#Dsm 5 on asd how to#

Through group play, children learn even more how to read the intentions of others. Their play is marked by the imitation of activities that they see adults around them doing or that they see on TV. This is observed at a time when the child has little spoken language.īy 3 or 4 years old, children begin to show an understanding of the thoughts and motives of others (theory of mind and mentalizing) and learn to use this knowledge to govern social interactions. In the second year of life, the child develops joint attention skills by 15 months, the child will check the mother's facial expression or tone of voice to learn what to do in an ambiguous situation. Soon an infant learns to engage in affective reciprocity (i.e., to recognize and read early social signals mediated through facial expression, prosody, gesture, and body language, not only with his or her mother but with an expanded range of caretakers). The face of an infant's mother (or primary caretaker) is a complex stimulus, and the newborn will look at it more and more over the first few weeks. Infants come into the world with a behavioral propensity to look at complex rather than simple visual stimuli. The normal development of social communication has been thoroughly described in many studies over the past 30 years ( 1). When social communication itself was revealed to be a developmental progression that begins at birth and continues into adulthood, autism was better understood as an arrest or deviation in this developmental trajectory. In the initial autism literature, twin and family studies showed that symptoms of “socially odd behaviors” were more likely to be observed in the relatives of people with autism than in the general population, suggesting a spectrum of social communication deficits. Whereas DSM-IV included three sets of symptoms for autism, in the draft version of DSM-5, social and communication problems have been melded to form “social/communication deficits” and “fixated interests and repetitive behaviors.” The criteria for both sets must be met for the diagnosis of ASD to be made.Īlthough DSM-5 uses the term “spectrum” to characterize the disorder, one might ask: a spectrum of what? The most immediate suggestion is that the autistic spectrum captures variations on social communication problems. In fact, ASD encompasses a number of syndromes that were individually classified in DSM-IV Asperger's disorder and pervasive developmental disorder not otherwise specified are gone. The name of the broader category in which autism is situated is no longer pervasive developmental disorder it is autism spectrum disorder (ASD). While many things about autism, such as key diagnostic features, remain similar in DSM-5, other aspects of the diagnosis involve major changes in DSM-5. It is good that DSM-5 allows for this, but the popularity of this practice reflects the still limited understanding we have of pathophysiology in autism and other syndromes defined on purely behavioral grounds. If, however, the symptoms are sufficient to meet criteria for other disorders, then the patient should be diagnosed as having two or more disorders. The presence of these other symptoms should be noted, and, if necessary, the patient should be treated. It is understood in both DSM-IV and DSM-5 that children who meet the criteria for autism often have symptoms of other disorders (anxiety disorders, affective disorders, attention deficit hyperactivity disorder, specific language disorders, and intellectual disability in particular). Rejecting a categorical understanding of autism (with its all-or-nothing approach to diagnosis) and replacing it with a dimensional model is a considerable improvement over DSM-IV. DSM-5 has been conceived as both conservative and progressive it attempts to keep important diagnostic traditions intact while it introduces clinically important paradigmatic shifts.

Dsm 5 on asd