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Definition of Autism Spectrum Disorder

Autism Spectrum Disorder (ASD), as defined by the Diagnostic and Statistical Manual Fifth Edition of the American Psychiatric Association (DSM 5)*, is a neurodevelopmental disorder associated with symptoms that include "persistent deficits in social communication and social interaction across multiple contexts" and "restricted, repetitive patterns of behavior, interests, or activities."  The DSM 5 gives examples of these two broad categorizes:

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): 

• Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

• Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

• Deficits in developing, maintaining, and understand 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): 

• Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, 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 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 interests).

• Hyper- or hyporeactivity to sensory input or unusual interest 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).

These symptoms result from underlying challenges in a child’s ability to take in the world through their senses, and to use their body and thoughts to respond to it. When these challenges are significant, they interfere with a child’s ability to grow and learn, and may lead to a diagnosis of autism.

 

UNDERSTANDING AUTISM

When the challenges of autism are understood and appropriately addressed, and the autistic individual is accepted for who they are, their potential is no less than a neurotypical person. Too many professionals look at autism as something that needs to be controlled and contained.  We look at autism as a neurodiversity that needs to be understood and the person needs to be supported in the right way.  Once understood, then the person's potential can be realized. There are aspects of autism that are disabling and very challenging.  Nevertheless, seeking to understand the neurodevelopmental differences in an effort to promote growth and development can help the autistic individual reach their potential while addressing the disabling aspects.   

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