ASD IN THE DSM-5: SENSITIVTY AND SPECIFICITY

Appendix A

DSM-5 item assignments for the Autism Diagnostic Interview- Revised (ADI-R)

DSM-5 Criteria / ADI-R Assigned Items
A1: Deficits in social-emotional reciprocity (current) / 31: Use of other’s body to communicate
34: Social verbalization/chat a
35: Reciprocal conversation (within subject’s level of language) a
46: Attention to voice
52: Showing and directing attention
54: Seeking to share enjoyment with others
55: Offering comfort
61: Imitative social play
A2: Deficits in nonverbal communicative behaviours used for social interaction (current) / 42: Pointing to express interest
43: Nodding
44: Head shaking
45: Conventional/instrumental gestures
50: Direct gaze
51: Social smiling
56: Quality of social overtures
57: Range of facial expressions used to communicate
58: Inappropriate facial expressions
A3: Deficits in developing, maintaining and understanding relationships (current) / 36: Inappropriate questions or statements a
49: Imaginative play with peers b
53: Offering to share
59: Appropriateness of social responses
62: Interest in children
63: Response to approaches of other children
64: Group play with peers b
65: Friendships c
66: Social disinhibition b
B1: Stereotyped or repetitive motor movements, use of objects or speech
(ever) / 33: Stereotyped utterances and delayed echolalia a
37: Pronominal reversal a
38: Neologisms/idiosyncratic language a
69: Repetitive use of objects or interest in parts of objects
77: Hand and finger mannerisms
78: Other complex mannerisms or stereotypes body movements
B2: Insistence in sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behaviour (ever) / 39: Verbal rituals a
70:Compulsions/rituals
74: Difficulties with minor changes in subject’s own routines or personal environment
75: Resistance to trivial changes in the environment (not directly affecting the subject)
B3: Highly restricted, fixated interests that are abnormal in intensity or focus (ever) / 67: Unusual preoccupations
68: Circumscribed interests d
76: Unusual attachment to objects
B4: Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (ever) / 71: Unusual sensory interests
72: Undue general sensitivity to noise
73: Abnormal, idiosyncratic, negative response to specific sensory stimuli

a Item only applies to verbal subjects only. b Item only applies to children aged 4 years or older. c Item only applies to children aged 5 years or older. d Item only applies to children aged 3 years or older.

Appendix B

Autism Diagnostic Observation Schedule (ADOS) Items Assigned to the DSM-5 Criteria

DSM-5 Criteria / ADOS Assigned Items (Module 1) / ADOS Assigned Items (Module 2)
A1: Deficits in social-emotional reciprocity / A2: Frequency of vocalization directed to others / A2: Amount of social overtures/maintenance of attention
A6: Use of other’s body to communicate / A6: Conversation
B2: Responsive social smile / B3: Shared enjoyment in interaction
B5: Shared enjoyment in interaction / B4: Response to name
B6: Response to name / B5: Showing
B8: Giving / B6: Spontaneous initiation of joint attention
B9: Showing / B8: Quality of social overtures
B10: Spontaneous initiation of joint attention / B10: Amount of reciprocal social communication
B12: Quality of social overtures
A2: Deficits in nonverbal communicative behaviours used for social interaction / A7: Pointing / A7: Pointing
A8: Gestures / A8: Descriptive, conventional or informational gestures
B1: Unusual eye contact / B1: Unusual eye contact
B3: Facial expressions directed to others / B2: Facial expressions directed to others
B4: Integration of gaze and other behaviours during social overtures / B7: Response to joint attention
B7: Requesting
B11: Response to joint attention
A3: Deficits in developing, maintaining and understanding relationships / B9: Quality of social response
B11: Overall quality of rapport
B1: Stereotyped or repetitive motor movements, use of objects or speech / A4: Immediate echolalia / A4: Immediate echolalia
A5: Stereotyped/idiosyncratic use of words or phrases / A5: Stereotyped/idiosyncratic use of words or phrases
D2: Hand and finger and other complex mannerisms / D2: Hand and finger and other complex mannerisms
D4: Usually repetitive interests or stereotyped behaviours / D4: Usually repetitive interests or stereotyped behaviours
B2: Insistence in sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behaviour
B3: Highly restricted, fixated interests that are abnormal in intensity or focus
B4: Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment / D1: Unusual sensory interest in play material/person / D1: Unusual sensory interest in play material/person

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