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Diagnosis

Diagnosis

DSM-5 Criteria for a
diagnosis of Autism

Typical traits that are considered for diagnosis are as follows:

Persistent difficulties in social communication and social interaction in various contexts

Difficulty with socio-emotional reciprocity, ranging, for example, from atypical social approach and difficulties in holding conversations; to sharing of interests, emotions, or affect; or difficulty initiating or responding to social interactions.

Do you find it difficult to start conversations?

Do you find it difficult to hold a group conversation?

Do you interrupt people talking, or leave pauses in the conversation?

Do you find it difficult to know when it is your turn to speak?

Are you easily bored when someone wants to talk about something that doesn’t interest you?

Do you find it difficult to engage in small talk?

Do you see the conversation as an exchange of information rather than an emotional connection?

Do you think you don’t enjoy social situations like the others seem to?

Do you feel tired after social occasions?

Difficulties with non-verbal communication used for social interaction (gestures, facial expressions, etc), ranging, for example, from no non-verbal communication; to atypical eye contact, or difficulties in understanding and using gestures and body language; to a complete lack of facial expressions and non-verbal communication.

Do you find it difficult and upsetting to look someone in the eye, even if you can? 

Do you not like to look people in the eyes, or do you look too much?

Have you ever received comments about how your facial expressions didn’t match the situation?

Do you imitate other people’s gestures and expressions and ways of speaking?

Have you ever received questions like “Are you upset?” when you weren’t?

Do you find it difficult to purposefully make facial expressions for a situation, like smiling for a photo?

If you are having a conversation with someone, do you usually look away if you need to think about something?

Have you been told that you have facial expressions not congruent with the situation (like smiling in a sad situation?)

Has anyone ever told you that you look aggressive, bored or upset when you are not?

Do you happen to imitate accents and expressions of the people you speak to?

Do you find it difficult to recognise sarcasm and irony?

Do you have difficulty reading body language and facial expressions?

Difficulties in developing, maintaining and understanding how to make and keep relationships, ranging, for example, from difficulties in adjusting behaviour to suit various social contexts; to difficulties in sharing imaginative play or making friends.

Do you find it difficult to understand how other people are feeling or reacting to what you are saying?

Do you happen to miss social cues or information “between the lines”?

Does it happen to laugh or smile at the wrong time?

Have you ever been told that you are indifferent or that you are in your own world?

Do you prefer and need some time alone?

Do you struggle to know how much contact you need to maintain friendships?

Do you find it difficult to make new friends?

Do you find it hard to tell if someone is joking or ridiculing you?

Do you prefer individual interaction over groups?

Do you feel there is a manual of social interactions that you have never had access to, but that others seem to have?

Do you use a specific script in social interactions?

Do you review old conversations and think too much about future ones?

Restricted and repetitive patterns of behaviour, interests or activities

Stimming or repetitive motor movements, use of objects or speech, in a repetitive and constant manner

Do you repeat words, phrases or expressions you hear in films or conversation, or that you like to sound of (echolalia)?

Did you lined up and/or organise your toys while playing?

Do you use exceptionally formal words or speech structures?

Do you have any phrases you use often, even when inappropriate?

Do you make repetitive movements with your hands, such as waving your hands, wiggling your fingers or manipulating objects?

Do you have an unusual sitting position?

Do you grit your teeth or bite your lips or cheek?

Do you jump, rock back and forward, touch your hair or do any repetitive movements a lot, specially when you feel overwhelm?

Insistence on maintaining routines, inflexible adherence to routines or ritualised patterns of verbal or non-verbal behaviour.

Do you find it difficult to stop one activity and start another? 

Do you struggle to complete self-care tasks such as bathing or brushing your teeth?

Do other people say you overreact to changes in plans?

Do you use the same supermarkets, buy the same brands and eat the same type of food for long periods of time? 

Do you have rules and rituals you like to follow?

Does anyone ever told you that they think you are controlling?

Do you get frustrated with situations that are not defined (for example, if you ask which restaurant to go to and someone replies “let’s see”)?

Do you get upset if your usual routine changes without warning?

Highly narrow and fixed interests that are atypical in intensity or focus.

Are you very interested in certain topics, with an intensity that your colleagues lack?

When you are interested in a topic, do you take on many aspects of your life (talking, collecting and thinking about it)?

Do you find that you focus more on the details than the big picture?

Do you have interests that people around you find unusual ?

Does your leisure time tend to be spent in devoting to these interests?

Do you like to collect items or information?

Hyper or hyporeactivity to sensory stimuli or unusual interest in sensory aspects of the environment, i.e. has low reactivity and seeks stimuli, or has high reactivity and avoids sensory stimuli.

Do you find certain textures or styles of clothing (such as seams, labels, etc.) to be irritating and painful?

Do you find some self-care tasks, such as brushing your teeth or cutting your hair, physically uncomfortable or painful?

Are you unusually sensitive to heat or cold?

Do you find certain sounds (not necessarily loud, but repetitive, like people talking) painful or uncomfortable?

Do you find it difficult to follow conversations with background noise?

Do you find certain lighting painful or difficult to tolerate?

Are you sensitive to smells to the point of being nauseous?

Can’t eat some foods because of their texture or colour?

Do you have an exceptionally high pain tolerance?

Are you attracted to certain textures, smells or visual patterns?

Are you looking for deep pressure, such as tight hugs, heavy blankets or tight spaces?

The traits should be present early in the developmental period. They may not, however, manifest fully until social demands exceed limited capacities, or they may be masked by strategies learned later in life. The traits can cause clinically significant impairment in social, occupational or other important areas of current functioning. This does not just mean lack of employment or relationships, it can mean impact on mental health.
It is also necessary to ensure that these difficulties cannot be explained by intellectual disability or global developmental delay. Intellectual disability and autism spectrum disorders can co-occur.

If you have read the typical traits of Autism and identify with many of them...

And now what?

Take the Autism test to get a better idea of the characteristics and to validate your suspicions. You can do it through the “test” button – The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) or The Autism Spectrum Quotient (AQ test).
If you think your child might be autistic, watch the video using the “video” button.

If the test gave similar scores for autistic people, start reading about the particulars of the traits, as a child (you can see the video above), teenager and adult, as the traits vary in intensity and type, or social dynamics, depending on age. Join online autistic groups on Facebook and follow autistic people on social media (you can find autistic voices online using #actuallyautistic). Ask questions in #AskAutistics. Sometimes we have traits we didn’t even know we had because we thought everyone else felt that way.
If the autistic person is your child, ask autistic adults questions about when they were a child. This is a very important resource as we sometimes have similar difficulties but have learned to manage them. Make a list of the characteristics you felt you have with examples from your life. Try to use specific personal experiences, for example, “when I was a child I hid under the table when people sang happy birthday” (hypersensitivity to sound).

Look for a specific specialist for your case, giving particular importance to experience in the field, especially if you are a woman or an adult. Give preference to professionals with proven experience in diagnosing and monitoring people with Autism Spectrum Disorders (ASD), as a less experienced psychologist may have a less updated view of ASD.

Continue to explore who you are. Many of us have spent years feeling that we are not enough, because we compare ourselves to neurotypicals. The autistic brain is too beautiful and complex to restrict ourselves to trying to be like others.

Any questions you have about steps to take, or even Autism in general, please contact us or join our Support Groups.