# Autistic Spectrum Psychometrics
## Criteria of Autism or Autistic Spectrum disorders
### DSM-III (1980)
#### Infantile Autism

* Onset before 29 months of age
* Pervasive lack of responsiveness to other people (autism)
* Gross deficits in language development
* If speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, pronominal reversal.
* Bizarre responses to various aspects of the environment, e.g., resistance to change, peculiar interest in or attachments to animate or inanimate objects.
* Absence of delusions, hallucinations, loosening of associations, and incoherence as in Schizophrenia.

### DSM-III-R (1987)
#### Autistic Disorder

At least eight of the following sixteen items are present, these to include at least two items from A, one from B, and one from C.
* Qualitative impairment in reciprocal social interaction (the examples within parentheses are arranged so that those first listed are more likely to apply to younger or more disabled, and the later ones, to older or less disabled) as manifested by the following:
** Marked lack of awareness of the existence or feelings of others (for example, treats a person as if that person were a piece of furniture; does not notice another person's distress; apparently has no concept of the need of others for privacy);
** No or abnormal seeking of comfort at times of distress (for example, does not come for comfort even when ill, hurt, or tired; seeks comfort in a stereotyped way, for example, says "cheese, cheese, cheese" whenever hurt);
** No or impaired imitation (for example, does not wave bye-bye; does not copy parent's domestic activities; mechanical imitation of others' actions out of context);
** No or abnormal social play (for example, does not actively participate in simple games; refers solitary play activities; involves other children in play only as mechanical aids); and
** Gross impairment in ability to make peer friendships (for example, no interest in making peer friendships despite interest in making fiends, demonstrates lack of understanding of conventions of social interaction, for example, reads phone book to uninterested peer.
* Qualitative impairment in verbal and nonverbal communication and in imaginative activity, (the numbered items are arranged so that those first listed are more likely to apply to younger or more disabled, and the later ones, to older or less disabled) as manifested by the following:
** No mode of communication, such as: communicative babbling, facial expression, gesture, mime, or spoken language;
** Markedly abnormal nonverbal communication, as in the use of eye-to-eye gaze, facial expression, body posture, or gestures to initiate or modulate social interaction (for example, does not anticipate being held, stiffens when held, does not look at the person or smile when making a social approach, does not greet parents or visitors, has a fixed stare in social situations);
** Absence of imaginative activity, such as play-acting of adult roles, fantasy character or animals; lack of interest in stories about imaginary events;
** Marked abnormalities in the production of speech, including volume, pitch, stress, rate, rhythm, and intonation (for example, monotonous tone, question-like melody, or high pitch);
** Marked abnormalities in the form or content of speech, including stereotyped and repetitive use of speech (for example, immediate echolalia or mechanical repetition of a television commercial); use of "you" when "I" is meant (for example, using "You want cookie?" to mean "I want a cookie"); idiosyncratic use of words or phrases (for example, "Go on green riding" to mean "I want to go on the swing"); or frequent irrelevant remarks (for example, starts talking about train schedules during a conversation about ports); and
** Marked impairment in the ability to initiate or sustain a conversation with others, despite adequate speech (for example, indulging in lengthy monologues on one subject regardless of interjections from others);
* Markedly restricted repertoire of activities and interests as manifested by the following:
** Stereotyped body movements (for example, hand flicking or twisting, spinning, head-banging, complex whole-body movements);
** Persistent preoccupation with parts of objects (for example, sniffing or smelling objects, repetitive feeling of texture of materials, spinning wheels of toy cars) or attachment to unusual objects (for example, insists on carrying around a piece of string);
* Marked distress over changes in trivial aspects of environment (for example, when a vase is moved from usual position);
** Unreasonable insistence on following routines in precise detail (for example, insisting that exactly the same route always be followed when shopping);
** Markedly restricted range of interests and a preoccupation with one narrow interest, e.g., interested only in lining up objects, in amassing facts about meteorology, or in pretending to be a fantasy character.
* Onset during infancy or early childhood

### Gillberg's criteria for Asperger syndrome (1989)

* Severe impairment in reciprocal social interaction (at least two of the following)
** inability to interact with peers
** lack of desire to interact with peers
** lack of appreciation of social cues
** socially and emotionally inappropriate behavior
* All-absorbing narrow interest (at least one of the following)
** exclusion of other activities
** repetitive adherence
** more rote than meaning
* Imposition of routines and interests (at least one of the following)
** on self, in aspects of life
** on others
* Speech and language problems (at least three of the following)
** delayed development
** superficially perfect expressive language
** formal, pedantic language
** odd prosody, peculiar voice characteristics
** impairment of comprehension including misinterpretations of literal/implied meanings
* Non-verbal communication problems (at least one of the following)
** limited use of gestures
** clumsy/gauche body language
** limited facial expression
** inappropriate expression
** peculiar, stiff gaze
* Motor clumsiness: poor performance on neurodevelopmental examination

### DSM-IV (1994)
#### Autistic Disorder

A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):
* Qualitative impairment in social interaction, as manifested by at least two of the following:
** 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.
** failure to develop peer relationships appropriate to developmental level
** 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)
** lack of social or emotional reciprocity
* Qualitative impairments in communication as manifested by at least one of the following:
** 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)
** in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
** stereotyped and repetitive use of language or idiosyncratic language
** lack of varied spontaneous make-believe play or social imitative play appropriate to developmental level
* Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:
** encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
** apparently inflexible adherence to specific, nonfunctional routines or rituals
** stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
** persistent preoccupation with parts of objects
** Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
* The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.

#### Asperger's

* Qualitative impairment in social interaction, as manifested by at least two of the following:
** marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
** failure to develop peer relationships appropriate to developmental level
** a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
** lack of social or emotional reciprocity
* Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
** encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
** apparently inflexible adherence to specific, nonfunctional routines or rituals
** stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
** persistent preoccupation with parts of objects
* The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.
* 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)
* There is no clinically significant 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.
* Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."

### Asperger criteria by Szatmari, Bremner and Nagy (1998)

* Social isolation (at least two of the following):
** no close friends
** avoids others
** no interest in making friends
** a loner
* Impaired social interaction (at least one of the following):
** approaches others only to have own needs met
** clumsy social approach
** one-sided responses to peers
** difficulty sensing feelings of others
** indifference to the feelings of others
* Impaired non-verbal communication (at least one of the following):
** limited facial expressions
** impossible to read emotions through facial expression of the child
** inability to convey message with eyes
** avoids looking at others
** does not use hands to aid expression
** large and clumsy gestures
** infringes on other people’s physical space
* Speech and language peculiarities (at least two of the following):
** abnormalities of inflection
** over-talkative
** non-communicative
** lack of cohesion to conversation
** idiosyncratic use of words ( uses words in a different way then what they would normally mean)
** repetitive patters of speech

### DSM-IV-TR (2000)
#### Autistic Disorder

A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):
* Qualitative impairment in social interaction, as manifested by at least two of the following:
** 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.
** failure to develop peer relationships appropriate to developmental level
** 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)
** lack of social or emotional reciprocity
* Qualitative impairments in communication as manifested by at least one of the following:
** 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)
** in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
** stereotyped and repetitive use of language or idiosyncratic language
** lack of varied spontaneous make-believe play or social imitative play appropriate to developmental level
* Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:
** encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
** apparently inflexible adherence to specific, nonfunctional routines or rituals
** stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
** persistent preoccupation with parts of objects
** Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
* The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.

#### Aspergers

* Qualitative impairment in social interaction, as manifested by at least two of the following:
** 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
** failure to develop peer relationships appropriate to developmental level
** 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)
** lack of social or emotional reciprocity
* Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
** encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity of focus
** apparently inflexible adherence to specific, nonfunctional routines or rituals
** stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
** persistent preoccupation with parts of objects
* The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
* 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).
* There is no clinically significant 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.
* Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
* PDD-NOS

### ICD-10 (1992)

* Qualitative impairment in reciprocal social interaction, three from the following five areas:
** failure to use eye gaze, body posture, facial expression and gesture to regulate interaction adequately;
** a failure to develop (in a manner appropriate to mental age, and despite ample opportunity) peer relationships that involve a mutual sharing of interests, activities and emotions;
** rarely seeking and using other people for comfort and affection at times of stress or distress and/or offering comfort and affection to others when they are showing distress or unhappiness;
** a lack of shared enjoyment in terms of vicarious pleasures in other people’s happiness and/or a spontaneous seeking to share their own enjoyment through joint involvement with others;
** a lack of socio-emotional reciprocity, as shown by an impaired or deviant response to communicative behaviours;
* Qualitative impairments in communication, two from the following five areas
** a delay in, or total lack of, spoken language that is not accompanied by an attempt to compensate through the use of gesture or mime as alternative modes of communication;
** a relative failure to initiate or sustain conversational interchange (at whatever level of language skills is present) in which there is a reciprocal to and fro responsiveness to the communication of the other person;
** stereotyped and repetitive use of language and/or idiosyncratic use of words or phrases;
** abnormalities of pitch, stress, rate. rhythm and intonation of speech;
** a lack of varied spontaneous make-believe play, or when young, social imitative play.
* Restricted repetitive and stereotyped patterns of behaviour, interests and activities, two from the following six areas
** an encompassing preoccupation with stereotyped and restricted patterns of interest;
** specific attachments to unusual objects;
** apparently compulsive adherence to specific, non-functional routines and rituals;
** stereotyped and repetitive motor mannerisms that involve either hand/finger flapping or twisting or complex whole body movements;
** preoccupation with part-objects or non-functional elements of play materials (such as odour, the feel of their surface, or the noise/vibration that they generate);
** distress over changes in small, non-functional details of their environment.
* Developmental abnormalities must be present in the first three years for the diagnosis to be made
* Clinical picture is not attributable to other varieties of pervasive developmental disorder, specific developmental disorders of receptive language with secondary socio-emotional problems; reactive attachment disorder or disinhibited attachment disorder, mental retardation with some associated emotional/ behavioural disorder, schizophrenia of unusually early onset; and Rett syndrome.

### DSM-V (2013)
#### Autism Spectrum Disorder

* Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
** 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 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, currently or by history (examples are illustrative, not exhaustive; see text):
** 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 pattern, 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 hyporeactivity 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).
* Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
* Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
* These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

## Psychometrics
### Autism-Spectrum Quotient or 'AQ' (2001)

* - I prefer to do things with others rather than on my own.
* I prefer to do things the same way over and over again.
* - If I try to imagine something, I find it very easy to create a picture in my mind.
* I frequently get so strongly absorbed in one thing that I lose sight of other things.
* I often notice small sounds when others do not.
* I usually notice car number plates or similar strings of information.
* Other people frequently tell me that what I've said is impolite, even though I think it is polite.
* - When I'm reading a story, I can easily imagine what the characters might look like.
* I am fascinated by dates.
* -In a social group, I can easily keep track of several different people's conversations.
* - I find social situations easy.
* I tend to notice details that others do not.
* I would rather go to a library than to a party.
* - I find making up stories easy.
* -I find myself drawn more strongly to people than to things.
* I tend to have very strong interests, which I get upset about if I can't pursue.
* -I enjoy social chitchat.
* When I talk, it isn't always easy for others to get a word in edgewise.
* I am fascinated by numbers.
* When I'm reading a story, I find it difficult to work out the characters' intentions.
* I don't particularly enjoy reading fiction.
* I find it hard to make new friends.
* I notice patterns in things all the time.
* -I would rather go to the theater than to a museum.
* -It does not upset me if my daily routine is disturbed.
* I frequently find that I don't know how to keep a conversation going.
* -I find it easy to 'read between the lines' when someone is talking to me.
* -I usually concentrate more on the whole picture, rather than on the small details.
* -I am not very good at remembering phone numbers.
* -I don't usually notice small changes in a situation or a person's appearance.
* -I know how to tell if someone listening to me is getting bored.
* -I find it easy to do more than one thing at once.
* When I talk on the phone, I'm not sure when it's my turn to speak.
* -I enjoy doing things spontaneously.
* I am often the last to understand the point of a joke.
* -I find it easy to work out what someone is thinking or feeling just by looking at their face.
* -If there is an interruption, I can switch back to what I was doing very quickly.
* I am good at social chitchat.
* People often tell me that I keep going on and on about the same thing.
* -When I was young, I used to enjoy playing games involving pretending with other children.
* I like to collect information about categories of things (e.g., types of cars, birds, trains, plants).
* I find it difficult to imagine what it would be like to be someone else.
* I like to carefully plan any activities I participate in.
* -I enjoy social occasions.
* I find it difficult to work out people's intentions.
* New situations make me anxious.
* -I enjoy meeting new people.
* I am a good diplomat.
* -I am not very good at remembering people's date of birth.
* -I find it very easy to play games with children that involve pretending.

### Novel items
#### Motor
##### Fine-motor, Knot-tying

* Shoe tying
* Knot Tying
* Velcro shoes or Sandals
* Tying a necktie

##### Fine-motor, Handwriting

* Penmanship?
* Typing or handwriting?

##### Gross Motor

* Sports? Athletics?
* Hopskotch / Jump Rope?
* Skipping?

## Aspie Zero

* Autistic Spectrum Psychometrics/Aspie Zero

## Sources

* http://www.unstrange.com/dsm1.html