Table 1.
The autistic continuum (features most often used in diagnosis*). Reproduced with permission from Wing10
|
Manifestations†
|
||||
|---|---|---|---|---|
| Item | Tend to be seen in the most severely disabled | Tend to be seen in the least severely disabled | ||
| Social interaction | (1) Aloof and indifferent | (2) Approaches for physical needs only | (3) Passively accepts approaches | (4) Makes bizarre one-sided approaches |
| Social communication (verbal and non-verbal) | (1) No communication | (2) Needs only | (3) Replies if approached | (4) Spontaneous, but repetitive, one-sided, odd |
| Social imagination | (1) No imagination | (2) Copies others mechanically | (3) Uses dolls, toys correctly but limited, uncreative, repetitive | (4) Acts out one theme (eg, Batman) repetitively; may use other children as “mechanical aids” |
| Repetitive pattern of self chosen activities | (1) Simple, bodily directed (eg, face tapping, self injury) | (2) Simple, object directed (eg, taps, spins, switches lights) | (3) Complex routines, manipulation of objects, or movements (eg, bedtime ritual, lining up objects, attachment to objects, whole body movements) | (4) Verbal, abstract (eg, timetables, movements of planets, repetitive questioning) |
| Language—formal system | (1) No language | (2) Limited—mostly echolalic | (3) Incorrect use of pronouns, prepositions; idiosyncratic use of words or phrases; odd constructions | (4) Grammatical but long winded, repetitive, literal interpretations |
| Responses to sensory stimuli (oversensitive to sound, fascinated by lights, touches, tastes, self spinning; smells objects or people; indifferent to pain, heat, cold, etc) | (1) Very marked | (2) Marked | (3) Occasional | (4) Minimal or absent |
| Movements (flaps, jumps, rocks, tiptoe walking, odd hand postures, etc) | (1) Very marked | (2) Marked | (3) Occasional | (4) Minimal or absent |
| Special skills (manipulation of mechanical objects; music; drawing; mathematics; rote memory; constructional skills, etc) | (1) No special skills | (2) One skill better than others, but all below chronological age | (3) One skill around chronological age—rest well below | (4) One skill at high level well above chronological age, very different from other abilities |
*
Other clinical features are seen in disorders in the autistic continuum, but they are not listed here because they are not mentioned in the various sets of criteria considered essential for diagnosis.
†
The manifestations of each item (numbered 1 to 4 under each heading) are arbitrarily chosen points along a continuum. In reality, each shades into the next without any clear divisions.