Listing 12.10 applies to adults with autism spectrum disorder (ASD)—including what was formerly called autistic disorder, Asperger’s syndrome, and pervasive developmental disorder-NOS—when the core features (deficits in social communication and restricted, repetitive behaviors) create marked or extreme functional limitations or present a serious-and-persistent pattern despite continuous support. Meeting or equaling this listing at Step 3 results in an automatic disability determination.
Regulatory Text
12.10 Autism spectrum disorder, satisfied by A and B, or A and C
- Medical documentation of both:
1. Qualitative deficits in verbal communication, nonverbal communication, and social interaction; and
2. Significantly restricted, repetitive patterns of behavior, interests, or activities.
AND
- Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (12.00 F):
1. Understand, remember, or apply information;
2. Interact with others;
3. Concentrate, persist, or maintain pace;
4. Adapt or manage oneself;
OR
- Serious and persistent disorder (12.00 G2):
• Evidence over a period of ≥ 2 years, and
1. Ongoing medical treatment, mental-health therapy, psychosocial support, or highly structured setting that reduces symptoms; and
2. Marginal adjustment—minimal capacity to adapt to changes not already part of daily life.
(Effective Jan 17 2017; technical corrections May 18 2018.)
Key Elements
- Criterion A — Core ASD Features
- • Documented deficits in social communication/interaction and
- • Documented restricted, repetitive behaviors or interests.
- Functional Severity
- Paragraph B: Extreme in 1 domain or marked in 2 of the 4 mental-function domains.
- Paragraph C: ≥ 2-year history plus ongoing treatment/structured support and marginal adjustment.
- Duration
- Lasts (or is expected to last) ≥ 12 months (B) or satisfies the 2-year “serious-and-persistent” standard (C).
Tips on Proving Listing 12.10
| Evidence | What to Collect | Role in Criteria |
|---|---|---|
| Developmental records | Childhood IEPs, speech-language pathology notes, early diagnostic reports | Show lifelong ASD pattern; bolster Criterion A |
| Current comprehensive evaluation | Autism Diagnostic Observation Schedule-2 (ADOS-2), Autism Diagnostic Interview-Revised (ADI-R), DSM-5 diagnosis by psychologist/psychiatrist | Primary documentation of social-communication deficits & repetitive behaviors |
| Occupational & speech-therapy notes | Progress logs on pragmatic language, sensory issues, ADL training | Demonstrate persistent deficits despite intervention |
| Standardized rating scales | Social Responsiveness Scale-2 (SRS-2), Vineland-3 Adaptive Behavior Composite, Repetitive Behavior Scale | Quantify severity; map to mental-function domains |
| Mental RFCs / clinician letters | Marked/extreme limits in attention, pace, social interaction, self-management | Address Paragraph B domains directly |
| Structured-setting documentation | Supported employment, adult-day programs, ABA sessions, residential support logs | Key for Paragraph C (ongoing highly structured environment) |
| Third-party statements | Family, job coaches, case managers describe meltdowns, rigid routines, inability to cope with change | Corroborate functional limitations & “marginal adjustment” |
| Rule-out labs / imaging | Genetic testing (e.g., Fragile X), metabolic panels—if performed, show no alternate cause | Supports diagnostic accuracy |
Testing cues from SSA Medical-Tests Guide (2024 edition)
- Eye-tracking tasks to document atypical social attention.
- NEPSY-II or D-KEFS subtests for executive-function deficits contributing to pace/persistence problems.
Practical Takeaway
To satisfy Listing 12.10, establish objective ASD diagnosis (Criterion A) and show either marked/extreme work-related limits (Paragraph B) or a long-standing, treatment-resistant course with marginal adaptation (Paragraph C). A Social Security Disability lawyer can help combine gold-standard autism assessments, adaptive-behavior scales, therapy records, and vivid functional narratives to build a compelling Step 3 case.