DSM‐5 and the ASD Spectrum 61According to the new criteria introduced by DSM‐5, people with ASD dem-
onstrate persistent deficits in two areas: (1) persistent social behaviors in the
areas of general interaction and communication; and (2) behavioral patterns
that are repetitive and restricted. Even more precisely, those with ASD need to
display, either at present or in the past, deficits in: (1) reciprocal interaction in
social–emotional settings; (2) the nonverbal behaviors they use to communi-
cate in social interactions; and (3) the development, maintenance, and compre-
hension of interpersonal relationships. Moreover, individuals with ASD must
exhibit at least two repetitive behavioral patterns, such as stereotyped motor
motions, inflexible insistence on routines, excessive interest in sensory stimuli,
or an exaggerated emphasis on sameness. DSM‐5 recommends that clinicians
rate these deficits according to level of severity, and to base this decision on the
amount of support patients require [22].
Changes in ASD diagnosis approved by the APA
In the new DSM‐5 issue, the APA approved five significant changes: First, ear-
lier autism spectrum subcategories, such as Asperger syndrome, autistic disor-
der, and pervasive developmental disorder not otherwise specified (PDD‐NOS),
have been brought together under the umbrella of the more general term ASD.
Secondly, three autistic symptom areas were reduced to just two: impairment
in social communication; and repetitive behaviors or restricted interests.
Persons with ASD display a minimum of 6 deficits (out of 12) in their com-
munication, social interaction, or repetitive behaviors. ASD diagnosis now
requires that the individual shows three or more deficits in their social com-
munication patterns, and two or more symptoms in a category focused on
repetitive behaviors and a limited range of activities. Thirdly, the APA approved
of diagnoses based on either past or present patient histories. Fourthly, besides
the ASD diagnosis, healthcare professionals should provide a description
regarding known genetic conditions (e.g., Rett or fragile X syndromes), disabil-
ity level in the areas of intellect and language usage, and medical challenges
such as depression, anxiety, seizures, or negative gastrointestinal (GI) condi-
tions. Fifthly, social communication disorder (SCD) was added as a new cate-
gory to facilitate diagnosis in cases where a social communication disability
exists in the absence of a repetitive behavior disorder.
The impact of the Recent DSM‐5 Changes on Diagnosis
and Support Practices
Anyone with a current ASD diagnosis, including PDD‐NOS or Asperger syn-
drome diagnoses, will retain their current ASD diagnosis. This diagnosis is
valid for life, and entitles affected individuals to appropriate treatment for the
remainder of their lives.