Diagnostic criteria for autism: DSM-5 and ICD-11 explained

The two core areas according to DSM-5

According to an expert overview, the core symptoms under DSM-5 consist of two areas: ^[1]

1. Social communication and interaction (all three features must be met; the criteria describe them as “deficits”):

• difficulties in social-emotional reciprocity, for example a lack of two-way communication or little shared enjoyment in interaction,
• differences in non-verbal communication, for example in gestures, facial expression and eye contact and how they work together,
• difficulties in starting, maintaining and understanding relationships, for example in making friends.

2. Restricted, repetitive patterns of behaviour, interests or activities that interfere with activities or everyday life (at least two of four features):

• stereotyped or repetitive movements, stereotyped use of objects (for example lining up) or of language (for example echolalia),
• inflexible adherence to sameness, to routines or ritualised patterns,
• very limited and fixated interests that are unusual in intensity or content,
• over- or under-reaction to sensory input or unusual interest in stimuli from the environment.

The words “deficits” and “disorder” come from the diagnostic criteria. In its own texts, Autismus Wissen writes “people on the autism spectrum”; in the community there are different language preferences.

Further requirements

The combination of features from both core areas is a necessary requirement. In addition, the reported and observable features must have appeared in early childhood, occur across situations and cause distress or impairment in a clinically significant way. It must be checked whether the features can be better explained by another disorder, because they also occur in many other mental disorders. ^[1] More on this: How an autism assessment works.

Several diagnoses became one spectrum

According to the expert overview, the formerly separate diagnoses “childhood autism”, “Asperger syndrome” and “atypical autism” have now been grouped under the category “autism spectrum disorder”. Over time the diagnostic criteria were revised several times to better reflect the diversity of differences. ^[1] Earlier findings may still carry the old labels. That does not change the fact that the differences exist.

Which classification applies in Germany?

The expert overview names DSM-5 and ICD-11 as the criteria currently in force and places autism there among the “neurodevelopmental disorders”. ^[1] For coding in Germany, the BfArM states: until ICD-11 is introduced in the relevant area of application, ICD-10 remains the valid official classification, and for diagnoses in outpatient and inpatient care it is ICD-10-GM. According to the BfArM, introducing ICD-11 for coding diagnoses will take several more years. ^[2] The label and code in your findings can therefore differ from the terms in this article. In ICD-10-GM (version 2026), the former diagnoses are coded F84.0 (Frühkindlicher Autismus, “childhood autism”), F84.1 (Atypischer Autismus, “atypical autism”) and F84.5 (Asperger-Syndrom, “Asperger’s syndrome”) within the “pervasive developmental disorders” (F84.-). ^[3]

What the criteria do not do

• They are not a self-test. A diagnosis arises from a detailed assessment using several sources of information, not from ticking off a list. ^[1] More: ADOS-2, ADI-R and screening.
• They say nothing about how much support someone needs in everyday life; the findings describe that in the individual case.
• This article states the criteria as given in the expert overview that was read. The DSM-5 manual and ICD-11 themselves were not checked here word for word; the revised text version DSM-5-TR is not taken into account.

Sources and literature

1. Höhne E, Kamp-Becker I (Klinik für KJP, Universitätsklinikum Marburg): Diagnostik der Autismus-Spektrum-Störung. Pädiatrie (Rosenfluh) 2024;(4+5):27–32. https://rosenfluh.ch/media/paediatrie/2024/04-05/Diagnostik-der-Autismus-Spektrum-Stoerung.pdf – Expert overview (in German)
2. Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM): Informationsseiten „ICD-11“ und „ICD“. https://www.bfarm.de/DE/Kodiersysteme/Klassifikationen/ICD/ICD-11/_node.html – Authority website (in German)
3. Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM): ICD-10-GM Version 2026, Kapitel V, Tiefgreifende Entwicklungsstörungen (F84.-) (klassifikationen.bfarm.de/icd-10-gm/kode-suche/htmlgm2026/block-f80-f89.htm). Retrieved 23.10.2026 – Classification (official, in German)