Autistic Spectrum Disorders (a.k.a. Pervasive Developmental Disorders)

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Autistic Spectrum Disorders (a.k.a. Pervasive
Developmental Disorders)
Thomas Nichols
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Autistic Spectrum Disorders

• "Inability to relate in an ordinary way to people
  and to situations"..."an anxiously obsessive
  desire for the maintenance of sameness" Kanner,
  1943
• Now not considered rare as diagnostic criteria
  have changed
• Organic disorder with genetic component
• gt60 concordance in mono-zygotic twins

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Disease Development

• More common in boys 31 ratio
• Links with William's syndrome, Fragile X (?
  Conflicting evidence)
• 40 have raised Serotonin levels
• 70 have mental handicap
• 25-40 develop epilepsy during adolescence
• IQlt70 poor prognosis
• Link with Schizophrenia has been disproved

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The Clinical Triad

• Deficit in three fields
• Impaired Social Relationships
• Language Abnormalities
• Repetitive activities

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Autism

• Impaired Social Relationships
• ? gaze aversion
• ? minimal facial expression
• ? fail to smile
• ? prefers toys to people
• ? appear aloof

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Autism

• Language Abnormalities
• ? slow to speak, and 50 never learn
• ? echolalia
• ? little non-verbal communication
• ? little imagination fail to develop abstract
  thinking - no distinction between you and I

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Autism

• Repetitive activities
• ? ritualistic behaviour patterns
• ? repetitive movements such as flicking fingers
  in front of eyes, rocking, whirling objects, head
  banging

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Presentation

• Parents often think child is deaf because of slow
  language development
• May have been odd from birth - may be
  unresponsive to being held
• Crying may not be related to anything, or may not
  cry when expected to
• Symptoms and signs usually apparent before 30
  months

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Management

• Establish routines
• Sleeping tablets if associated sleep problem
• Brain imaging important - asymmetry in cerebellum
  and cerebral cortex
• Behavioural training

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Other Autistic Spectrum Disorders
Autism Described above
Rett's Syndrome Regression of skills Loss of purposeful hand use Decreased head growth
Asperger Syndrome Language and cognition normal but with poor social interaction
Developmental Dysphasias Disease limited to communication and language
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Conclusion

• Autism is abnormality in three fields
• Impaired social relationships
• Language communication
• Repetitive activities
• It is an increasingly diagnosed disorder more
  common in boys, that is apparent by the age of
  three. It is associated with mental retardation
  and epilepsy.