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What "Spectrum" Means to Me: Pattern is Important



The term spectrum may mean different things to different people. To me, it makes sense to think of spectrum as pattern. Understanding the pattern within the diagnostic criteria for each diagnosed individual is IMPORTANT. It's this pattern that should drive the recommendations.


The chart above highlights the seven diagnostic criteria that should be assessed during an autism evaluation. The first three criteria have to do with social communication and relationships. Each of these criteria must be met. In this graph, you can see that the orange individual and the blue individual both show elevated struggle within each required area.


The second group of four criteria describe restricted, repetitive patterns of behavior: things like stereotyped movements, verbalizations, use of objects; ritualistic behaviors, difficulty with change, problems with abstract thinking; intense interests, attachment to objects; and sensory processing symptoms. Only TWO of these four criterion groups must be met to qualify for a diagnosis.


In the chart above, we can see that the two individuals vary in their expression of those four criteria. Therefore, there day-to-day strengths and struggles with be different.


In addition to a pattern ACROSS the criteria, there will also be a pattern within each criterion.


For example, one individual may struggle in the nonverbal criterion with comprehension of facial expressions, voice, and body language, but show adequate range of emotion in his own face. He may show fairly adequate eye contact, but struggle to allow appropriate personal space and speed/volume of his voice. The second individual may show restricted range of emotion in her own face, poor eye contact, an extreme need for personal space, and very soft and slow volume of voice with restricted emotional tone.


Both individuals would meet the nonverbal criterion for autism, but in unique ways. Their nonverbal communication patterns will look different in daily interaction.


The most effective way to impact each individual during the diagnostic process is to identify, not only the correct diagnosis, but also the individualized pattern of characteristics with individualized recommendations.


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