Visit us on Facebook

OUR MISSION:
donate now
to provide the opportunity for everyone living with autism spectrum disorders to achieve their fullest potential, by enriching the autism community with education, training, accessible resources, and partnerships with local and national projects. Learn more.
Our weekly e-newsletter addresses a range of Autism Spectrum Disorder topics.
WHAT IS AUTISM

ICD-10-CM

DSM-5 (NEW)

DSM-IV-TR (OLD)

HOME

CONTACT US

 

WHAT IS AUTISM, ASPERGER SYNDROME, AND PERVASIVE DEVELOPMENTAL DISORDERS?

There are two established systems for identifying mental disorders:
The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) produced by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) and the National Institute of Mental Health (NIMH).

ICD-10-CM
The International Classification of Diseases (ICD) is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups.

It is used to monitor the incidence and prevalence of diseases and other health problems. It is used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and health records. In addition to enabling the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes, these records also provide the basis for the compilation of national mortality and morbidity statistics by WHO Member States. It is used for reimbursement and resource allocation decision-making by countries.

ICD-10 was endorsed by the Forty-third World Health Assembly in May 1990 and came into use in WHO Member States as from 1994. The 11th revision of the classification has already started and will continue until 2015. - World Health Organization

ICD-10 Diagnostic Criteria for Pervasive Developmental Disorders, Atypical autism, and Asperger syndrome:

F84 Pervasive Developmental Disorders

A group of disorders characterized by qualitative abnormalities in reciprocal social interactions and in patterns of communication, and by a restricted, stereotyped, repetitive repertoire of interests and activities. These qualitative abnormalities are a pervasive feature of the individual's functioning in all situations. Use additional code, if desired, to identify any associated medical condition and mental retardation.

F84.0 Childhood autism
A type of pervasive developmental disorder that is defined by: (a) the presence of abnormal or impaired development that is manifest before the age of three years, and (b) the characteristic type of abnormal functioning in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour. In addition to these specific diagnostic features, a range of other nonspecific problems are common, such as phobias, sleeping and eating disturbances, temper tantrums, and (self-directed) aggression.

Autistic disorder
Infantile:
autism
psychosis

Kanner syndrome
Excl.: autistic psychopathy (F84.5)

F84.1 Atypical autism
A type of pervasive developmental disorder that differs from childhood autism either in age of onset or in failing to fulfil all three sets of diagnostic criteria. This subcategory should be used when there is abnormal and impaired development that is present only after age three years, and a lack of sufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restricted, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals and in individuals with a severe specific developmental disorder of receptive language.

Atypical childhood psychosis
Mental retardation with autistic features
Use additional code (F70-F79), if desired, to identify mental retardation.

F84.2 Rett syndrome
A condition, so far found only in girls, in which apparently normal early development is followed by partial or complete loss of speech and of skills in locomotion and use of hands, together with deceleration in head growth, usually with an onset between seven and 24 months of age. Loss of purposive hand movements, hand-wringing stereotypies, and hyperventilation are characteristic. Social and play development are arrested but social interest tends to be maintained. Trunk ataxia and apraxia start to develop by age four years and choreoathetoid movements frequently follow. Severe mental retardation almost invariably results.

F84.3 Other childhood disintegrative disorder
A type of pervasive developmental disorder that is defined by a period of entirely normal development before the onset of the disorder, followed by a definite loss of previously acquired skills in several areas of development over the course of a few months. Typically, this is accompanied by a general loss of interest in the environment, by stereotyped, repetitive motor mannerisms, and by autistic-like abnormalities in social interaction and communication. In some cases the disorder can be shown to be due to some associated encephalopathy but the diagnosis should be made on the behavioural features.

Dementia infantilis
Disintegrative psychosis
Heller syndrome
Symbiotic psychosis
Use additional code, if desired, to identify any associated neurological condition.
Excl.: Rett syndrome (F84.2)

F84.4 Overactive disorder associated with mental retardation and stereotyped movements
An ill-defined disorder of uncertain nosological validity. The category is designed to include a group of children with severe mental retardation (IQ below 35) who show major problems in hyperactivity and in attention, as well as stereotyped behaviours. They tend not to benefit from stimulant drugs (unlike those with an IQ in the normal range) and may exhibit a severe dysphoric reaction (sometimes with psychomotor retardation) when given stimulants. In adolescence, the overactivity tends to be replaced by underactivity (a pattern that is not usual in hyperkinetic children with normal intelligence). This syndrome is also often associated with a variety of developmental delays, either specific or global. The extent to which the behavioural pattern is a function of low IQ or of organic brain damage is not known.

F84.5 Asperger syndrome
A disorder of uncertain nosological validity, characterized by the same type of qualitative abnormalities of reciprocal social interaction that typify autism, together with a restricted, stereotyped, repetitive repertoire of interests and activities. It differs from autism primarily in the fact that there is no general delay or retardation in language or in cognitive development. This disorder is often associated with marked clumsiness. There is a strong tendency for the abnormalities to persist into adolescence and adult life. Psychotic episodes occasionally occur in early adult life.
Autistic psychopathy
Schizoid disorder of childhood

F84.8 Other pervasive developmental disorders

F84.9 Pervasive developmental disorder, unspecified


DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

Autism Spectrum Disorder
An individual must meet criteria A, B, C and D:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction.

2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.

3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and in making friends to an apparent absence of interest in people.

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

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).

2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).

3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning


History of DSM-IV-TR and Pervasive Developmental Disorders

(History of the Manual)

According to the National Institute of Neuroligical Disorders and Stroke, the diagnostic category of pervasive developmental disorders (PDD) [referred] to a group of disorders characterized by delays in the development of socialization and communication skills. Parents may note symptoms as early as infancy, although the typical age of onset is before 3 years of age. Symptoms may include problems with using and understanding language; difficulty relating to people, objects, and events; unusual play with toys and other objects; difficulty with changes in routine or familiar surroundings, and repetitive body movements or behavior patterns. Autism (a developmental brain disorder characterized by impaired social interaction and communication skills, and a limited range of activities and interests) [was] the most characteristic and best studied PDD. Other types of PDD include[d] Asperger's Syndrome, Childhood Disintegrative Disorder, and Rett's Syndrome. Children with PDD var[ied] widely in abilities, intelligence, and behaviors. Some children [did] not speak at all, others [spoke] in limited phrases or conversations, and some [had] relatively normal language development. Repetitive play skills and limited social skills [were] generally evident. Unusual responses to sensory information, such as loud noises and lights, [were] also common.

DSM-IV (1994-2013)
The Diagnostic and Statistical Manual of Mental Health Disorders, Fourth Edition was revised in 1994. It was written to help you better understand the constellation of symptoms that comprise autism. The 943-page DSM-IV-TR, published by the American Psychiatric Publishing Inc., listed 297 disorders in the DSM-IV and made revisions in May 2013 which is currently the DSM-5. The DSM first recognized autism as a disorder during the same year Ronald Reagan was elected president - 1980.

The Pervasive Developmental Disorders (PDD) heading in the DSM-IV-TR listed subgroups that included Autistic Disorder, Asperger's Disorder, Rett Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified, (Including Atypical Autism). Each of the PDD disorders had their own code and symptoms. PDD was not a specific disorder; it only referred to the category that all of the disorders fell under.

Former Diagnostic Criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR):
Autistic Disorder - 299.00
Asperger's Disorder - 299.80
Rett's Disorder - 299.80
Childhood Disintegrative Disorder - 299.10
Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism) - 299.80

Diagnostic Criteria for Autistic Disorder - 299.00
The following criterion are from the 2000 Revision of the Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR).

A. A total of Six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3).

  1. Qualitative impairment in social interaction, as manifested by at least two of the following:
    • marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
    • failure to develop peer relationships appropriate to development level
    • a lack of spontaneous seeking to share enjoyment, interest, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
    • lack of social or emotional reciprocity
  2. Qualitative impairments in communication as manifested by at least one of the following:
    • delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alterative modes of communication such as gesture or mine)
    • in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
    • stereotyped and repetitive use of language or idiosyncratic language
    • lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
  3. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
    • encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
    • apparently inflexible adherence to specific, nonfunctional routines or rituals
    • stereotypes and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
    • persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.

American Psychiatric Association. (2000). Diagnostic criteria for autistic disorder. In Diagnostic and statistical manual of mental disorders (Fourth edition---text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, 75.

Diagnostic Criteria for Asperger's Disorder - 299.80
The following criterion are from the 2000 Revision of the Diagnostic and Statistical Manual, Fourth Edition-Text (DSM IV-TR). Note: Asperger's Disorder is one of five specific Pervasive Developmental Disorders listed in the DSM IV-TR under the general heading of Pervasive Developmental Disorders.

  1. Qualitative impairment in social interaction, as manifested by at least two of the following:
    • marked impairment in the use of multiple nonverbal behaviors such as eye-to eye gaze, facial expression, body postures, and gestures to regulate social interaction
    • failure to develop peer relationships appropriate to developmental level
    • a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
    • lack of social or emotional reciprocity
  2. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
    • encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity of focus
    • apparently inflexible adherence to specific, nonfunctional routines or rituals
    • stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
    • persistent preoccupation with parts of objects
  3. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
  4. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
  5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
  6. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

American Psychiatric Association. (2000). Diagnostic criteria for autistic disorder. In Diagnostic and statistical manual of mental disorders (Fourth edition---text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, 84.

Diagnostic Criteria for Rett's Disorder - 299.80

Diagnostic criteria for Rett syndrome (RS) were developed by representatives of the International Rett Syndrome Association and the Centers for Disease Control for use in future clinical and epidemiological studies. Necessary criteria are: normal prenatal and perinatal period; normal psychomotor development through the first 6 months of life; normal head circumference at birth, with subsequent deceleration of head growth; loss of purposeful hand skills; severely impaired expressive and receptive language; apparent severe mental retardation; and gait apraxia and truncal apraxia/ataxia. Supportive criteria include breathing dysfunction, seizures, spasticity, scoliosis, and growth retardation. The diagnosis of RS is considered tentative until 2 to 5 years of age. The differential diagnosis includes other disorders associated with mental retardation, cerebral palsy, and seizure disorders. These diagnostic criteria for RS should foster reliable communication among investigators and enhance the epidemiological and clinical research of this important disorder.
— PMID: 2454607 [PubMed - indexed for MEDLINE]

  1. All of the following:
    • apparently normal prenatal and perinatal development
    • apparently normal psychomotor development through the first 5 months after birth
    • normal head circumference at birth
  2. Onset of all of the following after the period of normal development:
    • deceleration of head growth between ages 5 and 48 months
    • loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (e.g., hand-wringing or hand washing)
    • loss of social engagement early in the course (although often social interaction develops later)
    • appearance of poorly coordinated gait or trunk movements
    • severely impaired expressive and receptive language development with severe psychomotor retardation

Childhood Disintegrative Disorder - 299.10

  1. Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior.
  2. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
    1. expressive or receptive language
    2. social skills or adaptive behavior
    3. bowel or bladder control
    4. play
    5. motor skills
  3. Abnormalities of functioning in at least two of the following areas:
    • qualitative impairment in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity)
    • qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play)
    • restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms
  4. The disturbance is not better accounted for by another specific Pervasive Developmental Disorder or by Schizophrenia.

Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism) - 299.80
This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes atypical autism --- presentations that do not meet the criteria for Autistic Disorder because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these.


The information presented herein does not necessarily reflect the position or policy of USAAA and no official endorsement should be inferred.

 

 

WHO ARE YOU
Advocate
Educator
Living with Autism

Living with Asperger's
Member
Parent or Caregiver
Professional
Relative
Volunteer

Who we are

SOCIAL MEDIA
Blog
Facebook

Twitter
USAAA TV
YouTube

MARKETPLACE
Advertise in our Programs
Bookstore
Donations
Membership
Nutrition and Supplements
Shop our Partners
Sponsorships
Video and Audio Downloads
PROJECTS
Conferences
Corporate Program
Educational Training
How You Can Help
MyAutismTeam
Parent/Practitioner Program

Sibling Program
Speaker's Bureau
USAAA TV
US College Autism Project
RESOURCES
ASDs: What are they?
Definition of Terms
E-Newsletter
FAQs
Scholarships/Financial Aid
Intervention and Therapies
Job Postings
Legal
Newsletter Archive
Online Resources
Research

Services donated by www.xmission.com, internet solutions provider. US Autism & Asperger Association is a 501(c)(3) nonprofit organization.
Copyright 2014 US Autism & Asperger Association, Inc. All rights reserved. 1-888-9AUTISM (1-888-928-8476) (801-816-1234)