GRASP

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While the DSM-5-TR outlines autism using a deficit-oriented framework, at GRASP we adopt a neurodiversity-affirming perspective.  This means we view autism not as a set of deficits, but as a distinct and valid way of experiencing the world, one that involves unique patterns of thinking, communication, and perception.  Rather than focusing on what autistic individuals lack, we emphasize the importance of providing appropriate support and accommodations to help them thrive.  The challenges associated with autism are real, but they do not define the whole person.

It is important to understand that autistic traits vary greatly from person to person.  Every individual on the spectrum will present a unique combination of characteristics, strengths, and needs.  There is no universal checklist or behavior that applies to all autistic people.  Each person brings their own identity, preferences, and perspective.  The nature and intensity of their challenges often depend on the level of support available and their environment.  In short: meeting one autistic person means you’ve only met one autistic person.  Autism affects people across all racial, cultural, and socioeconomic backgrounds; factors like income, education, and lifestyle do not influence whether someone is autistic.

Given the above information, in the United States, healthcare professionals do rely on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) to diagnose autism.  For reference, we provide this information for educational and understanding purposes.  This manual outlines the official diagnostic criteria used by government agencies, insurance providers, and other organizations to determine the types of support and services an individual may qualify for.

To be diagnosed with autism spectrum disorder (ASD), a person must exhibit traits in two primary domains. According to the DSM-5-TR, these areas include:

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following:

• 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 or respond to social interactions.
• Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
• Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following:

• Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
• Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
• Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
• Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

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