Persistent deficits in social communication and social interaction

DSM-5 says that to meet the diagnostic criteria for ASD there must be persistent deficits in all three of the areas below.

  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.

So why is it some of us are completely alone and isolated while others seem to have friends, partners and active social lives?

How do people who meet the above criteria achieve this?

Parents
  • I think you've miss quoted the DSM-5? That's only a list of examples of catagory A I think. In order to diagnose with ASD catagories A through E all need to be satisfies.

    The general text for catagory A is "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):" And below it the list you quote.

    So yes all autistic people have issues with their social skills but they aren't forced to fit with those 3 examples. It is posible to have good relationships with poor social skills if your friends learn to tolerate you being really blunt and ocasionaly socially inappropreat. Maybe some people are just so interesting, witty or atractive that people don't care that they don't make eye contact and are always getting the wrong end of the stick, speaking out of turn or saying the wrong thing. etc.

Reply
  • I think you've miss quoted the DSM-5? That's only a list of examples of catagory A I think. In order to diagnose with ASD catagories A through E all need to be satisfies.

    The general text for catagory A is "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):" And below it the list you quote.

    So yes all autistic people have issues with their social skills but they aren't forced to fit with those 3 examples. It is posible to have good relationships with poor social skills if your friends learn to tolerate you being really blunt and ocasionaly socially inappropreat. Maybe some people are just so interesting, witty or atractive that people don't care that they don't make eye contact and are always getting the wrong end of the stick, speaking out of turn or saying the wrong thing. etc.

Children
  • So yes all autistic people have issues with their social skills

    No I don’t agree, please don’t generalise about an entire community. I don’t have ‘issues’ with socialising, I socialise and communicate differently as do all autistics.

    The only reason why we are described as having issues with socialising is because there are more neurotypical people than us! We are purely described like this because we are a minority group-

  • I agree the wording is slightly ambiguous, but here’s a clarification from the Embrace Autism site:

    embrace-autism.com/.../

    When I speak to people I assess, I explain that the DSM-5 criteria that you need to fulfill consist of 3 As, 2 Bs, and C, D & E.

    It then goes on to say all three of the criteria I quoted are required.