Autism, Pervasive Developmental Disorders, childhood onset Schizophrenia

1) Pervasive developmental disorders: autistic disorder

2) Autism is a severe developmental disorder characterized by abnormalities in communication, language, social functioning, and by having unusual interests and behaviors. Autism especially disrupts social responsiveness and the ability to communicate and develop relationships with others.

3) “autistic spectrum”

a) 4/5 in 10,000 - 3-4 times more common in boys, unrelated to social class

b) DSM-IV requires at least 6 symptoms, with at least two from each the first set and at least one from the next set:

c) Qualitative impairment in reciprocal social interactions

i) Inability to relate to others

ii) Lack of social/emotional reciprocity

iii) Poor attachment - touching, painful, distressing (Nobody, Nowhere)

iv) Little social play, gaze aversion, rarely make friends

d) Qualitative impairment in communication and imaginative activity

i) Difficulty speaking and learning language

ii) Dysprosody (don't get rhythm and intonation, e.g., humor

iii) Pronoun reversal (reverse you and I)

iv) Diminished capacity for abstract thinking and limited imagination

e) Markedly restricted repertoire of activity and interests

i) Stereotyped behaviors, may be nonsensical rituals, rigidity in sticking to routines

f) Apparent sensory deficits - e.g., may seem to be deaf although hearing is fine

g) Self-injury - head-banging and other self-stimulation

h) Savants, although rare even among autistics

Autism can be reliably detected/diagnosed by between 12 and 18 months of age.

Outcomes

4) Two autistic-like disorders that are rarer than autism:

a) Asperger's disorder

b) Childhood Disintegrative disorder

i) 2 years okay and then PDD/autistic symptoms

ii) very rare

iii) usually onset between 3 and 4 years

iv) no known medical/neurological condition

v) if after 5 years, usually something neurological, but not always

vi) may be abrupt and rapid loss of skills

vii) loss is progressive especially when associated w/neurological disorder

viii) severe MR

ix) lifelong in a majority of cases

c) Rett's

i) At least 6 months ok and then regression (onset always before 4 years)

ii) head growth decelerates

iii) loss of hand skills

iv) develop hand-wringing and hand-washing

v) social interest diminishes

vi) severe and profound MR

vii) reported only in females, appears rare

viii) lifelong