DSM-5 A.1

There’s a lot of gate-keeping around autism diagnoses. While ASD comes with many experiences, the diagnostic tools used in ASD assessment and evaluation are biased toward specific traits.

I’ll break down one specific assessment for Autism Spectrum Disorder: the DSM-5. While not every psychologist uses the DSM-5, the traits emphasized will most likely translate to other tools. Let’s take a look at each diagnostic criterion, discuss its corresponding traits, and describe examples of how those traits may look daily. (I am not a licensed professional, and I am speaking from my experience as an autistic diagnosed as an adult. DSM-5 information is available at CDC.gov.)

• Criteria. DSM-5 A looks at social communication and interaction. More specifically, A.1 focuses on the following: Persistent “deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.”

• Traits. Possible ASD traits that fall under DSM-5 A.1 include: Monopolizing conversations; special interests and hyper-fixations; alexithymia; reduced cognitive empathy; less-emotive facial expressions; rarely speaking in social situations.

• Examples. Interrupting others; always being the last one to speak in a conversation; nonstop or never talking as a child; struggling with phone calls; not recognizing specific emotions in others and interpreting them incorrectly (like seeing confusion as anger); often neutral or unsure of feelings; singular, passionate interests since childhood that last several years; only talking about or always changing the subject to special interests.

Remember to recall both adult and childhood examples of the traits. DSM-5 C requires that “symptoms must be present in the early developmental period.” While that may be frustrating, it’s very rewarding to think through how ASD has always been a part of our lives.

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