Social Communication Criteria Persistent deficits in

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Social Communication Criteria Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all three of the following, currently or by history: Deficits in social-emotional reciprocity Behavior Child examples Adult examples Abnormal social approach Standing next to a peer, without Beginning a conversation looking directly at them in order without making sure they have to start a conversation. the attention of the person they wish to speak with; talking without an introduction or making eye contact. Failure of normal back-and-forth Failing to imitate or repeat Answering a question if directly conversation words spoken by an adult. spoken to, but then not continuing the conversation by asking the person a question, or providing a follow up statement. Reduced sharing of interests, Not introducing new ideas into Not asking a person about how emotion, affect play. they feel, or what they like. Failure to initiate or respond to Not independently going up to Difficulty striking up a social interaction an adult and show them a toy or conversation independently with try to get their attention. a stranger, or shying away from talking with people. Deficits in nonverbal communicative behaviors used for social interaction Behavior Child Examples Adult Examples Poorly integrated verbal and Having difficulty coordinating Shaking their head up and down nonverbal communication gestures with verbal language, to indicate “yes” to someone, so they might not use phrases while looking down at the floor like “look over there” while instead of at the person’s face. pointing. Abnormalities in eye contact Speaking while looking at Difficulty standing still in a and body language objects and not while looking at social situation while talking to a person’s face. others. Deficits in understanding and Failing to follow an adult’s gaze Not knowing how to react when use of gestures when hearing “look at that”. another person’s facial expression indicates concern, disgust or fear. Lack of facial expressions and Failing to use gestures, such as Difficulty coordinating the nonverbal communication pointing or waving, when emotion of what to say with the interacting with others. appropriate facial expression. Deficits in developing, maintaining and understanding relationships Behavior Child Examples Adult Examples Difficulties adjusting behavior Difficulty adjusting their speech Difficulty using more formal to suit various social contexts to fit the listener; so they may language with a boss, and less use the same language when formal language with a peer. speaking to a 5-year-old as when speaking to a toddler. Difficulties in sharing Challenges in creating pretend Finding it challenging to make imaginative play or in making scenarios in play that are new and keep friends that share friends and flexible. similar recreational interests without help from others.

Absence of interest in peers

Difficulty in making friends with typically-developing peers of the same age.

Adapted from DSM-5 (American Psychiatric Association, 2013)

May not be particularly interested in seeking out others with whom to share social interests.