DSM‐5 Criterias for ASD

Social Communication

Social Interaction

Restrictive/Repetitive behaviour

Sensory Processing difficulties


  • Unusual social initiations (e.g. intrusive touching; licking of others)
  • Failure to respond when name called
  • Does not initiate conversation
  • One‐sided conversations/monologues/tangential speech

Reduced sharing of interests

  • Doesn’t share
  • Lack of showing, bringing, or pointing out objects of interest to other people
  • Impairments in joint attention (both initiating and responding)
  • Lack of responsive social smile
  • Failure to offer comfort to others
  • Indifference/aversion to physical contact and affection

A2. Deficits in nonverbal communicative behaviors- examples

  • Impairments in social use of eye contact
  • Impairment in the use and understanding of gestures (e.g. pointing, waving, nodding/shaking head)
  • Abnormal volume, pitch, intonation, rate, rhythm, stress, prosody or volume in speech

A3. Deficits in developing and maintaining relationships- examples

  • Deficits in developing and maintaining relationships, appropriate to developmental level
    • Lack of “theory of mind”;
    • inability to take another person’s perspective
  • Difficulties adjusting behavior to suit social contexts
    • Does not notice another person’s lack of interest in an activity
    • lack of response to contextual cues (e.g. social cues from others indicating a change in behavior is implicitly requested)
    • Inappropriate expressions of emotion (laughing or smiling out of context)
    • Unaware of social conventions/appropriate social behavior
    • Does not notice another’s distress or disinterest
    • Limited recognition of social emotions
    • Lack of imaginative play with peers, including social role playing (>4 years developmental age)
    • Difficulties in making friends
    • Does not try to establish friendships
  • Abnormal volume, pitch, intonation, rate, rhythm, stress, prosody or volume in speech

Absence of interest in others

  • Lack of interest in peers
  • Withdrawn; aloof; in own world



  • Echolalia (immediate or delayed); may include repetition of words, phrases, or more extensive songs or dialogue
  • Pronoun reversal (for example, “You” for “I”; not just mixing up gender pronouns)
  • Refers to self by own name (does not use “I”)

Repetitive vocalizations such as repetitive guttural sounds, intonational noise‐making, unusual squealing, repetitive humming

Stereotyped or repetitive motor movements

  • Repetitive hand movements (e.g., clapping, finger flicking, flapping, twisting)
  • Stereotyped or complex whole body movements (e.g., foot to foot rocking, dipping, & swaying; spinning)
  • Abnormalities of posture (e.g., toe walking; full body posturing)
  • Intense body tensing
  • Unusual facial grimacing
  • Excessive teeth grinding
  • Repetitively puts hands over ears

Stereotyped or repetitive use of objects

  • Nonfunctional play with objects (waving sticks; dropping items)
  • Lines up toys or objects
  • Repetitively opens and closes doors
  • Repetitively turns lights on and off

B2. Excessive adherence to routines- examples

  • Adherence to routine
    • Insistence on rigidly following specific routines
    • Unusual routines
  • Ritualized Patterns of Verbal and Nonverbal Behavior
    • Repetitive questioning about a particular topic
    • Verbal rituals
    • Compulsions (e.g. insistence on turning in a circle three times before entering a room)
  • Excessive resistance to change
    • Difficulty with transitions
    • Overreaction to trivial changes
  • Rigid thinking
    • Inability to understand humor
    • Inability to understand nonliteral aspects of speech such as irony or implied meaning
    • Excessively rigid, inflexible, or rule‐bound in behavior or thought

Sensory Processing difficulty- examples

  • High tolerance for pain
  • Poking own eyes
  • Preoccupation with texture or touch (includes attraction/aversion to texture) oTactile defensiveness; does not like to be touched by certain objects or textures
  • Significant aversion to having hair or toenails cut, or teeth brushed
  • Unusual visual exploration / activity
    • Close visual inspection of objects or self for no clear purpose (for example, holding things at unusual angels) (no vision impairment)
    • Looks at objects, people out of corner of eye
    • Unusual squinting of eyes
    • Extreme interest or fascination with watching movement of other things (e.g., the spinning wheels of toys, the opening and closing of doors, electric fan or other rapidly revolving object)
  • In all domains of sensory stimuli (sound, smell, taste, vestibular, visual), consider: oOdd responses to sensory input (e.g. becoming extremely distressed by the atypical sound)
  • Atypical and/or persistent focus on sensory input
  • Unusual sensory exploration with objects (sound, smell, taste, vestibular)
  • Licking or sniffing objects (note: as part of a ritual, consider B2; licking or sniffing people consider A1)