ASD Characteristics

1. Restricted, repetitive behavior patterns, activities, interests, as manifested by at least two of the following, currently or by history

1.1. Stereotyped or repetitive motor movements, use of objects, or speech

1.2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior

1.3. Highly restricted, fixated interests that are abnormal in intensity or focus

2. Symptoms must be present in the early developmental period (may not manifest until social demands exceed capacities or possibly masked by learned strategies in later life)

3. Symptoms cause clinically significant impairment in social, occupational, or other important areas of functioning

4. Deficits: social communication and social interaction across multiple contexts

4.1. Social-emotional reciprocity: abnormal social approach; failure of normal back-and-forth conversation; reduced sharing of interests, emotions/affect; failure to initiate/respond to social interactions.

4.2. Nonverbal communicative behaviors used for social interaction: poorly integrated verbal/nonverbal communication, abnormalities in eye contact and body language or deficits in comprehension and use of gestures, possible lack of facial expressions and nonverbal communication.

4.3. Developing, maintaining, and understanding relationships: difficulties adjusting behavior to suit different social contexts, difficulties in sharing imaginative play, making friends, absence of interest in their peers.

5. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level