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DIAGNOSTIC STATISTICAL MANUAL V CRITERIA FOR THE DIAGNOSIS OF
AUTISM SPECTRUM DISORDERS
A.
Deficits in use or understanding of social communication and social interaction in multiple
contexts, not accounted for by general developmental delays, and manifest by all 3 of the
following:
1. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly
integrated verbal and nonverbal communication, through abnormalities in eye contact and bodylanguage, or deficits in understanding and use of nonverbal communication, to total lack of facial
expression or gestures.
2. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of
normal back and forth conversation through reduced sharing of interests, emotions, and affect and
response to total lack of initiation of social interaction.
3. Deficits in developing and maintaining relationships appropriate to developmental level (beyond
those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts
through difficulties in sharing imaginative play and in making friends to an apparent absence of
interest in people
B.
Restricted, repetitive patterns of behavior, interests, or activities as manifested by 2 of the
following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor
stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases); OR
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive
resistance to change; (such as motoric rituals, insistence on same route or food, repetitive
questioning, or extreme distress at small changes); OR
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong
attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative
interests). OR
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment;
(such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures,
excessive smelling or touching of objects, fascination with lights or spinning objects).
REFERENCES:
American Psychiatric Association, Autism Spectrum Disorders,
http://www.psychiatry.org/autism Accessed July 5, 2014.
Carbone PS, Farley M, Davis T. Primary care for children with
autism. Am Fam Physician. 2010 Feb 15;81(4):453-60.
Centers for Disease Control and Prevention, Autism spectrum
disorder (ASD): Diagnostic criteria. http://www.cdc.gov/ncbddd/
autism/hcp-dsm.html Accessed July 5, 2014.
Myers SM, Johnson CP; American Academy of Pediatrics Council on Children With Disabilities. Management of children with
autism spectrum disorders. Pediatrics. 2007 Nov;120(5):1162-82.
http://pediatrics.aappublications.org/content/120/5/1183.full.pdf
Accessed July 5, 2014.
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LOUISVILLE MEDICINE
Oregon Center for Children and Youth with Special Health Needs,
Oregon Commission on Autism Spectrum Disorder; DSM-V checklist for autism spectrum disorder. http://www.ohsu.edu/xd/outreach/occyshn/programs-projects/upload/ASD-ID-Teams-DSMV-Checklist.pdf Accessed July 5, 2014.
Schaefer GB, Mendelsohn NJ; Professional Practice and Guidelines
Committee. Clinical genetics evaluation in identifying the etiology
of autism spectrum disorders: 2013 guideline revisions. Genet Med.
2013 May;15(5):399-407.
Note: Dr. James is the Corporate Medical Director of Clinical Policy
at The AmeriHealth Caritas Family of Companies in Philadelphia. He
has a part-time practice within Main Line Healthcare in Philadelphia.