Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects communication, social interaction, behavior, and sensory processing. It’s called a “spectrum” disorder because its characteristics vary widely from person to person. However, there are some core diagnostic characteristics that help professionals identify and understand ASD.
Two Main Areas of Diagnostic Criteria
The diagnostic criteria for autism, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are centered around two main areas:
- Social Communication and Interaction
Autistic individuals may experience differences in the following areas:
- Social-emotional reciprocity: This includes variations in back-and-forth conversations, sharing interests, and understanding social cues like facial expressions and tone of voice.
- Nonverbal communication: Differences may include using and understanding gestures, eye contact, and facial expressions.
- Developing, maintaining, and understanding relationships: This can include differences in development of relationships, adjusting behavior to varying social contexts, and engaging in imaginative play.
- Restricted, Repetitive Patterns of Behavior, Interests, or Activities
This category includes:
- Stereotyped or repetitive motor movements: This can include hand flapping, rocking, or repeating certain words or phrases (sometimes called “stimming”). These movements are often self-soothing and should be respected.
- Insistence on sameness: Autistic individuals may have strong preferences for routines and rituals, as these provide a sense of predictability and comfort. Changes to routines should be approached with sensitivity and support.
- Highly focused interests: This can involve intense interests in specific topics, objects, or activities. These interests can be a source of joy and motivation.
- Sensory sensitivities: This can manifest as differences in preference for or aversion to various aspects of the environment (e.g., textures, smells) or different reactions to certain sensory experiences (e.g., loud noises, bright lights). Sensory needs should be accommodated and respected.
Additional Diagnostic Considerations
- Symptoms must be present in the early developmental period – while they may not fully manifest until social demands exceed limited capacities, the characteristics must be present from early childhood.
- Symptoms cause clinically significant impairment: The characteristics must significantly impact the individual’s daily functioning in areas like social interaction, communication, or other important areas of life.
- Symptoms are not better explained by intellectual disability or global developmental delay: While autism can co-occur with intellectual disability, the diagnostic characteristics of autism must be distinct.
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