DSM-5 Flashcards
DSM -5
- Diagnostic criteria for autism spectrum disorder (ASD)
and the related diagnosis of social communication
disorder (SCD), - Fifth edition of the Diagnostic and Statistical Manual
of Mental Disorders (DSM-5). - As of May 2013, psychologists and psychiatrists have
been using these criteria when evaluating individuals
for these developmental disorders.
SOCIAL (PRAGMATIC) COMMUNICATION
DISORDER 315.39
A
A. Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of
the following:
1. Deficits in using communication for social purposes, such as greeting and sharing information, in a
manner that is appropriate for the social context.
2. Impairment of the ability to change communication to match context or the needs of the listener,
such as speaking differently in a classroom than on the playground, talking differently to a child than to
an adult, and avoiding use of overly formal language.
3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation,
rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate
interaction.
4. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or
ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the
context for interpretation).
SOCIAL (PRAGMATIC) COMMUNICATION
DISORDER 315.39
BCD
B. The deficits result in functional limitations in effective communication, social
participation, social relationships, academic achievement, or occupational
performance, individually or in combination.
C. The onset of the symptoms is in the early developmental period (but deficits
may not become fully manifest until social communication demands exceed limited
capacities).
D. The symptoms are not attributable to another medical or neurological condition
or to low abilities in the domains or word structure and grammar, and are not better
explained by autism spectrum disorder, intellectual disability (intellectual
developmental disorder), global developmental delay, or another mental disorder.
AUTISM SPECTRUM DISORDER
299.00
A
A. 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. 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.
2. 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.
3. 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.
AUTISM SPECTRUM DISORDER
299.00
B
B. 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):
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor
stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal
nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid
thinking patterns, greeting rituals, need to take same route or eat food every day).
3. 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).
4. 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).
Level 3
Requiring very substantial support
Social communication
Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited
initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or
she does, makes unusual approaches to meet needs only and responds to only very direct social approaches
Restricted, repetitive behaviors
Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly
interfere with functioning in all spheres. Greatdistress/difficulty changing focus or action.
Level 2
“Requiring substantial
support
Social communication
Marked deficits in verbal and nonverbal social communication
skills; social impairments apparent even with supports in place;
limited initiation of social interactions; and reduced or abnormal
responses to social overtures from others. For example, a
person who speaks simple sentences, whose interaction is
limited to narrow special interests, and how has markedly odd
nonverbal communication.
Restricted, repetitive behaviors
Inflexibility of behavior, difficulty coping with change, or
other restricted/repetitive behaviors appear frequently
enough to be obvious to the casual observer and interfere
with functioning in a variety of contexts. Distress and/or
difficulty changing focus or action
Level 1
“Requiring support”
Social communication
Without supports in place, deficits in social communication cause
noticeable impairments. Difficulty initiating social interactions,
and clear examples of atypical or unsuccessful response to
social overtures of others. May appear to have decreased
interest in social interactions. For example, a person who is able
to speak in full sentences and engages in communication but
whose to- and-fro conversation with others fails, and whose
attempts to make friends are odd and typically unsuccessful.
Restricted, repetitive behaviors
Inflexibility of behavior causes significant interference with
functioning in one or more contexts. Difficulty switching
between activities. Problems of organization and planning
hamper independence.
AUTISM SPECTRUM DISORDER
299.00
C. 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).
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current
functioning.
E. 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
SPECIFY IF
- With or without accompanying intellectual impairment
- With or without accompanying language impairment
- Associated with a known medical or genetic condition or environmental factor
(Coding note: Use additional code to identify the associated medical or genetic condition.) - Associated with another neurodevelopmental, mental, or behavioral disorder
(Coding note: Use additional code[s] to identify the associated neurodevelopmental, mental, or
behavioral disorder[s].) - With catatonia (refer to the criteria for catatonia associated with another mental disorder, pp.
119-120, for definition) (Coding note: Use additional code 293.89 [F06.1] catatonia associated
with autism spectrum disorder to indicate the presence of the comorbid catatonia.)
