Non-derogatory DSM-5 diagnosis criteria for Autism
Here it the link to this @Twitter thread🧵
You might be Autistic if you meet the DSM-5 criteria for Autism, presented here in a non-deficient manner.
Category A: Intuitive Autistic Empathy
You have Intuitive Autistic Empathy instead of Intuitive Allistic Empathy
You intuitively communicate and interact using Autistic Empathy rather than Allistic Empathy, but you may have learned to mask, mimic, or emulate Allistic Empathy.
Three Requirements:
- 1. You do not naturally reciprocate social-emotional Allistic norms.
Example: you Infodump.
- 2. You do not demonstrate natural proficiency or acceptance of non-verbal Allistic communication.
Example: people ask why you always look mad because you are not smiling all the time.
- 3. You do not demonstrate that relationships dependent solely upon Allistic empathy are fulfilling.
Example: You don't want to hang out with people you don't like "just to socialize."
Category B: The Four Identifying Autistic Traits
Beyond Autistic Empathy there are four primary Autistic Trait.
Note again that masking, ABA, emulation, etc may have eliminated outward manifestations of some or all of these traits so when assessing consider your entire life experiences (see Category C).
At some point in your life you must have demonstrated 2 out of 4 of the following:
1. Stimming or Self-Stimulatory Behavior
Basically, does it feel "good" to repeat actions, physical, vocal, or otherwise? Do you have a natural impulse to move your body or state things in a systematic fashion that Allistics do not demonstrate?
- Note that it is very common to suppress this behavior to fit into Allistic norms and one may need to practice with stimming to re-access their ability to stim.
- Note that Stimming might only manifest during moments of extreme stress such as rocking your hips or intense pacing.
- Note that feeling overwhelming muscle pain over your entire body may be a sign of years of suppressed stimming.
Vocal stimming takes many forms:
- Making animal noises (meowing, etc...)
- Random sounds
- Repeating what was stated by another
- Repeating phrases Even more random sounds.
Stimming is rooted in an Autistic person's need to relieve Autistic stress.
The desire to stim rises with Autistic stress and Autistic stress is relieved by stimming.
2. Demonstrating a Strong Preference for Predictable Outcomes
- Strong desire for expectations to be set and met
- Able to excel in static environment that Allistic people could not handle.
- Resistance to illogical changes
3. Special Interests
- Deriving joy and or personal fulfilment from exceptional exploration of a topic of interest.
- Note that this may take many unexpected forms. Example, one might develop an interest in learning a broad spectrum of interests i.e. "collecting hobbies"
4. Hyper and/or Hypo Senses
An Autistic person may have any of their senses in whole or in part be more or less sensitive than the Allistic standard. Note that as this is related to perception it may go unnoticed until a thorough assessment is made.
Note that the Hyper/Hypo Sensory aspect of Autism is the definitive proof that Autism is a Neurological condition. Many people misunderstand Autism to be Behavioral or Psychological but it is based on a different wiring of the brain.
This Hyper/Hypo Sensitivity to the environment can take on a vast spectrum of phenomena and can be extremely broad or specific.
Category C: Confirm You Where Born Autistic
This is a nuanced category and is a bit of a "cover your ass" scenario with two major points:
- People are born Autistic BUT Autistic traits might not show up until late in life AND can be masked
- Acquired Neurodivergencies can mimimic Autistic traits, and that would not be Autism.
People are born Autistic
You cannot acquire Autism. The Autism is present in early development but may go unnoticed until late in like due to:
- Masking
or
- Lack of Autistic Stress
Masking
Masking is when an Autistic person consciously or unconsciously suppresses Autistic traits.
Lack of Autistic Stress
The intensity of Autistic traits is linked to Autistic stress.
If an Autistic person is in a conducive and accommodating environment that is compatible with their Autistic needs, then their problematic traits may not rise to observable levels until Autistic stress exceeds the limited capacity of the person to manage them without accommodations and support.
To be extremely clear, people can become aware that they are Autistic at any stage of life. People in their 70's learn that they are Autistic without seriously suspecting it earlier in life.
Acquired Neurotypes Can Mimic Autistic Traits
The most relevant aspect of Category C is that Autism-like traits may be acquired through ptsd, tbi, and other acquired Neurotypes.
For an official DX it is important for the diagnostician to make an effort to eliminate the possibility that presented Autistic traits where not acquired from a non-Autistic origin.
Category D: Medical Diagnosis Qualifier
Category D is of no relevance to a Self Diagnosis.
Even if a person is Autistic, due to the limits upon which society is willing to accommodate the disabled, a society based functional limited is mandated on those who may be medically diagnosed as Autistic.
At the time of assessment an Autistic person, even if meeting all qualifications of Category a, b, and c, must convince a licensed practitioner that, at the time of the assessment, the net effect of their Autistic traits and their current level of ability requires support.
If an Autistic person manages to convince a practitioner that they need accommodations during any assessment, then that Autistic person is protected for life, at that level of assessed need, independent of changing circumstances.
What this means is that an Autistic person who is receiving all necessary accommodations going into assessment may fail Category d and not be eligible for a diagnosis of Autism.
Category D is, by definition a social construct applied to limit the number of people who can be diagnosed as Autistic and as long as Category D remains part of the DSM, the diagnosis of Autism will not 100% match the number of people assessed to BE Autistic.
Many older individuals are identified by their diagnosticians as Autistic but are not given a DX, on the basis that the diagnostician decides that they "don't need it."
Category D is inherently flawed in that an Autistic person's support needs are linked to their environment and other dynamic factors that can change at any time.
Category E: No "Better" Explanation
Category E is extremely similar to Category C.
The nuanced difference is that Category C is about acquired Neurotypes but Category E applies to other Neurotypes that arise in early development.
Category E boils down to "make sure another neurotype does not make more sense for explaining the displayed behaviours.
Summary
To summarise and simplify, If you have:
- Intuitive Autistic Empathy instead of Intuitive Allistic Empathy
And 2 or more of the following:
- Stimming
- Desire for Predictable Outcomes
- Special Interests
- Hyper/Hypo Senses
And
- There is not a reasonable explanation for it other than Autism
Then you are VERY LIKELY Autistic.
Video Explanation
Yo Samdy Sam has an excellent video that goes over this as well
Special Note on Stimming
If you are suppressing stimming, it should become obvious pretty quickly.
