Autism Spectrum Disorders: An Overview

Objectives

  • The reader will learn the names and basic characteristics of each of the Autism Spectrum Disorders
  • The reader will learn how Autism Spectrum Disorders are diagnosed

Definitions:

DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition - Text Revision.
This is a published manual that outlines the specific characteristics required for all psychiatric disorders.

PDD: Pervasive Developmental Disorder.
The clinical or medical term for a constellation of five diagnoses listed in the DSM-IV-TR with core difficulties in social communication.

ASD: Autism Spectrum Disorders
A layperson term for one of the five diagnoses listed in the DSM-IV-TR as a Pervasive Developmental Disorder.

Facts

There are five disorders under the label Pervasive Developmental Disorders:

  1. Autistic Disorder
  2. Asperger's Disorder
  3. Pervasive Developmental Disorder
  4. Childhood Disintegrative Disorder
  5. Rett's Disorder

Individuals with Autistic Disorder meet criteria in three main areas:

  1. Social Interaction - e.g., limited eye contact and gestures, difficulty making friends, difficulty understanding common social rules
  2. Communication - e.g., late development or regression, unusual use of language (not conversant), limited or no creative play
  3. Repetitive/Restricted Interests - e.g., excessive interest in unusual objects, limited use of objects and interests or intense interest in limited topic areas, repetitive motor mannerisms, excessive need for routine

Individuals with Asperger's Disorder meet criteria in two main areas:

  1. Social Interaction
  2. Repetitive/Restricted Interests
*Additionally, individuals have no significant delay in language or cognitive skills, though they often have unusual and pressured language and have difficulty maintaining conversations not about an area of interest.

Individuals with PDD-NOS, show similar patterns of symptoms:

  1. Social Interaction impairments
    2. *Additionally, impairments exist in either of the following two areas:
    1. Communication
    2. Repetitive/Restricted Interests

Individuals with Rett's Disorder develop appropriately for the first five months and then experience:

  1. Loss of hand skills and development of classic repetitive hand movements (i.e., hand wringing)
  2. Loss of social interaction at onset of disorder
  3. Communication difficulties (both with expression and understanding of language)

Individuals with Childhood Disintegrative Disorder develop appropriately for at least two years and then experience:

  1. Loss of skills (communication, bladder control, play skills, motor skills)
  2. Abnormalities in at least two of the following three areas:
    1. Social Interaction
    2. Communication
    3. Repetitive/Restricted Interests


Diagnosing a PDD

  1. Done by one of a few types of professionals:
    • Clinical Psychologists
    • Psychiatrists
    • Neurologists
  2. A variety of methods are used
    • Behavioral observations
    • Standardized testing
    • Clinical impressions focused on criteria in the DSM-IV-TR

Recommended Actions

When working with individuals with PDDs, try to capitalize on their strengths
  • Present information visually, whenever possible
  • Establish consistent routines to help individuals know what to expect
  • Break complex routines into simple steps when teaching new routines

Learning Assessment - Review the material covered

  • What are the five Pervasive Developmental Disorders?
  • What are the three main characteristics of Autism?
  • Who can diagnose a PDD?
  • What types of systems work well for individuals with a PDD?

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, D.C.: American Psychiatric Association.

Pozdol, S. L. & Korzekwa, P. A. (2006). Autism 101, a talk presented at OASIS: Indianapolis, IN.