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Diagnostic Criteria (adapted from DSM-IV)

Autistic Disorder

1. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each for (2) and (3):
   1. Qualitative impairment in social interaction, as manifested by at least two of the following:
      1. Marked impairment in the use of multiple nonverbal behaviors such as eye to eye gaze, facial expression, body postures, and gestures to regulate social interaction.
      2. Failure to develop peer relationships appropriate to developmental level.
      3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest.
      4. Lack of social or emotional reciprocity.
   2. Qualitative impairments in communication as manifested by at least one of the following:
      1. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
      2. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others.
      3. Stereotyped and repetitive use of language or idiosyncratic language.
      4. Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.
   3. Restricted repetitive and stereotypical patterns of behavior, interests, and activities, as manifested by at least one of the following:
      1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
      2. Apparently inflexible adherence to specific, nonfunctional routines or rituals.
      3. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements).
      4. Persistent preoccupation with parts or objects.
2. Delays or abnormal functioning in at least one of the following areas, with onset prior to ate three years (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
3. The disturbance is not better accounted for by Rhett's Disorder or Child Disintegrative Disorder.

Pervasive Developmental Disorder, not Otherwise Specified (PDD-NOS)
This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. For example, this category includes "atypical" autism - presentations that do not meet the criteria for autistic disorder because of late age at onset, atypical symptomology, or sub-threshold symptomology, or all of these.

Rhett's Disorder

1. All of the following
   1. Apparently normal prenatal and postnatal development.
   2. Apparently normal psychomotor development through the first 5 months after birth.
   3. Normal head circumference at birth.
2. Onset of all of the following after the period of normal development.
   1. Deceleration of head growth between ages of 5 and 48 months.
   2. Loss of previously acquired purposeful hand skill between ages 5 and 30 months with the subsequent development of hand wringing or washing motions.
   3. Loss of social engagement early in the course (although often social interaction develops later).
   4. Appearance of poorly coordinated gait or trunk movements.
   5. Severely impaired expressive and receptive language development with severe psychomotor retardation

Childhood Disintegrative Disorder

1. Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior.
2. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
   1. Expressive or receptive language
   2. Social skills or adaptive behavior
   3. Bowel or bladder control
   4. Play
   5. Motor skills
3. Abnormalities of functioning in at least two of the following areas:
   1. Qualitative impairments in communication (e.g., delay or lack of language, stereotyped and repetitive use of language, lack of varied make-believe play).
   2. Qualitative impairments in communication (e.g., delay or lack of stereotyped and repetitive use of language, lack of varied make-believe play).
   3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypes and mannerisms.
4. The disturbance is not better accounted for by another specific Pervasive Developmental Disorder or by Schizophrenia

Asperger's Disorder

1. Qualitative impairment in social interaction, as manifested by at least two of the following:
   1. Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.
   2. Failure to develop peer relationships appropriate to developmental level.
   3. A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people).
   4. Lack of social or emotional reciprocity.
2. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
   1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
   2. Apparently inflexible adherence to specific, nonfunctional routines or rituals.
   3. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements).
   4. Persistent preoccupation with parts of objects.
3. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
4. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years.
5. There is no clinically significant general delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
6. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

Attention-Deficit / Hyperactivity Disorder

1. Either (1) or (2):
   1. Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
      Inattention
      1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
      2. Often has difficulty sustaining attention in tasks or play activities.
      3. Often does not seem to listen when spoken to directly.
      4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
      5. Often has difficulty organizing tasks and activities.
      6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).
      7. Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools).
      8. Is often easily distracted by extraneous stimuli.
      9. Is often forgetful in daily activities.
   2. Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
      Hyperactivity
      1. Often fidgets with hands or feet or squirms in seat.
      2. Often leaves seat in classroom or in other situations in which remaining seated is expected.
      3. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness).
      4. Often has difficulty playing or engaging in leisure activities quietly.
      5. Is often "on the go" or often acts as if "driven by a motor."
      6. Often talks excessively.
      Impulsivity
      1. Often blurts out answers before questions have been completed.
      2. Often has difficulty waiting turn.
      3. Often interrupts or intrudes on others (e.g., butts into conversations or games).
2. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
3. Some impairment from the symptoms is present in two or more settings (e.g., at school, and at home).
4. There must be clear evidence of clinically significant impairment in social, academic or occupational functioning.
5. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

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