“Waiting for a Diagnosis: What the DSM-5-TR Really Means”

 

“Waiting for a Diagnosis: What the DSM-5-TR Really Means”

Waiting for an Autism Diagnosis: What the DSM-5-TR Criteria Actually Mean for You 

If you're on a waiting list for an autism assessment, or supporting someone who is, it can feel like you're in limbo. You may already see the signs, feel the daily challenges, or sense you don’t fit into the “typical” box… but without a diagnosis, it’s hard to get support. That’s why it helps to understand what clinicians are actually looking for when they assess autism, and how the criteria in the DSM-5-TR apply to real life. 

What Is the DSM-5-TR? 

The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders – Text Revision) is the guide clinicians use to assess and diagnose mental health conditions, including Autism Spectrum Disorder (ASD). In 2022, it clarified the criteria for autism, not by changing them, but by making the expectations clearer. 

 

So what does that mean for people waiting for a diagnosis? 

 

The Two Core Areas of Autism 

To be diagnosed with autism under the DSM-5-TR, a person must meet all criteria in Section A and at least two in Section B, with symptoms starting in early development. Here’s what that looks like in plain English: 

 

A. Social Communication & Interaction, All 3 Must Be Present 

These are not just “shyness” or social awkwardness. The criteria relate to deep differences in how people understand and use communication: 

 

Social-emotional reciprocity: 

You may struggle to keep conversations going, respond appropriately, or share thoughts and emotions in ways people expect. 

Nonverbal communication differences: 

Things like eye contact, gestures, facial expressions, and tone of voice may feel unnatural or confusing — or not come automatically. 

 

Relationships: 

You might find it hard to form or maintain relationships, adjust to different social situations, or even feel the need for social connection in the same way. 

 

B. Restricted or Repetitive Patterns, At Least 2 Must Be Present 

These are behaviours, interests, or sensory experiences that are often misunderstood: 

 

Repetitive actions – such as hand-flapping, repeating phrases, or routines 

 

Rigidity – needing things done a certain way, struggling with change 

 

Deep, narrow interests – hyper-focused on a specific topic or hobby 

 

Sensory differences – hypersensitivity (e.g., to noise or textures) or under-sensitivity (e.g., not noticing pain or temperature) 

 

Why This Matters While You Wait 

Understanding the criteria can be incredibly validating. Many people waiting for an assessment already tick these boxes — they just don’t realise these everyday challenges are part of what’s being assessed. 

 

Here’s what it doesn’t mean: 

 

You’re not “less autistic” because you’ve masked or coped well 

 

You don’t have to display every trait all the time 

 

You’re not required to meet some arbitrary “severity” to matter 

 

And here’s what it does mean: 

 

You’re allowed to self-recognise and seek support while you wait 

 

Understanding the criteria can help you advocate for yourself or your child 

 

It might help explain things you’ve experienced your whole life, even without realising they were linked to autism 

 

Final Thoughts 

A formal diagnosis can open doors to support, accommodations, and services, but understanding yourself is the first step. The DSM-5-TR criteria aren’t just medical checklists; they’re reflections of the real differences in how autistic people think, feel, and interact with the world. 

 

If you’re still waiting, don’t wait to start understanding yourself. Explore the traits, look at your life through a new lens, and know that your experiences are valid, diagnosis or not.