DSM-5 B.2

When it comes to a need for routine, autistic people are not being “fussy,” “nitpicky,” or “manipulative and controlling.” 

While many autistic people thrive in structured environments, we are even more reliant upon routines because of the general lack of supports. Imagine being constantly confused by social frameworks. When a person is frightened by non-stop unknowns, we greatly benefit from planning what’s next. However, our routines are often mistaken for OCD.

I’m breaking down the DSM-5 ASD assessment, so autistic people can prepare for an ASD evaluation with a fuller knowledge of how to explain their personal traits to a practitioner. The DSM-5 is not the only autism assessment, but its emphasized traits are present in other tools. We’ll take a look at each criterion, its traits, and daily examples of the traits. (I’m not a licensed professional. DSM-5 info is at CDC.gov.)

• DSM-5 B looks at restricted, repetitive patterns of behavior, interests, or activities. B.2 focuses on: “Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.”

• ASD traits under DSM-5 B.2 include: Extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, needing to take the same route or eat the same food every day.

• Examples: Declining spontaneous invites, even if the invite is to something we’d enjoy; feeling wronged when a work meeting is cancelled; having a melt/shutdown in school when there was a substitute; struggling to complete/start a project; unable to wake/sleep without adhering to a step-by-step routine; feeling panicked when we take a wrong turn when driving; getting irritated when someone drives differently from us; refusing to eat new foods as a child when we “liked everything” as a baby; happily eating the same food every day.

DSM-5 C states that “symptoms must be present in the early developmental period.” While that may be frustrating, it’s rewarding to see how ASD has always been a part of our lives.

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