Clinically Significant?

Post Reply New Topic

I know that part of the DSM-5 criteria for autism specifies that the impairments cause clinically significant impairment in one or more areas of current functioning. But I'm curious- does each symptom have to cause clinically significant impairment, or is it all the symptoms combined? If it is all the symptoms combined, then what counts as stimming? If stimming doesn't have to interfere with education or other areas of functioning, then wouldn't a lot of people (including people without autism) fit this part in the criteria? I have seen some threads on this topic already, but I haven't found a clear answer to my question. I'm just curious; it's not really a big deal to me. I'm just wondering how professionals can diagnose stimming behavior under the DSM-5 if the person is not constantly needing to stim.

Stimming isn't really a part of the diagnostic criteria, but it could come under repetitive behaviours. I think it's more related to anxiety than ASD directly.

People with anxiety not related to ASD *do* do what you could call stimming, but it would be seen as fidgeting or something instead.

I don't think the DSM-V specifically talks about stimming. "two or more" of things in section B seems to be sufficient. I only included part of section B1 as this is the one I think pertains to stimming:
B. RESTRICTED, REPETITIVE PATTERNS OF BEHAVIOR, INTERESTS, OR ACTIVITIES AS MANIFESTED BY AT LEAST
2 OF 4 SYMPTOMS:

B1 includes preoccupations
with objects or topics

• Stereotyped or repetitive speech
o Pedantic speech or unusually formal language
(child speaks like an adult or “little professor”)   B1 includes atypical speech,
movements, and play
o Echolalia (immediate or delayed); may include
repetition of words, phrases, or more extensive
songs or dialog
o “Jargon” or gibberish (mature jargoning after
developmental age of 24 months)  
o Use of “rote” language  
o Idiosyncratic or metaphorical language (language that has meaning only to those familiar with
the individual’s communication style); neologisms
o Pronoun reversal (for example, “You” for “I”; not just mixing up gender pronouns)
o Refers to self by own name (does not use “I”)
o Perservative language (note: for perseveration on a specific topic, consider B3)
o Repetitive vocalizations such as repetitive
guttural sounds, intonational noise‐making,
unusual squealing, repetitive humming   
• Stereotyped or repetitive motor movements
o Repetitive hand movements (e.g., clapping,
finger flicking, flapping, twisting)  
o Stereotyped or complex whole body movements (e.g., foot to foot rocking, dipping, & swaying;
spinning)  
o Abnormalities of posture (e.g., toe walking; full body posturing)  
o Intense body tensing  
o Unusual facial grimacing  
o Excessive teeth grinding  
o Repetitively puts hands over ears (note: if response to sounds, consider B4)  
o Perseverative or repetitive action / play / behavior (note: if 2 or more components, then it is a
routine and should be considered under B2)
o Repetitive picking (unless clear tactile sensory component, then consider B4)
• Stereotyped or repetitive use of objects
o Nonfunctional play with objects (waving sticks; dropping items)  
o Lines up toys or objects  
o Repetitively opens and closes doors  
o Repetitively turns lights on and off 

I meant, literally, they do not refer to stimming. The don't use the word. Stimming is short for Self-stimulatory (I'm being deliberately obvious, so yes, i know, "duh" ) Even though many things in this section would be called stimming, I don't think the DSM-V is taking the view that it is "self stimulation". Or at least I a see no language to suggest this. They also do not qualify the circumstances under which these things occur (ie, "in response to stress", etc).

From what I read and have personally experienced stimming increases in response to stressors, but it is not limited to a response to stress. I often stim simply because I find comfort in it. Staring at a light is not the kind of stimming I would call a stress response, yet it is still stimming.

I don't stim at all. But dxd as an aspie.

Though I did things that could be called "stims" when I was a child and a teen, that my sister might have reported in her interview about me.

I didn't think I stimmed. Until one day I had an epiphany and realized a lot of things I do that always seemed normal to me that are considered stimming.

A couple of weeks ago I saw someone on this board make a comment about not knowing what you don't know because you don't know what you don't know, when it comes to social cues.

I'm not saying you don't know if you stim or not. But it just made me wonder to myself do I know what I don't know? Do I know what I do?

I keep on having these ahaha moments where I realize things I never gave any thought to that were just part of my life were, when looked at from the outside, autistic