DSM-5 Autism criteria explained

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the standard reference clinicians use to diagnose Autism Spectrum Disorder (ASD). Published by the American Psychiatric Association, the DSM-5 defines autism through two primary domains: Social Communication and Interaction and Restricted, Repetitive Patterns of Behavior.

Our free autism self-assessment is informed by these clinical frameworks. While a self-test cannot replace a professional diagnosis, it helps you examine your traits against the same criteria experts use to identify neurodivergence.

Domain A: Social Communication & Interaction

This domain focuses on how individuals interact with others and process social information. For a diagnosis, deficits must be present across all three of the following areas:

1. Deficits in social-emotional reciprocity: This might look like difficulty with back-and-forth conversation, reduced sharing of interests or emotions, or a different way of initiating social interactions.
2. Deficits in nonverbal communicative behaviors: This includes differences in eye contact, body language, facial expressions, and gestural communication. Some autistic people find eye contact uncomfortable or "perform" it as part of masking.
3. Deficits in developing, maintaining, and understanding relationships: Difficulty adjusting behavior to suit various social contexts, challenges in sharing imaginative play, or a different approach to making friends.

Domain B: Restricted, Repetitive Patterns of Behavior

This domain covers behaviors, interests, and sensory processing. At least two of the following four areas must be present:

1. Stereotyped or repetitive motor movements, use of objects, or speech: This includes "stimming" (like hand flapping or rocking), lining up toys, flipping objects, or echolalia (repeating words/phrases).
2. Insistence on sameness and inflexible adherence to routines: Extreme distress at small changes, difficulties with transitions, rigid thinking patterns, or a need to take the exact same route every day.
3. Highly restricted, fixated interests that are abnormal in intensity or focus: Having "special interests"—topics or hobbies that you spend a vast amount of time on and possess deep knowledge of.
4. Hyper- or hyporeactivity to sensory input: Apparent indifference to pain/temperature, adverse response to specific sounds or textures (like clothing tags), excessive smelling or touching of objects, or visual fascination with lights or movement.

The "Spectral" Nature & Support Levels

Autism is a spectrum, meaning it affects every person differently. The DSM-5 uses "levels" to describe the amount of support an individual might need:

• Level 1: Requiring support (often referred to as "high-functioning").
• Level 2: Requiring substantial support.
• Level 3: Requiring very substantial support.

How Our Screening Helps

Our autism screening questionnaire translates these complex clinical descriptions into 18 everyday questions about your social preferences, sensory experiences, and behavioral patterns. It provides a structured way to reflect on your traits before speaking with a healthcare professional.