What is autism (ASD)?

A disorder in the autism spectrum (autism) is a mental condition.

Who: This disorder is described based on criteria that apply to people who meet certain characteristics.

Where: The criteria come from two domains: social communication and interaction, and repetitive behavior patterns with restricted interests and activities.

When: The diagnosis is made when a person meets the criteria in both domains.

How: In Domain 1, there must be deficits in social-emotional reciprocity, non-verbal communication, and relationships. In Domain 2, at least two criteria must be met, such as stereotyped movements, rigid adherence to routines, restricted interests, or abnormal sensory responses.

Who says that: The DSM-5 (DSM-5®-TR) provides a systematic classification of mental disorders, from the most common to the rarest, including all relevant criteria.

Domain 1: Social Communication and Interaction

Domain 1 of autism spectrum disorder focuses on social communication and interaction, where the individual exhibits deficits in three key areas. Firstly, there is a deficit in social-emotional reciprocity, meaning the person struggles with sharing emotions, thoughts, and responses during social interactions. Secondly, there are deficits in non-verbal communicative behaviors commonly used in social settings, such as eye contact, facial expressions, and gestures. Thirdly, the individual experiences difficulties in establishing, maintaining, and understanding relationships, which can lead to challenges in developing friendships and adapting to different social contexts. These deficits are often evident in both personal and professional relationships.

Domain 2: Repetitive Behavior Patterns, Restricted Interests, and Activities

Domain 2 of autism spectrum disorder focuses on repetitive behavior patterns, restricted interests, and activities. Individuals must meet at least two of the following criteria. Firstly, they may exhibit stereotyped or repetitive motor movements, such as hand-flapping, object spinning, or repeating specific phrases or sounds. Secondly, they may rigidly adhere to routines and be strongly attached to fixed patterns or rituals, where even minor changes can cause anxiety or frustration. Another criterion is having very limited but intensely focused interests that are abnormally intense or fixated, such as a deep fascination with a specific topic. Lastly, there may be over- or under-reactions to sensory stimuli, such as light, sound, or textures, or an unusual interest in sensory aspects of the environment, such as obsessively touching surfaces or sniffing objects. These characteristics contribute to a broader diagnosis of autism and can vary greatly in intensity and impact on daily life.

Criteria for ASD

The criteria for diagnosing autism spectrum disorder are carefully designed to reflect the complexity of the condition. In the domain of social communication and interaction, the focus is on the extent to which an individual struggles with social-emotional reciprocity, such as sharing emotions or responding to social cues. Deficits in non-verbal communication, such as eye contact and body language, are also assessed. Additionally, the ability to form, maintain, and understand relationships is a key criterion.

These deficits can range from subtle social discomfort to severe impairments in daily social interactions.

In the domain of repetitive behavior patterns and restricted interests, stereotyped behavior, such as repetitive movements or speech patterns, and a strong attachment to routines are evaluated. Additionally, individuals with autism may have very intense and fixed interests, which are often unusual in their focus or intensity. Sensory responses are also considered, where someone may be over- or under-sensitive to stimuli such as light, sound, or touch. These criteria help clinicians to obtain a nuanced understanding of how the disorder manifests in different people.