DSM-5 D

Functioning labels are assigned by psychologists to describe an autistic person coping skills when navigating social & professional environments. The idea is that autistic people have “higher or lower” skills in these areas. Given the misinformed practice among ASD therapies and organizations, these labels have divided autistic people into false camps of “more and less autistic.”

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

• DSM-5 D focuses on how autism “symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.”

• According to the APA, clinical significance is the extent to which a study result is judged to be meaningful in relation to the diagnosis of a disorder. Clinical significance of ASD is measured by professional observations on whether or not an individual’s traits meaningfully impact their daily life.

• Examples of Social Impacts: Scripting conversations but rarely able to make social or romantic connections; making friends but unable to maintain friendships; consistently in bullying situations without knowing why.

• Examples of Occupational Impacts: Experiencing constant miscommunications with co-workers; difficulty maintaining a job due to perceived inflexibility/disorganization; struggling to obtain a job, especially in the interview process.

• Examples of “Other Important” Impacts: Stimming publicly despite social consequences; regularly melting/shutting down due to sensory/social overload; requiring a routine to get through each day, otherwise unable to do regular tasks (even daily hygiene).

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