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Persistent deficits in social communication and social interaction

Amerantin (former member)
8 months ago

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
  • 8 months ago

    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.

  • 8 months ago in reply to Peter

    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.

     

  • 8 months ago in reply to Amerantin (former member)

    I'm sorry to say that's something that one particular doctor has just made up. (in the sence it's not in the dsm-5) I just pulled a copy on my universities library server to check. It doesn't make sence to say you have to meet every condition in a list that is 'illustrative' and 'not exhaustive.'

  • 8 months ago in reply to Amerantin (former member)

    Yes. It’s posible to meet the ICD-11 definition and miss the (non-exhaustive) examples given in the dsm-5. There are a lot of people with Aspergers type autism who won’t fit well example 1 for instance. They’ll more or less cope with initiating a conversation often happily. It’s why so many people say to people with Aspergers ‘you don’t seem autistic’ because they converse just fine 90% of the time except maybe they give off a slightly ‘off’ vibe. And example 3 is kind of problematic as well because there are plenty of people with Aspergers like autism who have deficits in maintaining and forming relationships who are very friendly, imaginative, gregarious and by and large nice people, but again they give off that ‘creepy’ vibe.

    There are going to be a lot of autistic people whose social skill issues stem mostly from nonverbal communication issues and difficulty following subtext and reading the room. Because the truth is you can be in the same ‘social context’, the same room with the same people, but they are in a different mood, and what was ok to say yesterday is going to cause a row today.

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  • 8 months ago in reply to Amerantin (former member)

    Yes. It’s posible to meet the ICD-11 definition and miss the (non-exhaustive) examples given in the dsm-5. There are a lot of people with Aspergers type autism who won’t fit well example 1 for instance. They’ll more or less cope with initiating a conversation often happily. It’s why so many people say to people with Aspergers ‘you don’t seem autistic’ because they converse just fine 90% of the time except maybe they give off a slightly ‘off’ vibe. And example 3 is kind of problematic as well because there are plenty of people with Aspergers like autism who have deficits in maintaining and forming relationships who are very friendly, imaginative, gregarious and by and large nice people, but again they give off that ‘creepy’ vibe.

    There are going to be a lot of autistic people whose social skill issues stem mostly from nonverbal communication issues and difficulty following subtext and reading the room. Because the truth is you can be in the same ‘social context’, the same room with the same people, but they are in a different mood, and what was ok to say yesterday is going to cause a row today.

Children
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