Need a topic to cover in your ABA parent training services? Consider addressing the diagnosis of autism spectrum disorder. Help parents understand what this diagnosis means for their child.
WHAT IS AUTISM SPECTRUM DISORDER?
Autism spectrum disorder (also referred to as “autism”) has a set of symptoms or behaviors that capture what someone with this disorder is likely to experience or what behaviors they may display. However, the disorder is referred to as a spectrum for a reason. The definition of the word spectrum is “used to classify something, or suggest that it can be classified, in terms of its position on a scale between two extreme or opposite points.” This definition of the word spectrum relates to the identified symptoms or behaviors seen in individuals with autism.
For example, all individuals with a formal diagnosis of autism have difficulties with communication. However, the severity of communication deficits could be anywhere on a spectrum from very severe and unable to speak to slight deficits in communication and, although the individual may be able to speak with full sentences and understandably, they may have some difficulties with certain communication skills like taking turns in a conversation or initiating conversations. Because of the nature of autism as a spectrum, autism is different for everyone.
DSM-V diagnostic criteria for Autism Spectrum Disorder
“The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) is a classification of mental disorders with associated criteria designed to facilitate more reliable diagnoses of these disorders….the DSM is intended to serve as a practical, functional, and flexible guide for organizing information that can aid in the accurate diagnosis and treatment of mental disorders.” (American Psychiatric Association, DSM-5 Task Force, 2013).
According to the DSM-V, autism spectrum disorder (autism) includes the following characteristics (Autism Speaks, DSM-V):
Persistent deficits in social communication and social interaction which includes:
- Deficits in social-emotional reciprocity (examples include difficulties approaching others, difficulty initiating and maintaining a conversation, reduced level of sharing of interests and emotions with others), and failure to appropriately respond to others in a social situation.
- Deficits in nonverbal communicative behaviors used for social interaction (examples include difficulties with verbal communication, difficulties with nonverbal communication, lack of appropriate eye contact, abnormalities in body language or using gestures, lack of appropriate facial expressions and expressing of emotions)
- Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
- Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotyped behavior, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat the same food every day).
- Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
- Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
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