Expert: James Michael Roan - 7/31/2008

Question
QUESTION: In the DSM criteria for autism, one of the social criteria is 'lack of social and emotional reciprocity'. Can you tell me what that means, and give examples?

ANSWER: Hi Ettina;

Social reciprocity refers to the social give-and-take between individuals. Examples: You smile at your child and they smile back. You give affection and receive an affectionate response. For slightly older children it includes chatting back and forth. It is the back and forth social exchange between two people.

I hope this helps.

Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: So, what's the distinction between that and the criteria 'in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others' (apart from how good their speech is)? Does one criteria refer to verbal reciprocity and the other to nonverbal?

Answer
Hi Ettina;

These are rather old criteria and they are working on the DSM-V, but that is years off. Yes, the first criteria refers generally to social behavior, including nonverbal social behavior. Your second citation refers to a situation where there is no significant language impairment. I assume this is because children with language delay "only" very often avoid social interactions with children with adequate language skills because they instinctively assess their social competence to be below those of peers in given group. It's like when I go to a party and I approach a group of men discussing sports. I know nothing about sports and keep moving until I find a group to join that I feel competent enough to contribute to. It can be very difficult to tease these two situations out from one another in very young children, especially in children who have autism AND speech delay.

In my experience, social development is this core deficit in autism spectrum disorders.

Kind regards,
James