DSM-5 A.3

Autistic people may develop Social Anxiety Disorder due to lack of supports while navigating the daily stresses of ableist environments. Even so, SAD is neither an ASD trait nor is it a diagnostic criterion on assessment tools. Telling a psychiatrist that we have social anxiety will often lead to a diagnosis of SAD, not ASD. During an evaluation, it’s essential to discuss the causes of our anxiety in relation to autism.

I’m breaking down the DSM-5 ASD assessment. 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 A looks at social communication & interaction. A.3 focuses on: Persistent “deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.”

• Possible ASD traits under DSM-5 A.3 include: not recognizing social cues; scripting; social mimicry; lining up toys instead of playing; persistent parallel play; opting for one-on-one over group activities; preferring to be alone.

• Examples: Talking loudly in quiet areas/softly in loud areas; raising hand to speak in laid back settings; keeping a mental record of “good” topics & responses overheard from others; planning casual chats in advance, but chatting never feels right; copying others’ words & actions instead of building upon conversations as a child, organizing toys into complex setups but “playing” for a few minutes; working/relaxing beside others but not with others; burning bridges; making & losing friends regularly; denying invites because being alone is more enjoyable.

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 since early childhood.

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