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Criteria for a diagnosis of Autism

Children

Based on the NICE Guidelines – https://www.nice.org.uk/guidance/cg128

Language and speech

Language delay (eg, less than ten words by age 2 years).

Regression or loss of speech use

Spoken language (if present) may include: vocalizations instead of words, different or flat tone of voice, frequent repetition of words and phrases (echolalia)

Reference to self by name or ‘you’ or ‘she/he’ beyond 3 years.

Answer others

Missing or delayed response to their name when called despite normal hearing.

Reduced or absent social responsive smile.

Reduced or absent response to other people’s facial expressions.

Exceptionally negative response to requests from others (demand avoidance behavior).

Rejection of cuddles initiated by parents or caregivers, although they may initiate cuddles themselves

Interact with others

Reduced or absent awareness of personal space, or intolerant of people who enter their personal space.

Reduced or absent social interest in others, including children their age; if interested, may approach others inappropriately.

Reduced or absent imitation of others’ actions (or excessive imitation. Girls are more likely to imitate others)

Reduced or absent initiation of social play with others, plays alone.

Reduced or absent pleasure from situations most children enjoy, for example birthday parties.

Emotional sharing reduced or absent 

Eye contact, pointing and other gestures

Reduced or absent use of gestures and facial expressions to communicate, or inappropriate to the situation (or copying from others around them).

Reduced and poorly integrated gestures, facial expressions, body orientation, eye contact (looking people in the eye when speaking)

Reduced or absent social use of eye contact, assuming adequate vision, or excessive use (or excessive/innapropriate eye contact)

Reduced or absent joint attention demonstrated by a lack of: change in gaze direction, follow a point (look where the other person is pointing – might look at the hand), use pointing or showing objects to share interest

Unusual or restricted interests and/or rigid and repetitive behaviors

Repetitive movements, such as flapping hands, rocking the body while standing, turning, flicking fingers.

Repetitive play, eg opening and closing doors.

Overly focused or unusual interests

Excessive insistence on following one’s own agenda.

Extremes emotional reactivity to changes or new situations, insistence that things be ‘the same’.

More or less reaction to sensory stimuli, eg textures, sounds, smells (eg constantly asking for hugs or avoiding any touch)

Excessive reaction to the taste, smell, texture or appearance of food or extreme food fads.

Ideas and imagination

Reduced or absent imagination and variety of make-believe play (but may have a rich inner imagination)

Adults

Based on DSM-5 –  American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

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 difficulty initiating or responding to social interactions.

Do you find it difficult to start conversations, especially in a group setting?

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?

Do you find it difficult to talk about something that doesn’t interest you, especially 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?

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

Do you use a specific script of conversation in social interactions?

Difficulties with non-verbal communication used for social interaction (gestures, body language, facial expressions, etc), atypical eye contact, and others.

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 you look too much?

Have you ever received comments about how your facial expressions didn’t match the situation? For example, to smile in a sad occasion.

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

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?

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

Do you find it difficult to recognise sarcasm and irony?

Do you have difficulty reading body language and facial expressions?

Difficulties in developing, maintaining or in understanding how to make and keep relationships.

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”?

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

Do you typically 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 mocking you?

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

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)?

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, touching your hair, 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 overwhelmed?

Insistence on maintaining routines/inflexible adherence to routines

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, does it 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 or quirky ?

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, or a mix of both.

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 children. 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 with adults, especially if you are a woman, trans or non-binary. 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 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.