Autism and Pervasive Developmental Disorder

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The symptoms of Autism can range from mild to severe, high functioning to low functioning.

According to the DSM-IV, a diagnosis of autism is given when (A, B, and C conditions are met):

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) are present (described below):

Qualitative impairment in social interaction, as manifested by at least two of the following:

	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
	failure to develop peer relationships appropriate to developmental level
	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)
	lack of social or emotional reciprocity

Qualitative impairments in communication, as manifested by at least one of the following:

	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
	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)
	in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
	stereotyped and repetitive use of language or idiosyncratic language
	lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:

	encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
	apparently inflexible adherence to specific, nonfunctional routines or rituals
	stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex whole-body movements)
	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

Pervasive Developmental Disorder is a developmental, neurological disorder that presents before the age of 3 and consists of lack of communication skills, both receptively and expressively, lack of social interaction skills and a lack of functional play skills. Pervasive Developmental Disorder-Not Otherwise specified (PDD-NOS) is identified when a child displays a number of autistic like characteristics but does not meet the DSM-IV criteria to receive an autism diagnosis. Treatment and educational approaches are quite similar for both PDD-NOS and autism.

Asperger's Syndrome

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Individuals with AS often have a dense vocabulary and advanced reading skills yet cannot use their vocabularies in a socially appropriate manner. Social pragmatics and prosody are lacking in those with AS, such as reading body language, maintaining personal space and matching their speech to others around them. An example: those with AS will not notice that others in the library are whispering, therefore missing the social cue that their voice needs to be lowered as well.

According to the DSM-IV, Asperger's Syndrome is defined as:

A. Qualitative impairment in social interaction, as manifested by at least two of the following:

	marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
	failure to develop peer relationships appropriate to developmental level
	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)
	lack of social or emotional reciprocity

B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

	encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
	apparently inflexible adherence to specific, nonfunctional routines or rituals stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
	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 behavior (other than social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

Treatment

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Options for treatment include...

	Applied Behavior Analysis: (a) Home-based Instruction-Home programs generally consist of 10-40 hours a week of 1:1 direct instruction under the supervision of a Board Certified Behavior Analyst; (b) Clinic-based Instruction-Treatment takes place away from the home; 1:1 direct instruction with a qualified therapist under the supervision of a Board Certified Behavior Analyst
	Verbal Behavior: Jack Michael, Ph.D., Vincent Carbone, Ph.D., Mark Sundberg, Ph.D., and James Partington, Ph.D., among others in the field, focused on researching B.F. Skinner’s Analysis of Verbal Behavior and its effectiveness of teaching language skills. This research has improved ABA programs by emphasizing the important elements in language acquisition.
	Relationship Development Intervention: Dr. Steve Gutstein; A parent-based clinical treatment program where parents are provided the tools to effectively teach Dynamic Intelligence skills and motivation to their child. developmental & systematic: a step-by-step program that focuses first on building the motivations so that skills will be used & generalized; followed by carefully and systematically building the skills for competence and fulfillment in a complex world.
	Floortime: Stanley Greenspan's Developmental Approach
	Speech Therapy: Nonbehavioral Speech and Language Therapists (SLPs) have developed many treatments building upon children's natural interests and ability to learn language; 1:1 instruction ranging from 1/2 hour to 3 hours per week
	Sensory Integration Therapy: Provided by licensed Occupational Therapists (OTs) in public schools or private clinics; therapy consists of stimulating children's skin and vestibular system with activities like swinging, brushing, balancing, etc.
	Auditory Integration Therapy: Treatment begins with a hearing test to determine which frequencies are most sensitive; the child wears headphones playing music which filters out the predetermined frequencies; 10 hours a week spread out over 2 weeks; other therapies are often discontinued during this week period
	Medications: Limited use; antidepressants, medicines for attention and hyperactivity; antivirals, antifungals, antibiotics; Nystatin and Diflucan to treat yeast infections, melatonin-to help children sleep and regulate the sleep cycle
	Diet: Gluten Free Casein Free (eliminating wheat and dairy), Feingold Diet-no preservatives, colorings, additives, and salicylates
	Chelation: used for heavy metal toxicity
	Megavitamins: B6 and magnesium

Resources & Quick Links

Learn more about Autism, PDD, PDD-NOS, ABA, Treatments, and much more in the Resources secion.

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