Introduction
The most fitting DSM diagnosis for Sam in the case is 299.00 autism spectrum disorder (ASD). According to DSM-5, to fit the diagnostic criteria for ASD, a child must have evident deficits in three major areas of social communication as well as 2 out of the 4 restricted or repetitive behaviors. The child must have deficits in social-emotional reciprocity, often characterized by lacking verbal interaction and reduced sharing of emotions and interests, failure to initiate or respond to social interactions. Furthermore, a child must have deficits in nonverbal communicative behaviors, such as eye contact and body language. Finally, deficits and difficulties in developing, maintaining, or understanding relationships, and adjusting to social contexts (CDC, 2020).
Discussion
Sam demonstrates all of these behaviors, he does not respond to initiated verbal contact, he fails to make eye contact, and he has no close relationships with anyone his age. Furthermore, he demonstrates highly restricted and fixated interest in certain objects or activities, tinkering with his radios. A dirty t-shirt that slightly smells despite the child being taken care of may indicate that it is potentially a favorite shirt, and ASD patients generally have an inflexible insistence on sameness and ritualized patterns.
A differential diagnosis to monitor for would be attention-deficit/hyperactivity disorder (ADHD), which may share some characteristics with ASD but also often serves as a comorbidity (Stavropoulos et al., 2018). The child will ultimately have to be monitored and observed for a clearer indication. So far, there is high confidence in the ASD diagnosis, but the child may meet more of the DSM-5 criteria for ASD, as well as the need to evaluate the severity of the condition based on social communication impairments and restricted patterns of behavior.
Conclusion
There is a specific quick 8-item assessment known as the Autism Mental Status Exam (AMSE) which allows a clinician to measure social, communicative, and behavioral functioning, used in combination with observations. This may be more appropriate for a child than a full-length Mental Status Exam, but the key is to test certain cognitive functions of memory, attention, reaction, language, orientation, and others.
References
CDC. (2020).Autism spectrum disorder (ASD). Web.
Stavropoulos, K.K., Bolourian, Y., & Blacher, J. (2018). Differential diagnosis of autism spectrum disorder and post traumatic stress disorder: Two clinical cases. Journal of Clinical Medicine, 7(4), 71.