DIAGNOSTIC MANUAL CRITERIA

Autism Spectrum Disorder Autism Spectrum Disorder

Diagnostic Criteria 299.00 (F84.0)

A. Persistent deficits in social communication and social interaction across

multiple contexts, as manifested by the following, currently or by history
(examples are illustrative, not exhaustive; see text):

1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal

social approach and failure of normal back-and-forth conversation; to reduced
sharing of interests, emotions, or affect; to failure to initiate or respond to social
interactions.

2. Deficits in nonverbal communicative behaviors used for social interaction,

ranging, for example, from poorly integrated verbal and nonverbal
communication; to abnormalities in eye contact and body language or deficits in
understanding and use of gestures: to a total lack of facial expressions and
nonverbal communication.

3. Deficits in developing, maintaining, and understanding relationships, ranging,

for example, from difficulties adjusting behavior to suit various social contexts; to
difficulties in sharing imaginative play or in making friends; to absence of interest
in peers. Specify current severity: Severity is based on social communication
impairments and restricted, repetitive patterns of behavior .

B. Restricted, repetitive patterns of behavior, interests, or activities, a Restricted,

repetitive patterns of behavior, interests, or activities, as manifested by at least
two of the following, currently or by history (examples are illustrative, not
exhaustive; see text):

1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g.,

simple motor stereotypes, lining up toys or flipping objects, echolalia,
idiosyncratic phrases).

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns

of verbal or nonverbal behavior (e.g., extreme distress at small changes,
difficulties with transitions, rigid thinking patterns, greeting rituals, need to take
same route or eat same food every day).

3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g.,
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 the environment (e.g., apparent indifference to pain/temperature,
adverse response to specific sounds or textures, excessive smelling or touching
of objects, visual fascination with lights or movement).

Specify current severity:

Severity is based on social communication impairments and restricted, repetitive
patterns of behavior .
C. Symptoms must be present in the early developmental period (but may
not become fully manifest until social demands exceed limited capacities,
or may be masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or
other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability
(intellectual developmental disorder) or global developmental delay. Intellectual
disability and autism spectrum disorder frequently co-occur; to make comorbid
diagnoses of autism spectrum disorder and intellectual disability, social
communication should be below that expected for general developmental level.

ADHD( Attention Deficit HyperActivity Disorder )

Diagnostic Criteria

A. A persistent pattern of inattention and/or hyperactivity-impulsivity that

interferes with
functioning or development, as characterized by (1) and/or (2):
1. Inattention: Six (or more) of the following symptoms have persisted for at
least
6 months to a degree that is inconsistent with developmental level and that
negatively impacts directly on social and academic/occupational activities:
a. Often fails to give close attention to details or makes careless mistakes
in
schoolwork, at work, or during other activities (e.g., overlooks or
misses details,
work is inaccurate).
b. Often has difficulty sustaining attention in tasks or play activities
(e.g., has difficulty remaining focused during lectures, conversations,
or lengthy reading).
c. Often does not seem to listen when spoken to directly (e.g., mind
seems elsewhere, even in the absence of any obvious distraction).
d. Often does not follow through on instructions and fails to finish
schoolwork,
chores, or duties in the workplace (e.g., starts tasks but quickly loses
focus and
is easily sidetracked).
e. Often has difficulty organizing tasks and activities (e.g., difficulty
managing sequential tasks; difficulty keeping materials and belongings
in order; messy, disorganized work; has poor time management; fails
to meet deadlines).
f. Often avoids, dislikes, or is reluctant to engage in tasks that require
sustained
mental effort (e.g., schoolwork or homework; for older adolescents
and adults,
preparing reports, completing forms, reviewing lengthy papers).
g. Often loses things necessary for tasks or activities (e.g., school
materials, pencils, books, tools, wallets, keys, papenwork, eyeglasses,
mobile telephones).
h. Is often easily distracted by extraneous stim for older adolescents and
adults, may include unrelated thoughts).
i. Is often forgetful in daily activities (e.g., doing chores, running errands;
for older adolescents and adults, returning calls, paying bills, keeping
appointments).
 a. Often fidgets with or taps hands or feet or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected (e.g.,
leaves his or her place in the classroom, in the office or other workplace, or
in other situations that require remaining in place).
c. Often runs about or climbs in situations where it is inappropriate. (Note:
In adolescents or adults, may be limited to feeling restless.)
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be
or uncomfortable being still for extended time, as in restaurants, meetings;
may be experienced by others as being restless or difficult to keep up with).
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed (e.g.,
completes people’s sentences; cannot wait for turn in conversation).
h. Often has difficulty waiting his or her turn (e.g., while waiting in line).
i. Often interrupts or intrudes on others (e.g., butts into conversations,
games, or activities; may start using other people’s things without asking or
receiving permission; for adolescents and adults, may intrude into or take
over what others are doing

C. Several inattentive or hyperactive-impulsive symptoms are present in

two or more settings (e.g., at home, school, or work; with friends or
relatives; in other activities).
D. There is clear evidence that the symptoms interfere with, or reduce the
quality of, social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of
schizophrenia or another psychotic disorder and are not better explained by
another mental disorder (e.g., mood disorder, anxiety disorder, dissociative
disorder, personality disorder, substance intoxication or withdrawal

SPECIFIC LEARNING DISORDER

Diagnostic Criteria
A. Difficulties learning and using academic skills, as indicated by the presence of
at least one of the following symptoms that have persisted for at least 6 months,
despite the provision of interventions that target those difficulties:

1. Inaccurate or slow and effortful word reading (e.g., reads single words aloud
incorrectly or slowly and hesitantly, frequently guesses words, has difficulty
sounding out words).

2. Difficulty understanding the meaning of what is read (e.g., may read text
accurately but not understand the sequence, relationships, inferences, or deeper
meanings of what is read).

3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or

consonants).

4. Difficulties with written expression (e.g., makes multiple grammatical or

punctuation errors within sentences; employs poor paragraph organization;
written expression of ideas lacks clarity).

5. Difficulties mastering number sense, number facts, or calculation (e.g., has

poor understanding of numbers, their magnitude, and relationships; counts on
fingers to add single-digit numbers instead of recalling the math fact as peers do;
gets lost in the midst of arithmetic computation and may switch procedures).

6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying

mathematical concepts, facts, or procedures to solve quantitative problems)

B. The affected academic skills are substantially and quantifiably below those
expected for the individual’s chronological age, and cause significant interference
with academic or occupational performance, or with activities of daily living, as
confirmed by individually administered standardized achievement measures and
comprehensive clinical
assessment.

C. The learning difficulties begin during school-age years but may not become
fully manifest until the demands for those affected academic skills exceed the
individual’s limited capacities (e.g., as in timed tests, reading or writing lengthy
complex reports for a
tight deadline, excessively heavy academic loads).
D. The learning difficulties are not better accounted for by intellectual disabilities,
uncorrected visual or auditory acuity, other mental or neurological disorders,
psychosocial
adversity, lack of proficiency in the language of academic instruction, or
inadequate
educational instruction.
Note; The four diagnostic criteria are to be met based on a clinical synthesis of
the individual’s history (developmental, medical, family, educational), school
reports, and psychoeducational assessment.

315.00 (F81.0) With impairment in reading:

Word reading accuracy Reading rate or fluency Reading comprehension
Note: Dyslexia is an alternative term used to refer to a pattern of learning
difficulties characterized by problems with accurate or fluent word
recognition, poor decoding, and poor spelling abilities. If dyslexia is used to
specify this particular pattern of difficulties, it is important also to specify
any additional difficulties that are present, such as difficulties with reading
comprehension or math reasoning.

315.2 (F81.81) Witli impairment in written expression: Spelling accuracy

Grammar and punctuation accuracy Clarity or organization of written
expression

315.1 (FBI .2) With impairment in mathematics:

Number sense Memorization of arithmetic facts Accurate or fluent
calculation Accurate math reasoning