A 7-year-old boy shows social communication deficits (difficulty with back-and-forth conversation, poor eye contact), restricted interests (preoccupied exclusively with trains for 2 years), and repetitive motor mannerisms (hand-flapping when excited). Symptoms were present from early development. He uses full sentences. IQ on WISC-V is 84. Per DSM-5, the diagnosis is:
- A Asperger's disorder
- B Intellectual Disability with autistic traits
- C Autism Spectrum Disorder without intellectual disability ✓
- D Social (pragmatic) communication disorder
Explanation
DSM-5 collapsed the previous sub-categories (Autistic Disorder, Asperger's, PDD-NOS) into the single umbrella diagnosis of Autism Spectrum Disorder (ASD), with specifiers for presence/absence of intellectual disability and language impairment. This boy meets diagnostic criteria for ASD: persistent deficits in social communication and interaction (social-emotional reciprocity deficit, non-verbal communication deficit) plus restricted/repetitive behaviour patterns (restricted interests, stereotyped motor mannerisms), with early developmental onset and functional impairment. With IQ 84 (borderline range, >70) and phrase speech, the specifier is 'without intellectual disability.' Asperger's Disorder is no longer a valid DSM-5 diagnosis.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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Written and medically reviewed by the StethoPrep medical team.