Clinical resources
Evidence-Based ASD Resources for Clinicians
Diagnostic criteria, validated screening instruments, risk factor guidance, and intervention protocols — curated for practitioners working in Nepal.
DSM-5 & ICD-11
Recognising ASD: Diagnostic Criteria & Clinical Signs
Autism Spectrum Disorder is characterised by persistent deficits in social communication and interaction, alongside restricted, repetitive patterns of behaviour. Both DSM-5-TR and ICD-11 require symptoms to be present in the early developmental period and cause clinically significant functional impairment.
1Social Communication & Interaction (DSM-5 Criterion A)
- Deficits in social-emotional reciprocity — ranging 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 behaviours — ranging from poorly integrated verbal and nonverbal communication, to abnormalities in eye contact and body language, to deficits in understanding and use of gestures, to total lack of facial expressions and nonverbal communication.
- Deficits in developing, maintaining, and understanding relationships — ranging from difficulties adjusting behaviour to suit various social contexts, to difficulties in sharing imaginative play or making friends, to absence of interest in peers.
2Restricted, Repetitive Behaviours (DSM-5 Criterion B)
- Stereotyped or repetitive motor movements, use of objects, or speech (e.g. simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
- Insistence on sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behaviour (e.g. extreme distress at small changes, difficulties with transitions, rigid thinking patterns, 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 responses to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Early Clinical Markers (12–24 months)
| Age | Red Flag |
|---|---|
| 12 months | No babbling, pointing, or other gestures |
| 12 months | No response to name |
| 16 months | No single words |
| 18 months | No pretend play |
| 24 months | No two-word spontaneous phrases (not echolalia) |
| Any age | Loss of previously acquired language or social skills |
ICD-11 Note: ICD-11 (6A02) aligns closely with DSM-5 but uses a dimensional approach, specifying functional impairment levels and whether intellectual or language impairment is present. Both systems require symptoms to manifest in the early developmental period, though they may not fully manifest until social demands exceed limited capacities.
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