Autism Spectrum Disorders (ASD) are a type of neurodevelopmental disorder. which especially affect communication, language and social interactions, but also skills and psychomotor skills.

They appear in childhood, and in severe cases can be detected very early. In this article know the five autism spectrum disorders that we can find in the DSM-5 (Diagnostic Manual of Mental Disorders).

Autism Spectrum Disorders: DSM Classification

In the DSM-IV-TR (Diagnostic Manual of Mental Disorders), autism spectrum disorders encompassed cases of “classic” autism, excluding within its group other categories such as Rett Disorder or Disintegrative Disorder.

Important changes

However, in the DSM-5 there is an important change, and the category of autism spectrum disorders becomes a category that encompasses not only autism (as in DSM-IV-TR), but also Asperger’s Disorder, Rett’s Disorder and Childhood Disintegrative Disorder. In other words, it becomes a much broader category.

These disorders in the DSM-IV-TR were included in the category of Generalized Developmental Disorders (GDDD), along with the unspecified GDDT. On the other hand, Rett Disorder and Childhood Disintegrative Disorder disappear from DSM-5 as such, and are now included in this new category with the name “Autism Spectrum Disorders”.

Disorders of this category

Just like that, in this article we will talk about autism spectrum disorders covered by this new categorybeyond the typically known autistic disorder.

Specifically, we will talk about Autistic Disorder, Asperger Disorder, Rett Disorder, Disintegrative Disorder and Generalized Developmental Disorder not specified:

Autistic Disorder

autism, also called autistic disorder is considered the disorder par excellence within autism spectrum disorders. This neurodevelopmental disorder mainly affects three areas: the social area, the communicative area, and the area of interests and behaviors. Autistic disorder is usually detected in childhood, and most often affects males.

In addition to the above, there is also (and this is a DSM-5 diagnostic criterion) a delay or alteration, before the age of 3, in at least one of the following areas: social interaction, symbolic play and social language.

Affected areas

Symptoms of autistic disorder appear in all three areas:

1. Communicative area

The child with autism has important alterations in communicationHe rarely uses non-verbal language (such as gestures), and his language is often altered. It may be that it does not directly present any type of language (absence of language), or that it appears with delay. Another characteristic of autistic language is that it is often stereotyped, repetitive or idiosyncratic.

In addition, they are children who have difficulty initiating or maintaining conversations (or directly have no interest in doing so, although not all).

In addition to language, another sphere within the communicative area that is affected is that of play; there is no spontaneous symbolic or realistic play. They usually “play” to group objects, to place them in line in the same position, etc., but for example they do not play games of simulated type, where the dolls have a role, for example, neither to the classic “fathers and mothers”, etc.

2. Social area

The social area is also altered, especially affecting social interactions.. Difficulties appear in nonverbal behavior, inability to establish relationships, and in the tendency not to share with others. In addition, they present a lack of social and emotional reciprocity.

Area of interests and behaviours

The last area affects behavior and interests. Thus, an autistic child often has restricted, stereotyped and repetitive interests. These interests are usually abnormal in relation to their intensity or objective; for example, they focus on parts of objects they like, on touching them, looking at them, spinning them, etc., but without any concrete or “functional” objective.

On the other hand, rigidly adhere to routines (or rituals)This is why they need a lot of day-to-day planning and a lot of anticipation of what they are going to do. If you change something from their routine without warning, they react negatively and anxiously. That’s why anticipation is important in autism spectrum disorders, especially autism.

Finally, they may present motor mannerisms and persistent concern for parts of objects (as mentioned above).

Asperger’s Disorder

Asperger’s Disorder is another autism spectrum disorder. Previously known as Asperger’s Syndrome. The fundamental difference with autism is that in Asperger’s Disorder there is no significant general language delay, as in autism. That is, their language is normative, and what is actually affected is communication and social interactions, rather than the language itself (which is not delayed).

On the other hand, in 75% of cases with autism there is also an intellectual disability. In Asperger’s disorder, on the other hand, intelligence is normal. (or sometimes above average).

That is, in Asperger’s there is no delay in cognitive development, nor in self-help skills, adaptive behavior, and curiosity about the environment in childhood (which does appear in autism).

Affected areas

The main areas affected in Asperger’s Disorder are two: the area of social interactions and the area of interests and behaviors.

Area of social interactions

A person with Asperger’s Disorder will have alterations in nonverbal behavior.Thus, he will not look into the eyes when interacting (absence of eye contact), facial expressions will sometimes not adjust to the emotions experienced or the context in which they appear, postures will be inadequate and gestures that regulate social interaction will either be absent or altered.

Relationships will also be affected, and it will be difficult for them to know how to act in social situations, or how to regulate/manage a conversation; that is, they have difficulties in understanding “social rules”.

Area of interests and behaviours

As with autism, a person with Asperger’s will present an absorbing concern for 1 or more stereotyped or restrictive patterns of interest (e.g., they may “obsess” about trains, and only talk about it or show interest in it).

Like autistic children, they also rigidly adhere to routines; they present motor mannerisms and “worry” about specific parts of objects.

3. Rett Disorder

Another autism spectrum disorder is Rett’s Disorder, characterized by a deceleration of cranial growthThis is due to the loss of acquired manual skills, the loss of social involvement and a serious alteration in language, as well as at the psychomotor level. There is also an ataxia of the march.

The surprising thing about Rett Disorder is that the pre and peri natal development are normal; in addition, the child who suffers it shows a normal psychomotor development up to 5 months, and his or her cranial circumference is normal at birth.
On the other hand, epileptic seizures and alterations in the electroencephalogram (EEG) frequently appear.

4. Childhood Disintegrative Disorder

The last of the autistic spectrum disorders is Disintegrative Disorder, characterized by normal development until at least 2 years, and by a loss of previously acquired skills that occurs before the age of 10.

Such loss occurs in at least two of the following areas: language (expressive or receptive), social skills (or adaptive behavior), bowel or bladder control, play, and motor skills.

In addition, abnormalities appear in any of the following areas (at least 2 to diagnose the disorder): social interaction, communication, and restrictive and repetitive behavior/interests.

Thus, like Rett Disorder, Childhood Disintegrative Disorder disappears as a diagnosis in DSM-5, although it is assumed that both can meet criteria for an autism spectrum disorder.

5. Pervasive Developmental Disorder Not Specified

The category of Generalized Developmental Disorder Not Specified is reserved for those cases that meet certain diagnostic criteria for Autism Spectrum Disorders, but not all of them.

It could be some case of “atypical autism”, for example, where the symptoms make one suspect of an ASD but without being able to have a clear diagnosis. The symptoms would affect the areas already mentioned in the previous disorders.

Bibliographic references

  • American Psychiatric Association (APA). (2002). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Barcelona: Masson.

  • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.

  • Society of Psychiatry and Neurology of childhood and adolescence. (2017). Autism Spectrum Disorder. Valparaiso.

  • Vallejo, M.A. (2012). Behavioral Therapy Manual. Volume I and II. Madrid: Dykinson (Topics 6-12).