Okay, so this video is for anyone who is interested in understanding more about what autism is, particularly in how it is diagnosed.

What I'm going to be reading is from the DSM-5-TR. This is the most current version of the manual as of 2025.

Now, for those who don't know, the DSM is the Diagnostic Statistical Manual of Mental Disorders, and this is written by the American Psychiatric Association.

So this is the manual used by all psychology professionals in the United States when diagnosing any condition that exists inside of this manual.

Okay, moving on to the actual diagnostic criteria.

So before I jump into reading this, I want to explain that the way the diagnostic criteria are written is that there are two main categories of autism.

What you see on the screen is talking about the first category, which has to do with social communication challenges.

The second category, which I'm going to show in a few screenshots from now, has to do with what the DSM calls restricted, repetitive patterns of behavior.

Now, within the first category, this one, there are three subcategories.

You see the first two fully on the screen. I'm going to show you the third one when I'm done reading this screen.

And then the second category of restricted, repetitive patterns of behavior, that one has four subcategories.

Now, for a little bit more context, in order for a person to be diagnosed with autism, they have to meet all three of these subcriteria from the first category of autism.

However, they only need to meet two of the four subcriteria from the second category.

And you're going to see that written in the actual verbiage of the DSM, but I wanted to call that out before I started reading.

Okay, so let's get into it.

A, persistent deficits in social communication and social interaction across multiple contexts as manifested by all of the following currently or by history.

And then it explains, examples are illustrative, if not exhaustive, see text.

So it’s saying, don't take this to mean that you have to have these exact things.

These illustrate what the criteria are talking about, but there are a lot of other ways the criteria can manifest.

Okay, number one.

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.

Okay, let's move to number two.

Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication, to abnormalities in eye contact and body language, or deficits in understanding and use of gestures, to a total lack of facial expressions and nonverbal communication.

Okay, moving to number three.

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.

Now, the last line in this section I want to call attention to… it says specified by current severity.

Severity is based on social communication impairments and restricted repetitive patterns of behavior. See table 2.

What this is referring to is how much support a person needs.

So in this case, severity has to do with how much support a person needs.

So right now, according to the DSM, every diagnosis should come with a level related to each of the main two categories.

And if you're interested in that, I created a whole video on that.

I'll see if I can link to it somewhere or provide some information on how to find it.

Okay, let's move on to the next section now, which is restricted repetitive patterns of behavior.

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

Same as before, examples are illustrative, not exhaustive. See text.

Okay, so again, this section has four subcriteria.

Number one, stereotyped or repetitive motor movements, use of objects, or speech.

For example, simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases.

This is the one that people sometimes refer to as stimming.

Number two.

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

Example, extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat the same food every day.

Okay, number three.

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

For example, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests.

Now this one is what people often refer to as special interests.

And number four.

Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment.

For example, apparent indifference to pain / temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement.

Now this is the one that has to do with sensory processing, which is something that I talk a lot about on my platform, which is how I got the name Sensory Stories by Nicole.

Okay, wrapping up section two.

You'll see the same comment under this section about specifying the current severity.

It's the same thing, basically just saying that a person will get a level of support needs related to this category as well.

Finally, let's move on to the last few sections of the diagnostic criteria.

So, section C.

Symptoms must be present in the early developmental period but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life.

This is actually really important.

And this has to do with the way that a person, particularly females, girls and women, tend to change their behaviors to fit in, which is oftentimes called masking.

And this is the DSM's way of saying, we get it, it could be masked, it might be hard to see, but a person must demonstrate autistic “symptoms” in early developmental life.

Section D.

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

This is basically what makes autism a disability.

This is the thing that makes it a disability.

Now a person might be impaired and not feel disabled, which is totally fine.

But this section right here is why autism is recognized by the Americans with Disabilities Act to be a disability.

Because it has to cause clinically significant impairment in social, occupational, or other important areas of current functioning.

Okay, wrapping this up.

Section E.

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.

And finally, there's a note…

Individuals with a well-established DSM-4 diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.

Individuals who have marked deficits in social communication but whose symptoms do not otherwise meet criteria for autism spectrum disorder should be evaluated for social pragmatic communication disorder.

Okay, so the autism section of the DSM is actually just about 22 pages long, so there is a lot more covered.

However, the diagnostic criteria that I just read is a good way to get a very high-level understanding of what diagnosticians look for when evaluating for autism.

So if there's one thing you take away from this, just please let it be that there's a lot more to autism than what I read to you today.

And if you suspect that you might be autistic or a loved one might be autistic, please know that what I shared today is not the complete picture by any means whatsoever.

Okay, so that's all I'm going to share today.

Hope you found this helpful.

And if you'd like to see more content like this, you know what to do.