Red flags for autism:

• Use of another persons's body as a tool is almost pathognomonic for autism (e.g. child using parent's hand as a tool to achieve a task)
• Seems to be in his/her “own world”
• Doesn't respond to own name when called
• Doesn’t respond to parent’s attempts to play, even if relaxed
• Avoids or ignores other children when they approach or interact
• No words by 16 months or no two-word phrases by 24 months
• Any loss of previously acquired language or social skills
• Doesn’t point to show others things he/she is interested in
• Inconsistent or reduced use of eye contact with people outside the family
• Rarely smiles when looking at others or does not exchange back and forth warm, joyful expressions
• Does not spontaneously use gestures such as waving, reaching or pointing with others
• Does not respond to gestures and facial expressions used by others
• More interested in looking at objects than at people’s faces
• May be content to spend extended periods of time alone
• Doesn’t make attempts to get parent’s attention
• Doesn’t follow/look when someone is pointing at something
• Doesn’t bring a toy or other item to parent to show them

Criterion A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history:

1. Deficits in social-emotional reciprocity (e.g. abnormal social approach and failure of normal back-and-forth conversation; reduced sharing of interests, emotions, or affect; failure to initiate or respond to social interactions)
2. Deficits in nonverbal communicative behaviours used for social interaction (e.g. poorly integrated verbal and nonverbal communication; abnormalities in eye contact and body language or deficits in understanding and use of gestures; total lack of facial expressions and nonverbal communication)
3. Deficits in developing, maintaining, and understanding relationships (e.g. difficulties adjusting behaviour to suit various social contexts; difficulties in sharing imaginative play or in making friends; absence of interest in peers)

Criterion B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following, currently or by history:

1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g. simple motor stereotypes like hand flapping or finger flicking, lining up toys or flipping objects, echolalia, idiosyncratic phrases)
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviour (e.g. extreme distress at small changes, difficulties with transitions, rigid thinking patterns, insistence on rules, greeting rituals, need to take same route or eat same food every day)
3. 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)
4. 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)

Criterion 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).

Criterion D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

Criterion E. 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 co-morbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Specifiers:

• With or without accompanying intellectual impairment
• With or without accompanying language impairment
• Associated with a known medical or genetic condition or environmental factor
• Associated with another neurodevelopmental, mental, or behavioral disorder
• With catatonia
• Severity specifier: