Diagnostic guidelines for autism
The American Association of Childhood and Adolescent Psychiatry (AACAP) has established guidelines for diagnosing autism.1 The criteria are designed so a health professional can assess a child's behaviour relating to core symptoms of autism. Different types of diagnostic behavioural tests may be used to complement these criteria. The specific AACAP diagnostic guidelines are as follows.1
A. A total of six (or more) items from (1), (2), and (3), with at least two from (1) and one from (2) and (3):
- (1) Qualitative impairment in social interaction, as manifested by at least two of the following:
- (a) Marked impairment in the use of multiple non-verbal behaviours, such as eye-to-eye gaze, facial expression, body postures, and gestures, to regulate social interaction
- (b) Failure to develop peer relationships appropriate to developmental level
- (c) Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
- (d) Lack of social or emotional reciprocity
- (2) Qualitative impairments in communication, as manifested by at least one of the following:
- (a) Delay in or total lack of the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
- (b) In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
- (c) Stereotyped and repetitive use of language or idiosyncratic language
- (d) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
- (3) Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
- (a) Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
- (b) Apparently inflexible adherence to specific, non-functional routines or rituals
- (c) Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
- (d) Persistent preoccupation with parts of objects
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: social interaction; language as used in social communication; symbolic or imaginative play.
C. The disturbance is not better accounted for by Rett's disorder or childhood disintegrative behaviour.
Note: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders (2000), 4th edition, text revision. Washington, DC: American Psychiatric Association.
| Author: | Carrie Henley Sabra L. Katz-Wise | Last Updated: August 17, 2006 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Tom Bailey, MD - Family Medicine Fred Volkmar, MD - Child Psychiatry | |
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