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Autistic Disorder |
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At least two symptoms in Cluster 1 (Social) DSM-IV-TR checklist relative to developmental level
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AND |
_______ |
At least one symptom in Cluster 2 (Communication) |
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AND |
_______ |
At least one symptom in Cluster 3 (Repetitive and/or Restricted Interests and Behaviors) |
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AND |
________ |
Child displays SIX OR MORE total symptoms |
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AND |
________ |
Onset was before age three years |
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AND |
________ |
Child’s age equivalence must be 12 months or higher on at least one of the following: Mullen Visual Reception, Receptive Language, or Expressive Language |
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ASD-Low MA |
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Child displays at least 1 symptom from Cluster 1 (Social): must have 1 symptom other than lack of interest in peers |
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AND |
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Child displays at least 1 other symptom from Cluster 2 (Communication) and/or Cluster 3 (Repetitive and/or Restricted Interests and Behaviors) |
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AND |
________ |
Child’s Mullen scores on Visual Reception, Receptive Language, and Expressive Language and Vineland scores on Communication and Social subdomains are ALL less than or equal to 12 months age equivalent |
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Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) |
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At least one symptom in Cluster 1 (Social) DSM-IV-TR checklist relative to developmental level: |
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_______ |
CANNOT include ONLY 1b (peer relationships) for Time 1 evaluations |
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AND |
_______ |
At least one symptom in Cluster 2 (Communication) and/orCluster 3 (Repetitive and/or Restricted Interests and Behaviors) |
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AND |
________ |
Child does not meet criteria for Autistic Disorder, Asperger’s Disorder, or Rett’s Syndrome |
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AND |
________ |
Symptoms noted on checklist cannot be better accounted for by another disorder (e.g., reactive attachment disorder, sensory or motor impairments, etc.) |
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AND |
________ |
Child’s age equivalence must be 12 months or greater on at least one of the following: Mullen Visual Reception, Receptive Language, or Expressive Language |
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AND |
________ |
Child displays clinically significant impairment in home, school, and/or community settings |
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Developmental Delay |
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Delay of at least 1.5 standard deviations on AT LEAST ONE of the following (“non-language”): |
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Mullen Visual Reception (T-score=35 or less) |
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Mullen Fine Motor (T-score=35 or less) |
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________ |
Vineland Motor Skills (SS=77 or less) |
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AND |
_______ |
Delay of at least 1.5 standard deviations on AT LEAST ONE of the following (“Language”): |
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________ |
Mullen Expressive Language (T-score=35 or less) |
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________ |
Mullen Receptive Language (T-score=35 or less) |
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________ |
Vineland Communication (SS=77 or less) |
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AND |
________ |
At least one from the 2 categories above must be a delay on the Mullen
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Other Diagnosis |
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DOES NOT meet criteria for an ASD diagnosis |
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AND |
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Meets criteria for a non-ASD DSM-IV-TR diagnosis, such as ADHD, ODD, Reactive Attachment Disorder, an anxiety disorder, a mood disorder, or some other psychological condition: Specify: ______________________ |
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No Diagnosis |
________ |
Meets criteria for a non-DSM-IV-TR disorder or condition (e.g., sensory processing difficulties): Specify: ________________________ |
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OR |
________ |
DOES NOT meet criteria for any DSM-IV-TR or study diagnoses, but DOES NOT meet criteria for Typical Development (include children who cannot complete reliable/valid testing due to non-compliance here) |
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AND |
________ |
Child displays sub-syndromic characteristics of a condition (reserve for clinically significant motor and/or speech-language difficulties that do not meet diagnostic criteria but present as clinically significant) |