- [Voiceover] So Autism Spectrum Disorder
is this really broad disorder where the affected
person has trouble communicating
and interacting with other people.
And they also have this sort of restrictive
and repetitive behavior where they can be
really restrictive with their interests,
maybe only showing interest in one or two activities
and repetitive with their behaviors
or maybe the routines that they need in place.
And while we're not entirely sure yet
what causes Autism Spectrum Disorder,
we do have a few clues that we've kind of
picked up over the years that are helping
us try to figure out what the cause is.
So we know that if kids have a family member,
someone who they share some of their DNA with,
also known as a blood relative,
if one of their family members has Autism Spectrum Disorder,
well they have a higher chance of
also having Autism Spectrum Disorder.
And we also know that boys are more likely
than girls to develop Autism Spectrum Disorder.
So both of these suggest to us that maybe
genetics is playing part of a role in the
development of Autism Spectrum Disorder.
And we also know that the older the parents
are when they have their kid, the higher
the chances that the kid will have Autism Spectrum Disorder.
And that kind of points to a genetic cause as well.
So those are some of the clues we have,
but we're still trying to figure out the whole puzzle
when it comes to the cause of Autism Spectrum Disorder.
So if we suspect that a kid might
have Autism Spectrum Disorder,
how might we go about confirming
or diagnosing Autism Spectrum Disorder?
Well, for Autism Spectrum Disorder there
really isn't a test like a blood test or a scan
or anything like that that we can use to make the diagnosis.
So what we have to do instead is really
look for the signs of Autism Spectrum Disorder.
The trouble with communicating and interacting
and the restrictive and repetitive behaviors.
So you can imagine that diagnosing Autism Spectrum Disorder
can be a little tricky, and that sometimes it can
take quite a while for a diagnosis to be made.
So to help us with diagnosing Autism Spectrum Disorder,
there's actually a really useful manual
sort of like a guidebook that we use called the
Diagnostic and Statistical Manual of Mental Disorders,
or what we often shorten to the DSM.
So let's actually pull up what we would find
if we cracked open the DSM and checked out
the criteria for diagnosing Autism Spectrum Disorder.
Now something that I should mention here
is that the most current version of the DSM
which is the fifth edition, so the DSM 5.
Well when it came out a few years ago,
there were actually some big changes
made to Autism Spectrum Disorder.
So in the DSM 4, the older version of the DSM,
there were several different Autism Spectrum Disorders
including Autistic Disorder, Asperger's Disorder,
Childhood Disintegrative Disorder,
and Pervasive Developmental Disorder
and now in the DSM 5 all of these different
Autism Spectrum Disorders have kind of
been merged into one spectrum disorder.
Autism Spectrum Disorder,
and this was done because kids with
these different disorders, they really do
fall along a spectrum, and the hope
was to make diagnosing a child a bit more accurate.
So now in the DSM 5 there's just one
Autism Spectrum Disorder and kids will fall
in different places along this spectrum.
Okay, so the current requirements
for diagnosing Autism Spectrum Disorder
are split up into two main categories
and these categories, they're actually
the main signs of Autism Spectrum Disorder.
So the first category that we would find in the DSM
is persistent deficits in social
communication and interaction.
And this just basically means that the child's
social development is not quite
tracking along the way it should be.
So a child would have to display issues
with their social interactions in order
for us to consider diagnosing them
with Autism Spectrum Disorder.
And there are actually a few specific ways
that a child would need to show this,
this deficit in social communication and interaction.
So the first one here is deficits in
social and emotional reciprocity.
Now reciprocity is when two people do
something for each other, so in a social situation
this is kind of the back and forth flow of a conversation
where we respond to each other in similar ways.
So maybe someone smiles at you and says good morning.
Well, you would likely do the same.
You would return their smile and say
good morning back to them as well.
And when you do that, you're returning,
you're reciprocating their emotions
and their social gestures.
So having trouble with understanding and using
this sort of social and emotional reciprocity
is one of the communication deficits that we would
need to see in someone in order to
diagnose Autism Spectrum Disorder.
And it's not simply because they don't want to say hi.
I'm sure everyone's got someone
they're not stoked to say hi to,
but it's because the reciprocation it doesn't
really occur to them as a social requirement, if you will.
Now another sign that we would need
to see in order to diagnose Autism Spectrum Disorder
is some sort of deficit in developing
and maintaining relationships.
And here we're talking about relationships
with peers, with people around the same age.
Because it's actually not uncommon
for kids with Autism Spectrum Disorder
to befriend people who are younger or older than them,
but then still struggle with building
relationships with people their own age.
And the last sign that we would need to see
under this social communication and interaction
category here is some sort of
deficit in nonverbal communication.
So this means that the person would
have trouble understanding and using
things like hand gestures and eye contact
and facial expressions when they're communicating.
So that's the fist category that would need
to be checked off before you would consider
diagnosing someone with Autism Spectrum Disorder.
And that makes sense, right?
Because trouble with social communication
and interaction is one of the main signs
that we see in someone with Autism Spectrum Disorder.
So there's one more main category that also
needs to be checked off before we can
officially make a diagnosis of Autism Spectrum Disorder.
And as you might have guessed,
this category is one of the other main signs
of Autism Spectrum Disorder, and that's
restrictive and repetitive behavior and interests.
So you might remember that for a kid
with Autism Spectrum Disorder, there are a few
different ways that they might show this,
this restrictive and repetitive behavior and interests.
So they might have really fixated interests.
Maybe they're only really interested in one or two
activities and they show no interest in any others.
They might be really strict about following
routines or rituals, or maybe they
really struggle with change.
They might have repetitive sounds or movements
or behaviors that they perform.
Or maybe they react to stimulation
like bright lights or loud sounds a bit more
or a bit less than what we would expect.
So these are the two main categories that
we would need to check off in order
to diagnose Autism Spectrum Disorder.
And there are two little things
that I should also mention that the DSM
requires from a kid in order to make that diagnosis.
So one is that all of these behaviors,
they start coming on when the kid is in early childhood.
And the other is that these behaviors,
they interfere with the kid's daily life.
All right, so now we know what we need
to see in order to diagnose a kid
with Autism Spectrum Disorder.
So how do we go about looking for these signs?
Well what we really rely on is asking
the parents questions and talking to and playing
with the kid to see if we can pick up
on any of these signs here.
Now these questions, they'll vary quite a bit
depending on how old the kid is.
So maybe if the child is a toddler,
let's say they're between the age
of six months old to two years old.
Well, to look for this deficit in social
communication and interaction,
we might ask the parents if their child makes eye contact
or smiles and laughs with the parent.
Or maybe we'll ask if the child tries
to show or share toys with the parent.
If the kid was a bit older, we might
ask the parent how the kid is doing
with making friends at school.
And if we wanted to look for this restrictive,
repetitive behavior, we might ask how the kid
handles change or unexpected situations
like a different bed time routine or going on a trip.
Maybe we'll ask the parents to see if their child
has any particular habits that they like to repeat
like lining up toys in a special way,
or if they've noticed that any environmental stimuli
like a car honking or a light flashing
really tends to bother their kid.
Now, while these are the diagnostic criteria,
part of diagnosing Autism Spectrum Disorder
also involves ruling out disorders
that can look like Autism Spectrum Disorder.
So for example, intellectual disability,
which is when someone has trouble functioning
in many areas of their life, like communication,
taking care of themselves at school
with their academics, well, intellectual disability
can actually kind of look the same
as Autism Spectrum Disorder,
especially when the kid is young.
It's hard to decide if a kid's trouble
with communication and interaction
is due to Autism Spectrum Disorder,
or due to an intellectual disability.
So, part of diagnosing Autism Spectrum Disorder
involves trying to really make sure
that the trouble that the kid is having
fits this picture here of Autism Spectrum Disorder
rather than the picture of another
disorder like intellectual disability.
And to make things a little trickier, it's actually
not uncommon for kids with Autism Spectrum Disorder
to also have an intellectual disability.
So this means that they would meet the criteria
for both Autism Spectrum Disorder
and intellectual disability.
This doesn't mean that all children
with Autism Spectrum Disorder
have intellectual disability, not at all.
Often, there's no intellectual impairment at all,
but this just highlights that sometimes,
especially when the kid is really young
and still growing and developing,
it can be a little tricky to figure out
exactly what's behind their struggles
with communication and interaction.
So it may take a few years to make a final diagnosis,
but diagnosing Autism Spectrum Disorder
really comes down to observing the child's
social behaviors and habits for some time.