Autism and other Pervasive Developmental Disorders - Meiri

Question 1

What are the 5 types of pervasive developmental disorders? (PDD)

Answer 1

• Autism
• Childhood disintegrative Disorder
(Heller’s syndrome)
• Rett’s Syndrome
• Asperger’s Syndrome
• PDD NOS

Question 2

What are the main diagnostic criteria for Autism Spectrum Disorders?

Answer 2

• Qualitative impairment in social interaction
• Qualitative impairment in communication
• Restricted repetitive and stereotype patterns of behavior, interests and activities
• Delayed or abnormal functioning prior to age 3

Question 3

What are the diagnostic criteria for autistic disorder?

Answer 3

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal
behaviours 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
(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, interests, 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 mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
(d) persistent preoccupation with parts of objects

• B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction,
(2) language as used in social communication, or (3) symbolic or imaginative play.
• C. The disturbance is not better accounted for by Rett’s disorder or childhood disintegrative disorder

Question 4

What are the diagnostic criteria for Asperger’s Disorder?

Answer 4

A. Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment in the use of multiple nonverbal
behaviours 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

B. Restricted, repetitive, and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
(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, non-functional 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
C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour
(other than in social interaction), and curiosity about the environment in childhood.
F. Criteria are not met for another specific pervasive developmental disorder or schizophrenia.

Question 5

What are the diagnostic criteria for Rett’s Disorder?

Answer 5

A. All of the following:
• (1) apparently normal prenatal and perinatal development
• (2) apparently normal psychomotor development through the first 5 months after birth
• (3) normal head circumference at birth
B. Onset of all of the following after the period of normal development:
• (1) deceleration of head growth between ages 5 and 48 months
• (2) loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (e.g., handwringing 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

Question 6

What are the differential diagnoses for PDD?

Answer 6

• Childhood Schizophrenia
• Mixed Receptive and Expressive
Language Disorder
• Congenital Deafness
• Psychosocial Depravation – Reactive
Attachment Disorder
• Late bloomers

Question 7

What are the differential diagnostic features of autism and nonautistic pervasive developmental disorders (including epi)?

Answer 7