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 adequated 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 interes 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 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.
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 suthreshold
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 receprocity
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) persistant 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 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 impairment
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.
