Such as sound discrimination issues and synaesthesia (eg seeing colours for sound can be very distracting and prevent understanding of what is said), Some autistic people struggle to tolerate being around other people because of sensory issues. Issues occur when sensory issues interfere with hearing and understanding what is said. In many cases, sensory issues do not prevent communication and social interaction, but in other cases they do. But these sensory issues vary widely from person to person. Estimates are that sensory issues affect around 90% of the autistic population. You do not have to be Autistic to have sensory issues. But such movements can be very off putting and it would need a very tolerant, patient and understanding person to make the effort to communicate with and make friends with the person. For the autistic person, such movements may make it possible to have a conversation. On the face of it, minor repetitive movements such as flapping hands should not prevent conversation. ![]() If you are unable to have a conversation, then you will struggle to make friends. When speech does not make sense or is difficult to follow, communication and conversation is also difficult or impossible. When applied to speech this is repetition of words or blurting out random words that make no sense. Stereotyped repetitive movements can be a variety of repetitive and uncontrolled movements from flapping hands, flicking fingers in front of eyes and flipping objects to head banging or picking at ones skin. Stereotyped, Repetitive Movements or speech How would that work? Here are some examples taken from the DSM-5 Diagnostic criteria but looking at it in reverse. What if we look at the Part B diagnostic criteria and see if these can explain Part A. So let’s consider this from a different perspective. Hyper- or hypo-reactivity to sensory input or unusual interests in sensory aspects of the environment e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).Highly restricted fixated interests that are abnormal in intensity or focus, e.g., strong attachment to or preoccupation with unusual objects, excessively pursued interest.Insistence on sameness, inflexible adherence to routines, ritualised verbal or non-verbal behaviour, e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day.Stereotyped or repetitive motor movements, use of objects, or speech, e.g., simple motor stereotypes (such as flapping hands), lining up toys or flipping objects, echolalia, idiosyncratic phrases.Part B: Restricted, Repetitive, Patterns of Behaviour, Interests or Activities (at least 2 of the following) Deficits in developing, maintaining and understanding relationships- for example, difficulties adjusting behaviour to suit various social contexts or difficulties in sharing imaginative play or in making friends.Deficits in non-verbal communication, - for example, poorly integrated verbal and nonverbal communication abnormalities in eye contact and body language or deficits in understanding and use of gestures including lack of facial expressions and nonverbal communication.Deficits in social emotional reciprocity - for example, abnormal social approach and failure of normal back-and-forth conversation, reduced sharing of interests, emotions, or failure to initiate or respond to social interactions.DSM-5 Diagnostic Criteria Part A: social communication and social interaction – across multiple contexts We have found that Part B of the diagnostic criteria for autism actually explain the Part A symptoms. ![]() Normally, clinicians establish that the criteria for Part A are met before examining the criteria for Part B.Īt Aspiedent, in order to find ways of helping autistic people, we identify what is causing the symptoms - the underlying issues. The DSM-5 diagnostic criteria consist of two checklists: Part A which is about symptoms regarding communication and social communication and Part B which is about other symptoms found in autism. In this version of the DSM, all the diagnoses related to autism, such as Asperger Syndrome have been conflated into one diagnosis: Autism Spectrum Disorder. In this blog post we consider the DSM-5 (2013) diagnostic criteria for ASD (Autism Spectrum Disorder). Part B Of The Diagnostic Criteria Cause Part A Image by Gerd Altmann from Pixabay
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