The Autistic Neurotype (in diagnostic terms)
While thinking of autism as a “diagnosis” rather than a neurotype is somewhat antithetical to the neurodiversity paradigm, I think it’s important to offer an abridged history of some of the milestones of the diagnostic criteria of autism to use as a starting point. In 2013, the 5th edition of the Diagnostic and Statistical Manual (DSM-5) was published. It expanded the criteria of the autism spectrum disorder diagnosis to include the previously separate diagnoses of Asperger syndrome, pervasive developmental disorder- not otherwise specified; and childhood disintegrative disorder. In 2022, a “text revision” to the DSM (DSM-5-TR) was published that clarified that all 3 of the conditions in the elements of the criteria that describes social communication must be met (rather than, as the orignal working could imply, just 1 or 2 of the 3).
In order to organize this handbook, I’ve broken it down into sections based on diagnostic criteria, however I’ve made significant alterations to the wording of descriptions, most notably describing things as “experiences” or “traits” rather than “differences” or “deficits” (the later being the term most often used in the DSM). This is how I’ve reconceptualized each of the criteria and subcategories:
Social Communication & Experiences is used to incapsulate all of Criteria A, in which all subcategories must be met: “deficits in social-emotional reciprocity,” “deficits in nonverbal communicative behaviors used for social interaction,” and “deficits in developing, maintaining, and understanding relationships.”
In Criteria B, at least 2 of the 4 subcategories are required for a formal diagnosis.
Experience & Expression of Emotion is used to replace “stereotyped or repetitive motor movements, use of objects, or speech.”
Processing & Perceiving is used to replace “insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.”
Special Interests is used to replace “highly restricted, fixated interests that are abnormal in intensity or focus.”
Sensory Needs & Experiences is used to replace “hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment.”
I’ve also included Executive Functioning because, while not mentioned specifically in the DSM 5-TR, a high percentage of autistic folks are also ADHDers. While AuDHD isn’t a specific diagnosis, it seems clear that AuDHD is not just co-occurring autism and ADHD, but is a very distinct neurotype in and of itself. It’s also evident that executive functioning differences are often experienced by autistic folks without ADHD.
For more on the ways in which the DSM criteria can be interpreted in real-life, less pathologizing, scenarios Dr. Megan Anna Neff and Patrick Casale recorded a 4 part series on their poscast, “Divergent Conversations,” called “What is Autism?” It begins with episode 48: “Understanding Autistic Communication” (https://www.divergentpod.com/blog/ep-48 - 1 hour, 2 minutes).