S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9903
 
                           I N  A S S E M B L Y
 
                              April 26, 2024
                                ___________
 
 Introduced  by  M.  of  A. SANTABARBARA -- read once and referred to the
   Committee on People with Disabilities
 
 AN ACT to amend the mental hygiene law, in relation to the definition of
   autism
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 1.03 of the mental hygiene law is amended by adding
 a new subdivision 60 to read as follows:
   60.  "AUTISM"  MEANS A PERVASIVE DEVELOPMENTAL DISORDER THAT MEETS ANY
 OF THE FOLLOWING CRITERIA:
   (A) AUTISTIC DISORDER, WHICH IS:
   (I) THE DIAGNOSES OF AT LEAST SIX OF THE FOLLOWING SYMPTOMS,  WITH  AT
 LEAST  TWO  SYMPTOMS  COMING  FROM  CLAUSE ONE OF THIS SUBPARAGRAPH, ONE
 SYMPTOM COMING FROM CLAUSE TWO OF THIS  SUBPARAGRAPH,  AND  ONE  SYMPTOM
 COMING FROM CLAUSE THREE OF THIS SUBPARAGRAPH.
   (1)  QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION, AS MANIFESTED BY AT
 LEAST TWO OF THE FOLLOWING:
   (A) MARKED IMPAIRMENT IN THE USE OF MULTIPLE, NONVERBAL BEHAVIORS SUCH
 AS EYE-TO-EYE GAZE, FACIAL EXPRESSION, BODY POSTURES, AND  GESTURES,  TO
 REGULATE SOCIAL INTERACTION.
   (B) FAILURE TO DEVELOP PEER RELATIONSHIPS APPROPRIATE TO DEVELOPMENTAL
 LEVEL.
   (C)  A  LACK  OF SPONTANEOUS SEEKING TO SHARE ENJOYMENT, INTERESTS, OR
 ACHIEVEMENTS WITH OTHER PEOPLE (E.G., BY A LACK OF SHOWING, BRINGING, OR
 POINTING OUT OBJECTS OF INTEREST).
   (D) LACK OF SOCIAL OR EMOTIONAL RECIPROCITY.
   (2) QUALITATIVE IMPAIRMENTS IN COMMUNICATION AS MANIFESTED BY AT LEAST
 ONE OF THE FOLLOWING:
   (A) DELAY IN, OR TOTAL LACK OF, THE  DEVELOPMENT  OF  SPOKEN  LANGUAGE
 (NOT  ACCOMPANIED  BY AN ATTEMPT TO COMPENSATE THROUGH ALTERNATIVE MODES
 OF COMMUNICATION SUCH AS GESTURE OR MIME).
   (B) IN INDIVIDUALS WITH ADEQUATE  SPEECH,  MARKED  IMPAIRMENT  IN  THE
 ABILITY TO INITIATE OR SUSTAIN A CONVERSATION WITH OTHERS.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD15103-01-4
              

 A. 9903                             2
 
   (C)  STEREOTYPED  AND  REPETITIVE  USE  OF  LANGUAGE  OR IDIOSYNCRATIC
 LANGUAGE.
   (D)  LACK OF VARIED, SPONTANEOUS MAKE-BELIEVE PLAY OR SOCIAL IMITATIVE
 PLAY APPROPRIATE TO DEVELOPMENTAL LEVEL.
   (3) RESTRICTED REPETITIVE AND STEREOTYPED PATTERNS OF BEHAVIOR, INTER-
 ESTS, AND ACTIVITIES, AS MANIFESTED BY AT LEAST ONE OF THE FOLLOWING:
   (A) ENCOMPASSING  PREOCCUPATION  WITH  ONE  OR  MORE  STEREOTYPED  AND
 RESTRICTED  PATTERNS OF INTEREST THAT IS ABNORMAL EITHER IN INTENSITY OR
 FOCUS.
   (B)  APPARENTLY  INFLEXIBLE  ADHERENCE  TO   SPECIFIC,   NONFUNCTIONAL
 ROUTINES OR RITUALS.
   (C)  STEREOTYPED  AND  REPETITIVE  MOTOR MANNERS (E.G., HAND OR FINGER
 FLAPPING OR TWISTING, OR COMPLEX WHOLE-BODY MOVEMENTS).
   (D) PERSISTENT PREOCCUPATION WITH PARTS OF OBJECTS.
   (II) DELAYS OR ABNORMAL FUNCTIONING IN AT LEAST ONE OF  THE  FOLLOWING
 AREAS, WITH ONSET PRIOR TO THREE YEARS OF AGE:
   (1) SOCIAL INTERACTION,
   (2) LANGUAGE AS USED IN SOCIAL COMMUNICATION, OR
   (3) SYMBOLIC OR IMAGINATIVE PLAY.
   (III)  THE  DISTURBANCE IS NOT BETTER ACCOUNTED FOR BY RETT'S DISORDER
 OR CHILDHOOD DISINTEGRATIVE DISORDER.
   (B) ASPERGER'S DISORDER, WHICH IS:
   (I) QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION, AS MANIFESTED BY  AT
 LEAST TWO OF THE FOLLOWING:
   (1)  MARKED IMPAIRMENT IN THE USE OF MULTIPLE NONVERBAL BEHAVIORS SUCH
 AS EYE-TO-EYE GAZE, FACIAL EXPRESSION, BODY POSTURES,  AND  GESTURES  TO
 REGULATE SOCIAL INTERACTION.
   (2) FAILURE TO DEVELOP PEER RELATIONSHIPS APPROPRIATE TO DEVELOPMENTAL
 LEVEL.
   (3)  A  LACK  OF SPONTANEOUS SEEKING TO SHARE ENJOYMENT, INTERESTS, OR
 ACHIEVEMENTS WITH OTHER PEOPLE (E.G., BY A LACK OF SHOWING, BRINGING, OR
 POINTING OUT OBJECTS OF INTEREST TO OTHER PEOPLE).
   (4) LACK OF SOCIAL OR EMOTIONAL RECIPROCITY.
   (II) RESTRICTED  REPETITIVE  AND  STEREOTYPED  PATTERNS  OF  BEHAVIOR,
 INTERESTS  AND  ACTIVITIES, AS MANIFESTED BY AT LEAST ONE OF THE FOLLOW-
 ING:
   (1) ENCOMPASSING  PREOCCUPATION  WITH  ONE  OR  MORE  STEREOTYPED  AND
 RESTRICTED  PATTERNS OF INTEREST THAT IS ABNORMAL EITHER IN INTENSITY OR
 FOCUS.
   (2)  APPARENTLY  INFLEXIBLE  ADHERENCE  TO   SPECIFIC,   NONFUNCTIONAL
 ROUTINES OR RITUALS.
   (3)  STEREOTYPED AND REPETITIVE MOTOR MANNERISMS (E.G., HAND OR FINGER
 FLAPPING OR TWISTING, OR COMPLEX WHOLE-BODY MOVEMENTS).
   (4) PERSISTENT PREOCCUPATION WITH PARTS OF OBJECTS.
   (III) THE DISTURBANCE  CAUSES  CLINICALLY  SIGNIFICANT  IMPAIRMENT  IN
 SOCIAL, OCCUPATIONAL, OR OTHER IMPORTANT AREAS OF FUNCTIONING.
   (IV)  THERE  IS  NO  CLINICALLY  SIGNIFICANT GENERAL DELAY IN LANGUAGE
 (E.G., SINGLE WORDS USED BY AGE TWO, COMMUNICATIVE PHRASES USED  BY  AGE
 THREE).
   (V)  THERE IS NO CLINICALLY SIGNIFICANT DELAY IN COGNITIVE DEVELOPMENT
 OR IN THE DEVELOPMENT  OF  AGE-APPROPRIATE  SELF-HELP  SKILLS,  ADAPTIVE
 BEHAVIOR  (OTHER  THAN  IN  SOCIAL INTERACTION), AND CURIOSITY ABOUT THE
 ENVIRONMENT IN CHILDHOOD.
   (VI) CRITERIA ARE NOT MET FOR ANOTHER SPECIFIC PERVASIVE DEVELOPMENTAL
 DISORDER OR SCHIZOPHRENIA.
 A. 9903                             3
 
   (C) PERVASIVE DEVELOPMENTAL DISORDER NOT OTHERWISE SPECIFIED  (INCLUD-
 ING  ATYPICAL  AUTISM),  WHICH  IS  WHEN THERE IS A SEVERE AND PERVASIVE
 IMPAIRMENT IN THE DEVELOPMENT OF RECIPROCAL SOCIAL  INTERACTION  ASSOCI-
 ATED  WITH IMPAIRMENT IN EITHER VERBAL OR NONVERBAL COMMUNICATION SKILLS
 OR WITH THE PRESENCE OF STEREOTYPED BEHAVIOR, INTERESTS, AND ACTIVITIES,
 BUT  THE  CRITERIA  ARE  NOT  MET FOR A SPECIFIC PERVASIVE DEVELOPMENTAL
 DISORDER, SCHIZOPHRENIA, SCHIZOTYPAL PERSONALITY DISORDER,  OR  AVOIDANT
 PERSONALITY  DISORDER.  FOR  EXAMPLE,  THIS  CATEGORY INCLUDES "ATYPICAL
 AUTISM" - PRESENTATIONS THAT DO  NOT  MEET  THE  CRITERIA  FOR  AUTISTIC
 DISORDER  BECAUSE  OF  LATE  AGE  AT  ONSET, ATYPICAL SYMPTOMATOLOGY, OR
 SUBTHRESHOLD SYMPTOMATOLOGY, OR ALL OF THESE.
   (D) RETT'S DISORDER, WHICH IS:
   (I) THE DIAGNOSIS OF ALL OF THE FOLLOWING:
   (1) APPARENTLY NORMAL PRENATAL AND PERINATAL DEVELOPMENT.
   (2) APPARENTLY NORMAL PSYCHOMOTOR DEVELOPMENT THROUGH THE  FIRST  FIVE
 MONTHS AFTER BIRTH.
   (3) NORMAL HEAD CIRCUMFERENCE AT BIRTH.
   (II) ONSET OF ALL OF THE FOLLOWING AFTER THE PERIOD OF NORMAL DEVELOP-
 MENT:
   (1)  DECELERATION  OF  HEAD GROWTH BETWEEN AGES FIVE MONTHS AND FORTY-
 EIGHT MONTHS.
   (2) LOSS OF PREVIOUSLY ACQUIRED PURPOSEFUL HAND  SKILLS  BETWEEN  AGES
 FIVE  MONTHS AND THIRTY MONTHS WITH THE SUBSEQUENT DEVELOPMENT OF STERE-
 OTYPED HAND MOVEMENTS (E.G., HAND-WRINGING OR HAND WASHING).
   (3) LOSS OF SOCIAL ENGAGEMENT EARLY  IN  THE  COURSE  (ALTHOUGH  OFTEN
 SOCIAL INTERACTION DEVELOPS LATER).
   (4) APPEARANCE OF POORLY COORDINATED GAIT OR TRUNK MOVEMENTS.
   (5)  SEVERELY  IMPAIRED  EXPRESSIVE AND RECEPTIVE LANGUAGE DEVELOPMENT
 WITH SEVERE PSYCHOMOTOR RETARDATION.
   (E) CHILDHOOD DISINTEGRATIVE DISORDER, WHICH IS:
   (I) APPARENTLY NORMAL DEVELOPMENT FOR AT LEAST  THE  FIRST  TWO  YEARS
 AFTER  BIRTH AS MANIFESTED BY THE PRESENCE OF AGE-APPROPRIATE VERBAL AND
 NONVERBAL COMMUNICATION, SOCIAL RELATIONSHIPS, PLAY, AND ADAPTIVE BEHAV-
 IOR.
   (II) CLINICALLY SIGNIFICANT LOSS OF PREVIOUSLY ACQUIRED SKILLS (BEFORE
 AGE TEN YEARS) IN AT LEAST TWO OF THE FOLLOWING AREAS:
   (1) EXPRESSIVE OR RECEPTIVE LANGUAGE.
   (2) SOCIAL SKILLS OR ADAPTIVE BEHAVIOR.
   (3) BOWEL OR BLADDER CONTROL.
   (4) PLAY.
   (5) MOTOR SKILLS.
   (III) ABNORMALITIES OF FUNCTIONING IN AT LEAST TWO  OF  THE  FOLLOWING
 AREAS:
   (1)  QUALITATIVE IMPAIRMENT IN SOCIAL INTERACTION (E.G., IMPAIRMENT IN
 NONVERBAL BEHAVIORS, FAILURE TO  DEVELOP  PEER  RELATIONSHIPS,  LACK  OF
 SOCIAL OR EMOTIONAL RECIPROCITY).
   (2)  QUALITATIVE  IMPAIRMENTS IN COMMUNICATION (E.G., DELAY OR LACK OF
 SPOKEN LANGUAGE, INABILITY TO INITIATE OR SUSTAIN A CONVERSATION, STERE-
 OTYPED AND REPETITIVE USE  OF  LANGUAGE,  LACK  OF  VARIED  MAKE-BELIEVE
 PLAY).
   (3)  RESTRICTED,  REPETITIVE,  AND  STEREOTYPED  PATTERNS OF BEHAVIOR,
 INTEREST, AND ACTIVITIES, INCLUDING MOTOR STEREOTYPES AND MANNERISMS.
   (IV) THE DISTURBANCE IS NOT BETTER ACCOUNTED FOR BY  ANOTHER  SPECIFIC
 PERVASIVE DEVELOPMENTAL DISORDER OR BY SCHIZOPHRENIA.
   § 2. This act shall take effect September 1, 2025.