christian counseling today
Vol. 20 no. 2
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impairment, communication difficulties and repetitive/
stereotyped behaviors. They manifest in a child’s early devel-
opmental period and impair social, occupational or other areas
of functioning. The
DSM-5
criteria include the following
(severity is specified according to the need for support):
2
a. Deficits in social communication and social interaction
across multiple contexts
n
In social-emotional reciprocity, ranging from an abnormal
social approach; to a reduced sharing of interests,
emotions or affect; to the failure to initiate or respond to
social interactions.
n
In nonverbal communication behaviors used for social
interaction, ranging from poorly integrated verbal-
nonverbal communication; to abnormalities in eye contact
and body language; to a total lack of facial expressions
and nonverbals.
n
In developing, maintaining and understanding relation-
ships, ranging from difficulties in adjusting behavior to fit
various social contexts; to difficulties in sharing imagina-
tive play or in making friends; to the absence of interest in
peers.
b. Restricted and repetitive patterns of behavior, interests or
activities
n
Stereotyped or repetitive motor movements, use of objects,
or speech (e.g., lining up toys, echolalia, idiosyncratic
phrases, etc.).
n
Insistence on sameness, inflexible adherence to routines,
or ritualized patterns of verbal/nonverbal behavior (e.g.,
extreme distress at small changes, difficulties with transi-
tions, rigid thinking patterns, greeting rituals, etc.).
n
Highly restricted, fixated interests that are abnormal in
focus and intensity.
n
Hyper- or hypo-reactivity to sensory input or an
unusual interest in sensory aspects of the environ-
ment (e.g., apparent indifference to pain/temperature,
adverse responses to specific sounds or textures, excessive
smelling/touching of objects, visual fascination with lights
or movement, etc.).
In the
DSM-IV
, Asperger’s Syndrome (named after pedia-
trician Hans Asperger) was added to the category of Pervasive
Development Disorders and referred to as part of the autism
spectrum. Since that time, Asperger’s has become a common
term in the fields of medicine, psychology, and educa-
tion. A controversial change in the
DSM-5
is the removal of
Asperger’s Syndrome as a distinct disorder. The
DSM
revi-
sion team decided the term, “autism,” was too broad and,
hence, was responsible for the increase in autism diagnoses
over the past 20 years. The main debate centered on whether
“Kanner” or “classical” autism (named after child psychiatrist,
Leo Kanner) is clinically significant from Asperger’s. In the
DSM-IV
and
DSM-IV-TR
, autism included Classic Autism,
Asperger’s Syndrome, Childhood Disintegrative Disorder,
