained odd play
- Stereotyped and repetitive motor mannerisms, i.e.:
- Hand or finger flapping or twisting, or complex whole-body movements
- Slapping or pinching or biting hands or other repetitive self-hurting behaviours
- Persistent preoccupation with parts of objects, i.e.:
a. Spinning objects
b. Extreme attention to particular details or belongings of a person rather than to the whole person – i.e. a person’s shoes or hair or zippers, etc.
c. Opening and closing doors or containers, flicking lights, etc.
Characteristics of Autism
Pumpkin Blog for more details about Early Signs of Autism, and more personal stories.