Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development characterized, in
varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. Though there are strengths and unique abilities associated with the disorder, autism is most often defined based on “deficits” and “symptoms” because the definition from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) is science-based and the manual is used to describe disorders for diagnosis. With the May 2013 publication of the fifth edition of the DSM (commonly referred to as the DSM-5), all autism disorders were merged under one umbrella diagnosis of ASD. Previously, they were recognized as distinct subtypes, including autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger Syndrome. Individuals with well-established diagnoses of these disorders prior to the publication of the DSM-5 should now be given the diagnosis of autism spectrum disorder. Under the current DSM-5, there are two domains where people with ASD must show persistent deficits. They include:
- Persistent social communication and social interaction
- Restricted and repetitive patterns of behavior
More specifically, people with ASD must demonstrate deficits (either in the past or in the present) in social emotional reciprocity, nonverbal communicative behaviors used for social interaction, as well as deficits in developing, maintaining and understanding relationships. In addition, they must show at least two types of repetitive patterns of behavior including:
- stereotyped or repetitive motor movements
- insistence on sameness or inflexible adherence to routines
- highly restricted, fixated interests
- hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
The DSM-5 also added an additional category called Social Communication Disorder (SCD). This allows for a diagnosis of disabilities in social communication, without the presence of repetitive behavior. SCD is a new diagnosis and much more research and information is needed to better understand it. There are currently few guidelines for the treatment of SCD. Until such guidelines become available, treatments that target social-communication, including many autism-specific interventions, should be provided to individuals with SCD.