How Diagnosis is Made DSM-5 Criteria



Leo Kanner, professor of child psychiatry at Johns Hopkins University, first described autism in 1943. Several decades of research determined that autism was not caused by parenting practices, but by abnormalities in the brain. By the 1970's, research began investigating the cognitive and brain basis of autism and the result was the first neurobehavioral (brain-behavior) models.
As each model was subjected to further testing, more was learned about the cognitive deficits and the brain in autism. The growing evidence for autism as a disorder of brain and cognitive development and as a family genetic disorder demonstrated to the broader scientific community the importance that autism had for understanding human function, brain development, and genetic regulation of brain development. An understanding of these processes is key to developing powerful interventions in this and other disorders. All of these events have led to substantial improvements in the recognition of autism and related disorders and earlier diagnosis. The goal now is to begin widespread screening at 18 months by primary care physicians and 0-3 programs.
Today, a research diagnosis of autism is primarily based on several diagnostic assessment tools: the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). Both are used in the research study process to determine traits and characteristics that are common in autism. They have become critical measures in providing an accurate research diagnosis of autism spectrum disorders.
The Autism Diagnostic Observation Schedule (ADOS) helps evaluate observable behaviors associated within the autism spectrum. It is a semi-structured test in which the individual is given a number of situations, tasks, and demands and the tester observes behaviors across four domains: communication, qualitative impairments in reciprocal social interaction, imagination/creativity and repetitive behaviors and restricted interests. The collected information is then quantified and calculated into an algorithm.   The total scores from two domains, communication and reciprocal social interaction are used to classify individuals as meeting the ADOS criteria for autism spectrum disorders (ASD).
The Autism Diagnostic Interview-Revised (ADI-R) is a structured interview designed to obtain detailed descriptions of those behaviors that are necessary for the differential diagnosis of pervasive developmental disorders (PDD). The interview primarily focuses on the key characteristics listed in the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)These features are social interactions and social communication  and restricted, repetitive behaviors and interests.


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2006 CeFAR at the University of Pittsburgh • Site last updated September, 2012