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Autism Diagnosis Criteria: DSM-5

In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 is the standard reference tool used by healthcare providers to diagnose mental and behavioral conditions, including autism.

By special permission of the American Psychiatric Association, you can read the full-text of the new diagnostic criteria for autism spectrum disorder and the related diagnosis of social communication disorder.

DSM-5 Frequently Asked Questions

What is the DSM-5?

The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM) to guide healthcare professionals diagnosing mental health conditions. The manual’s fifth edition – DSM-5 – took effect in May 2013.

Why was the new edition needed?

The American Psychiatric Association periodically updates the DSM to reflect new understanding of mental health conditions and the best ways to identify them.

The goals for updating the criteria for diagnosing autism included:

  • More accurate diagnosis
  • Identification of symptoms that may warrant treatment or support services
  • Assessment of severity level

How does the DSM-5 change the way autism is diagnosed?

Six major changes include:

1. Four previously separate categories of autism consolidated into one umbrella diagnosis of “autism spectrum disorder.”

Previous categories:

  • Autistic disorder
  • Asperger syndrome
  • Childhood disintegrative disorder
  • Pervasive developmental disorder-not otherwise specified (PDD-NOS)

2. Consolidation of three previous categories of autism symptoms into two categories of symptoms.

Previous categories:

  • Social impairment
  • Language/communication impairment and
  • Repetitive/restricted behaviors

New categories:

  • Persistent deficits in social communication/interaction and
  • Restricted, repetitive patterns of behavior

3. The addition of sensory issues as a symptom under the restricted/repetitive behavior category. This includes hyper- or hypo-reactivity to stimuli (lights, sounds, tastes, touch, etc.) or unusual interests in stimuli (staring at lights, spinning objects, etc.)

4. A severity assessment scale (levels 1-3) based on level of support needed for daily function.

5. Additional assessment for:

  • Any known genetic causes of autism (e.g. fragile X syndrome, Rett syndrome)
  • Language level
  • Intellectual disability and
  • The presence of autism-associated medical conditions (e.g. seizures, anxiety, gastrointestinal disorders, disrupted sleep)

6. Creation of a new diagnosis of social communication disorder for disabilities in social communication without repetitive, restricted behaviors.

How will these DSM-5 changes affect people already diagnosed with Asperger syndrome, PDD-NOS or other previous autism categories?

The DSM-5 states, “Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.”

What if I or my child want to keep the diagnosis of Asperger syndrome?

Many people strongly identify with their diagnosis of Asperger syndrome. Healthcare providers can still indicate a diagnosis of Asperger syndrome (or another previously used autism category) in a patient’s medical record, alongside the current DSM-5 coding for “autism spectrum disorder.” Colleges and school districts may vary in their policies for educational records.

What is the new diagnosis of social communication disorder? Who will it affect?

This new diagnosis applies to people who have persistent problems with the social use of language, but don’t have restricted interests or repetitive behaviors.

Some people who would have previously received a diagnosis of PDD-NOS may now receive a diagnosis of social communication disorder. However, this should apply only to newly diagnosed people. It should not be applied retroactively to someone already diagnosed with PDD-NOS under the DSM-IV criteria.

Is social communication disorder on the autism spectrum?

No. Social communication disorder is considered a communication disorder. People who have the symptoms of social communication disorder in addition to restricted, repetitive behaviors may receive a diagnosis of autism instead.

Recent Autism Diagnosis

The time following a diagnosis of autism can be overwhelming. You likely have a lot of questions and concerns about what lies ahead. You have come to the right place.

We have developed a series of comprehensive tool kits to help you and your family access the services and supports you need to get started on this new journey.

To help you find services in your area, we have developed a comprehensive library of resources, interventions and services available in your area. Autism Speaks Canada also offers personalized support from real human beings through our Autism Response Team.

Related resources from our online community—Autism Speaks Canada Autism Response Team

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