Definition of terms

Autistic Spectrum Disorder (ASD) termed Pervasive Developmental Disorders [PDDs] in the DSM 4th edition (text revision) DSM-IV-TR

This refers to developmental disorders of varying clinical presentations that share a core feature of pervasive and qualitative impairments in reciprocal social interaction.

Source: Carr and Le Blanc, ASDs in Early Childhood, Primary Care Clin Office Pract, 2007

Autism or Autistic Disorder

To qualify for a diagnosis, they must meet 6 criteria at least 2 in social interaction one each in communication and restrictive, repetitive behavior

Notes for Parents : Good sources on diagnostic criteria: DSM IV-TR The World of the Autistic Child by Bryna Siegel , 1996 p. 18 Autism Spectrum Disorders by Chantal Sicile –Kira, 2004 p. 21

Autism /Autistic Disorder

Substantial social impairment , poor peer interactionModerate to profound language impairmentsRestricted and repetitive behaviors

Asperger Syndrome/ DisorderTo qualify for a diagnosis, there should be at least 2 characteristic criteria in social interaction 1 characteristic criteria in restricted, repetitive behavior * No language delay/cognitive impairment

Notes for Parents: Good sources: Asperger Syndrome by Tony Attwood The Oasis Guide to Asperger Syndrome by Bashe and Kirby , 2005

Pervasive Developmental Disorder Not Otherwise SpecifiedPDDNOS

This diagnosis is used for “milder” problems. An individual with PDDNOS may exhibit behaviorsimilar to those diagnosed with autism or AspergerSyndrome but does not meet the criteria for oneof these disorders

Food for thought Some doctors use PDDNOS provisionally when the child is so young and some criteria are felt too difficult to see

The Diagnostic Evaluation Process

Medical Examination

Should be performed by qualified health professional * Regression or if with clinical neurologic abnormalities like microcephaly or neurologic asymmetries

Physical Exam dysmorphisms growth

impairments neurocutaneous

Neurologic exam neurologic

abnormalities

Laboratory tests as needed

Genetic tests High resolution

karyotype Fragile X

Neurological tests EEG * MRI/CT scan *

Newsweek December 4, 2006

Screening and Referral Screening for ASD should be conducted in

conjunction with routine developmental surveillance

RED FLAG INDICATORS

No babbling by 12 months No gestures like pointing, showing, reaching or waving by 12 months No words by 16 months No 2 word meaningful phrases by 24 months ANY loss of speech, babbling and social skills at ANY age

Prevalence Data “Autism is the fastest growing childhood

developmental condition in the USA with 1 child in 166 affected” US Centre for Disease Control 2004

“One child in 100 in the UK”Office of National Statistics 2004

Rates for autism in 50 prevalence reports reported 50 to 80 per 10000 Blaxill M.F. 2004 www.publichealthreports.org

Increasing prevalence: Is it better detection or better awareness ?

0

50

100

150

200

250

300

PGH 7 7 1 10 18 27 31 77 96 89 159 281 80 71 198 199

PCMC 47 70 79 38 42

87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2

U.S. DATAPopulation data

CDC/NCHS

PHILIPPINE DATAHospital records

PGH/PCMC

THE AUTISTIC SPECTRUM

a BEHAVIORAL syndrome

There is a cluster of unusual behavior patterns

“ The triad of impairments”

poor social interaction poor social communication restricted activities and interests