The question if diagnostic criteria for Autism Spectrum Disorder should change a little to be more accurate

[Oz67]

I wonder if there should be a much more clear childhood history to determine if a person has Autism Spectrum Disorder, I am not saying that Autism Spectrum Disorder cannot be diagnosed later in life, rather that there should be clear childhood history.

The problem with diagnostic criteria C for Autism Spectrum Disorder in DSM-5-TR:

C. 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).

That is a problem because if we look at it chronologically by age, it can manifest at different ages

For example:

1) What is normal to do in early childhood may be abnormal to do in late childhood

2) What is normal to do in late childhood might be abnormal to do in early adolescence

3) What is normal to do in early adolescence might be abnormal to do in late adolescents

4) What is normal to do in late adolescents might be abnormal to do in young adulthood

5) What is normal to do in young adulthood might be abnormal to do in adulthood, chronologically.

If Autism Spectrum Disorder doesn't fully manifest until social rules become more complex or by making learned strategies later in life, it might be harder to document childhood history.

 

[Shamar]

While I was diagnosed at age 60, I can state specifically and distinctly that in early childhood (age 3), I was non social, I could not figure out people (neither peers nor adults), I had no friends, and I preferred to be by myself. My behavior remained the same through late childhood, early adolescence, late adolescence, young adulthood, through to today. I am still wondering why nobody noticed in childhood. I can't document it (everyone who would know is deceased), but that is what I clearly remember.

"C. 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)." In other words, symptoms may be present, or may not be present, but one or the other must apply. This was conceived by experts in the field.

 

[scleod]

That is an interesting topic.

Many of the markers for autism are "hard wired" in us at a young age. As a child they present in our so call "play". Lining up toys, not responding to others, repetetive behaviors, swaying stimming, echolalia (advanced verbal) etc.

As someone who slipped through the cracks of society. I did not benefit from help till years later when I was diagnosed at 30. Due to the misconception that autism was "wrong" or something needed to be "corrected". I was forced to develope a mask VERY young. It was more finely tuned mask to "protect" myself. Allowing me to "fool" the assessor to believe I was not on the spectrum, simply by being a "master" masker. This assessment would have been in grade one. By this time I had already formed a mask that completely transformed who I was on the outside.

I believe the tolerance that has grown in the last X amount of years has been a huge factor. But the assessment itself was very well put together. When I was recently tested my mother had to answer assessment questions based on the childhood assessment, since I have no recorded information from my childhood.

A huge factor is the psychologist you have. Their knowledge, openness and unbiased views on the situation at hand.