DSM-5 B.4

Sensory stimulation is more than sensory overload.

Even though autistic people often have as many sensory likes as sensory dislikes, autism diagnostic tools tend to view sensory sensitivities and stimming as deficits. This means, when seeking a diagnosis, we have to stress sensory challenges more than joys. Instead of talking about a love for stim toys and sensory baths, those seeking a diagnosis have to elaborate on the frustrations of sensory overload.

I’m breaking down the DSM-5 ASD assessment, so autistic people can prepare for an 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.4 focuses on: “Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.”

• ASD traits under DSM-5 B.4 include: “Apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement.”

• Examples: Often colder/hotter than everyone else; liking lukewarm food; high tolerance to physical pain despite chronic pain; cringing at motorcycle revving; gagging on food textures; pain from clothing fabric/tags; constantly touching other people’s soft shirts; staring at flowing water/music visualizers for long periods; experiencing nausea/anxiety in fluorescent-lit places even when nothing “seems wrong.”

Remember: the DSM-5 C states that “symptoms must be present in the early developmental period.” Some childhood examples of B.4 may look like daily migraines from over stimulation; frequent stomach aches; picky eating; and meltdowns during dressing time.

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