Criterion A:
Criterion A is now updated to read as manifested by all of the following to clarify
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Autism Spectrum Disorder
Diagnostic Criteria 299.00 (F84.0)
Persistent deficits in social communication and social interaction across multiple contexts
, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
2
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Autism Spectrum Disorder
Diagnostic Criteria 299.00 (F84.0)
Persistent deficits in social communication and social interaction across multiple contexts
, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
1
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Autism Spectrum Disorder
Diagnostic Criteria 299.00 (F84.0)
Persistent deficits in social communication and social interaction across multiple contexts
, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
3
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Autism Spectrum Disorder
Severity is based on
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Level 3
"Requiring very substantial support"
Restricted, repetitive behaviors
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Level 3
"Requiring very substantial support"
Social communication
Level 2
"Requiring substantial support"
Social communication
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Level 1
"Requiring support
Restricted, repetitive behaviors
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Level 1
"Requiring support
Social communication
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Severity should be recorded as level of support needed for each of the two
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Severity of social communication difficulties and restricted, repetitive behaviors should be
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The descriptive severity categories should not be used to determine
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Regarding the specifier "with or without accompanying intellectual impairment," understanding the (often uneven)
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To use the specifier "with or without accompanying language impairment," the current level of verbal functioning should be assessed and described.
Examples of the specific descriptions for
"with accompanying language impairment"
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To use the specifier "with or without accompanying language impairment,
" Language level in individuals
"without accompanying language impairment"
might be further described by
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The specifier "associated with a known medical or genetic condition or environmental factor" should be used when the individual has a known genetic disorder
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Rett syndrome genetic
Can't be cured, but treatment may help
Requires a medical diagnosis
Lab tests or imaging always required
Chronic: can last for years or be lifelong
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Additional neurodevelopmental, mental or behavioral conditions should also be noted
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Diagnostic Features
The essential features of autism spectrum disorder are
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Autism spectrum disorder encompasses disorders previously referred to as
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The impairments in communication and social interaction specified in Criterion A are pervasive and sustained. Diagnoses are most valid and reliable when
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In adults without intellectual disabilities or language delays, deficits in social-emotional reciprocity may be most apparent in difficulties
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Deficits in social-emotional reciprocity (i.e., the ability to engage with others and share thoughts and feelings) are clearly evident in young children with the disorder
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Excessive adherence to routines and restricted patterns of behavior may be manifest in
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Stereotyped or repetitive behaviors include simple motor stereotypies (e.g., hand flapping, finger flicking), repetitive use of objects (e.g., spinning coins, lining up toys), and
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Many individuals with autism spectrum disorder also have
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Self-injury (e.g., head banging, biting the wrist) may occur, and disruptive/challenging behaviors are more common in
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Motor deficits are often present, including
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Adolescents and adults with autism spectrum disorder
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risk period for comorbid catatonia appears to be greatest
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The age and pattern of onset also should be noted for autism spectrum disorder.
Symptoms are typically recognized during the second year of life (12-24 months of age) but
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Some children with autism spectrum disorder experience developmental plateaus or regression, with a gradual or relatively rapid deterioration in social behaviors or use of language,
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The behavioral features of autism spectrum disorder first become evident in early childhood, with some cases presenting a lack of interest in social interaction
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First symptoms of autism spectrum disorder frequently involve delayed language development, often accompanied by lack of
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odd and repetitive behaviors and the absence of typical play become more apparent.
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For example, the report (by parents or another relative) that the individual had ordinary and sustained reciprocal
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Manifestations of the social and communication impairments and restricted/repetitive behaviors that define autism spectrum disorder are clear in the developmental period. In later life, intervention or compensation, as well as current supports, may
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The best established prognostic factors for individual outcome within autism spectrum disorder are
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A variety of nonspecific risk factors, such as
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Cultural and socioeconomic factors may affect age at recognition or diagnosis; for example, in the United States,
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Autism spectrum disorder is diagnosed four times more often in males
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Rett syndrome
(typically between 1-4 years of age)
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In selective mutism, early development is not typically disturbed. The affected child usually exhibits appropriate communication skills in
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When an individual shows impairment in social communication and social interactions but does not show restricted and repetitive behavior or interests, criteria for
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diagnosis of autism spectrum disorder supersedes that of social (pragmatic) communication disorder whenever the criteria for
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Intellectual disability without autism spectrum disorder may be difficult to differentiate
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A diagnosis of autism spectrum disorder in an individual with intellectual disability is appropriate when social communication and interaction are
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Motor stereotypies are among the diagnostic characteristics of autism spectrum disorder, so an additional diagnosis of stereotypic movement disorder is not given when such repetitive behaviors are better explained by
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Abnormalities of attention (overly focused or easily distracted) are common in individuals with autism spectrum disorder, as is hyperactivity. A diagnosis of
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Hallucinations and delusions, which are defining features of schizophrenia, are not features of
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Autism spectrum disorder is frequently associated with intellectual impairment and structural language disorder (i.e., an inability to comprehend and construct sentences with proper grammar),
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criteria for both ADHD and autism spectrum disorder are met, both diagnoses should be given. This same principle applies to concurrent diagnoses of
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Among individuals who are nonverbal or have language deficits, observable signs such as changes in sleep or eating and increases in challenging behavior
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Medical conditions commonly associated with autism spectrum disorder should be noted under the "associated with a known medical or genetic condition or environmental factor" specifier. Such medical conditions include