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I tried posting this yesterday, but I don't think people really understood what I was getting at, so I'm going to try and reword it. In the DSM-5 criteria for autism spectrum disorder, it states that: symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. I know the term "clinically significant" is subjective, but there is still one thing I am confused about. Do all the symptoms have to cause clinically significant impairment, or is it the symptoms all together?

For example, if you had person with social/communication impairments that were deemed clinically significant, and they had 2 out of 4 repetitive behaviors (that weren't "clinically significant"), would that be enough for a diagnosis? I'm asking this because I have seen quite a few arguments about this topic in other threads, and nobody seems to agree on a definite answer. I'm just curious: what do you guys think?

All the symptoms combined have to produce a "clinically significant" overall presentation in a person.

But...in the DSM-V, it specifically states that 2 out of the 4 behaviors within the B section must be present. It doesn't have to be severe, though---just present.

There has to be something from Section A, and something from Section C. It doesn't have to be severe.

Yep. That's what it implies.

The overall presentation of the person, ideally, should be "clinically significant" at least some of the time. It doesn't have to be all of the time.

It doesn't have to be severe. It should be obvious, at least when the person is under stress.

I should add a couple of things:

1. The "clinically significant" behaviors should not have started before about the age of 5 or so. If they started after that, it's probably not autism.

2. A person could be diagnosed with an autism spectrum disorder if he/she exhibited symptoms in babyhood/toddlerhood/childhood, but doesn't really exhibit "significant" symptoms in adulthood. This is an acknowledgement that symptoms of an ASD could return when a person is stressed.

It should also be pointed out that when a person has an "Aspergian" presentation, that person frequently does not appear stereotypically "autistic."

Usually, people who exhibit stereotypically autistic symptoms all the time are severely affected, though this is not universal.

"Stereotypical" autistic behaviors include:

1. Spinning things constantly

2. Something called "perseveration," which comes from the word "persevere." This means they become obsessed with things which most people don't become obsessed with----like a part of a hammer, say.

3. Flapping hands---but a certain type, the type where the entire hand moves, rather than just the fingers.

4. A severe aversion to being touched.

5. A severe reaction to being placed in a situation which departs from a situation which gave them evident pleasure

6. The expression of evident pleasure through various types of vocalizations--squeaks.

7. I should also add: a considerable amount of jumping in place. People with "severe" autism just love to jump.

How were you with other kids when you were in nursery school? Did you have trouble playing with other children? Did you isolate yourself? Did the little kids think you were weird?