DSM-5-TR autism criteria

The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision) is the American Psychiatric Association's 2022 manual. Clinicians use it to diagnose autism. First, a child must have lasting challenges in all three social areas. These are back-and-forth social exchange, nonverbal communication and relationships. The child must also show at least two of four kinds of repeated behaviors, interests or sensory responses.

These signs must start in early childhood, though they may not be clear until social demands grow. They must cause real trouble in daily life. They also can't be better explained by intellectual disability or global developmental delay. Next, clinicians give a support level from 1 to 3 for each of the two areas. The 2022 update mostly made clear that all three social areas are needed. Researchers said that's unlikely to change how clinicians diagnose.

No single test or checklist makes the diagnosis. Clinicians use two main sources. One is what you tell them about your child's growth, and the other is what they see themselves. Reacting too much or too little to sensory input counts as one of the four repeated behavior areas. Autism can usually be diagnosed reliably by age 2. A short screener can show whether a specialist should take a closer look, but it isn't a diagnosis.

• Ask the evaluating clinician: Ask which tools and sources of information they'll use, since no single tool should decide the diagnosis.
• Ask about support levels: Ask which support level your child has in each area and how it shows up in daily life.
• Prepare for the visit: Ask what history to bring, and track what you notice with an autism diagnosis checklist.