Table 1.
Example of Mapping Exemplars for DSM-5 (APA, 2013) Autism Spectrum Disorder (ASD) Criterion A1
|
DSM-5 ASD criterion text |
A1. 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… to social interactions |
To failure to… respond to social interactions |
|---|---|---|---|---|---|---|
| A1. Exemplars from DSM-5 Text | • Deficit in the ability to engage with others • Difficulties processing and responding to complex social cues |
• Language often one-sided, lacking in reciprocity • Language used to request or label rather than comment, share feelings, or converse |
• Deficits in sharing thoughts or feelings • No sharing of emotions |
• Little or no initiation of social interaction | • Reduced or absent imitation of others’ behavior | |
| DSM-IV-TR Criteria (APA, 2000) | 1d. Lack of social or emotional reciprocity | 2b. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others | 1a. Marked impairment… emotional expression… regulate social interaction 1c. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest) | |||
| DSM-IV-TR Exemplars from ADDM Network Clinician Review* | • Cuddle, failure to (infancy) • Lack of emotional reciprocity • Lack of social reciprocity • Does not or limited engagement in simple imitation games |
• Touching or acting on others without regard to other’s involvement or reaction (must indicate lack of social awareness instead of hyperactive or impulsive touching) | • Marked impairment in the ability to initiate or sustain conversation • Deficit in pragmatic language (social use) • Monologues, one-sided conversation • Can talk, but doesn’t • Says things that do not make sense without clarification • Tangential, associative talk • Self-directed communication |
• Does not bring objects to share • Affect, lack of shared, flat in response to others… • Joint attention impairment • Does not point out objects or events of interest • Reduced reaction to praise • Heavy support needed for sharing |
• Does not seek help when needed • Does not seek out others |
• Does not respond to name • Lack of response to people • Often appears deaf in response to people’s talking or noisemaking that is being directed to the child to get their attention (without hearing loss) |
| ADOS-2, Module (AM#) and item; and ADI-R Item | • AMT: - • AM1: B14 • AM2: B9, B10, B11 • AM3: B8, B10 • AM4: B10, B12 • ADI: - |
• AMT: B15 • AM1: B12 • AM2: B8 • AM3: B7 • AM4: B9 • ADI: 56 |
• AMT: A2, A9 • AM1: A2 • AM2: A5, A6, B10 • AM3: A6, A8, B9 • AM4: A6, A7, A8, B12 • ADI: 34, 35 |
• AMT: B6, B11, B12 • AM1: A8, A9, B5, B8, B9 • AM2: B3, B5 • AM3: A5, B4, B5 • AM4: A5, B4, B5, B6 • ADI: 52, 53, 54 |
• AMT: B8, B9, B10, B13, B16 • AM1: B7, B10, B12, B13 • AM2: A2, B6, B8, B9 • AM3: B7, B8 • AM4: B9, B10 • ADI: 55 |
• AMT: B7, B14 • AM1: B2, B6, B11 • AM2: B4, B7, B9 • AM3: B9 • AM4: B11 • ADI: 46, 59, 63 |
| Other Exemplars from clinician observations, reports, tests, etc.* | • One-sided interactions (impairment in reciprocal interaction; for example, child only hugs when he or she initiates) | • Talking or verbalizing to oneself in the presence of others (when talking to self would be considered socially unacceptable or odd) • Disturbance in the pragmatic (social use) of language |
• Very few attempts to get, maintain, or direct others' attention | • Gets things for self when it would be “easier” to ask for help; walks away rather than requesting help; does not request assistance in general or indicate need in situation where it would be expected) | • Does not respond to others or the social environment, when there is clear social opportunity • Often appears deaf in response to people’s talking or noisemaking that is being directed to the child to get their attention (without hearing loss) |
*
Sample of exemplars included, complete mapping not inculded for space reasons (See Supplementary Appendix for more complete Exemplar List)