Autism spectrum disorder (ASD) is a developmental disability characterized by persistent impairments in social interactions and communication, as well as restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. To be diagnosed, symptoms must be present during early development and cause clinically significant impairment in social, occupational, or other important areas of current functioning. The diagnostic criteria for ASD is outlined below. Please visit our developmental red flags page for additional information on early warning signs.

Diagnostic Criteria for Autism Spectrum Disorder (ASD)

Both parts of the following diagnostic criteria must be met.

Persistent deficits in social communication and social interaction across multiple contexts, manifested by the following:

• Deficits in social-emotional reciprocity, including abnormal social approach, reduced sharing of interests, emotions, or affect, or failure to initiate or respond to social interactions.
• Deficits in nonverbal communicative behaviors, used for social interaction, including poorly integrated verbal and nonverbal communication, abnormalities in eye contact and body language, deficits in understanding and use of gestures, or total lack of facial expressions and nonverbal communication.
• Deficits in developing, maintaining, and understanding relationships, including difficulties adjusting behavior to suit various social contexts, difficulties in sharing imaginative play or in making friends, or absence of interest in peers.

Restricted, repetitive patterns of behavior, interests, or activities, manifested by at least two of the following:

• Stereotyped or repetitive motor movements, use of objects, or speech (e.g., repetitive mannerisms, lining up toys, echolalia, idiosyncratic phrases).
• Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress in reaction to small changes, difficulties with transitions, rigid thinking patterns, need to complete same routine every day).
• Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment or preoccupation with unusual objects, excessively perseverative interests).
• Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., indifference to pain/temperature, adverse response to specific sounds or textures, excessive fascination with smelling, touching, or visually inspecting objects).

Diagnostic information summarized from:
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013