299.00 Autistic Disorder
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:
(a) 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
(b) failure to develop peer relationships appropriate to developmental level
(c) 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)
(d) lack of social or emotional reciprocity
(2) qualitative impairments in communication, as manifested by at least
one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied
by an attempt to compensate through alternative modes of communication such
as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to
initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) 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:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns
of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping
or twisting or complex whole-body movements)
(d) persistent precoccupation 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.
299.80 Pervasive Developmental Disorder, Not Otherwise Specified
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.
299.80 Asperger's Disorder
A. Qualitative impairment in social interaction, as manifested by at
least two of the following:
(1) 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
(2) failure to develop peer relationships appropriate to developmental level
(3) 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)
(4) lack of social or emotional reciprocity
B. Restricted, repetitive, and stereotyped patterns of behavior, interests,
and activities, as manifested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns
of interest that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping
or twisting, or complex whole-body movements)
(4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social,
occupational, or other important areas of functioning.
D. 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).
E. 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.
F. Criteria are not met for another specific pervasive developmental disorder
or schizophrenia.
299.80 Rett's Disorder
A. All of the following:
(1) apparently normal prenatal and perinatal development
(2) apparently normal psychomotor development through the first 5 months after
birth
(3) normal head circumference at birth
B. Onset of all of the following after the period of normal development:
(1) deceleration of head growth between ages 5 and 48 months
(2) loss of previously acquired purposeful hand skills between ages 5 and 30
months with the subsequent development of stereotyped hand movements (i.e.,
hand-wringing or hand washing)
(3) loss of social engagement early in the course (although often social interaction
develops later)
(4) appearance of poorly coordinated gait or trunk movements
(5) severely impaired expressive and receptive language development with severe
psychomotor retardation
299.10 Childhood Disintegrative Disorder
A. 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.
B. 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
C. Abnormalities of functioning in at least two of the following areas:
(1) qualitative impairement in social interaction (e.g., impairment in nonverbal
behaviors, failure to develop peer relationships, lack of social or emotional
reciprocity)
(2) 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)
(3) restricted, repetitive, and stereotyped patterns of behavior, interests,
and activities, including motor stereotypies and mannerisms
D. The disturbance is not better accounted for by another specific pervasive
developmental disorder or by schizophrenia.
Diagnostic and Statistical Manual, 4th Edition, ©1994, American Psychiatric
Association