Soon a new version of the DSM, the criteria used in the field of psychiatry to determine mental illnesses will be released. Many people are worried because of the removal of Asperger syndrome, and worry that this will remove their diagnostic label. I’m going to go down this and explain what these changes mean for the autistic community at large.
First you must fall under the following three categories.
1: Deficit in Social-Emotional reciprocity.
2: Deficit in Non-verbal Communication.
3: Deficit in Maintaining Relationships.
Now I’m going to go down and give common examples of the presentation of these features in Autism/Aspergers.
The first category includes many things. Speaking at people, rather than with people. A lack of interest in social situations. Difficulty talking about emotions. Inability to maintain a conversation. Conversing in an inappropriate formality. Not speaking at all. Difficulty with small talk. Essentially, if you have marked difficulties talking with people in a NT way, this will apply to you.
You meet the second category if you: Have little eye contact, abnormal body language, difficulty recognizing emotions or other non-verbal signals, lack or abnormal facial expressions.
Finally you meet the third category if: You lack friends, have difficulties maintaining social expectations of friendship, aren’t interested in people, or only have friends that share your special interest. (This is considered abnormal socialization from Neurotypical Standards)
Next, there is another set of categories, which you have to fall under TWO of.
1: Repetition of speech, movement, or interests.
2: Excessive adherence to routine.
3: Special Interests.
4: Sensory Processing Dysfunction.
Repetition of speech, movement and interest covers stimming, special interests/obsessions, repeating yourself or others.
Routines are obvious, and I don’t feel I need to explain them.
Fixated interests can be anything. From teaching yourself a new language, to architectural styles of the 1800’s, to video games, to horseback riding, to stargazing, to constantly carrying a piece of yarn around. They dont all have to be train-spotting and calendars.
Sensory processing dysfunction: Can range from picky eating, to not noticing when you get hurt, to being in pain from certain textures, never hearing things, hearing EVERYTHING. Any of the senses can be hyper or hypo-sensitive.
Finally this symptoms MUST be present since childhood, and they must limit everyday functioning. Functioning in this context means that you require some sort of way to compensate for your problems. A special environment devoid of sensory stimulus, a communication tool, or a full time living aid for example.
So who qualifies as an Autistic in these categories? I’ll give a few examples of fictitious people who would fall under this diagnosis.
1: John: John learned to speak early and discovered a love of science. He’s socially awkward and doesn’t speak to people much unless they’re interested in his latest project. He has a few friends he speaks to online, but rarely goes out. Whenever he things he tends to shake his foot and hums. He hates when people move things unexpectedly, and is hesitant to let people into his house because of it. John’s difficulties socializing have made it difficult to keep down a job.
John qualifies under the DSM 5.
2: Sarah: Sarah doesn’t speak. She uses her computer to communicate with people. She’s often lost in her own world. She’s a professional author who has sold many books. She wears the same clothes every day, and doesn’t go outside due to her sensitive ears.
Sarah qualifies under the DSM 5.
Two different people, two different presentations. Both qualify. If you were formally diagnosed on the spectrum chances are you will still be officially on the spectrum. The largest barrier is not the DSM, but how people interpret the DSM. Autism awareness, and discussion of the condition as a spectrum will encourage a view of autism that embraces the diversity of our community.