Usually evidenced w/i 1st 5 years. Autism. Main features ..

1
Pervasive Developmental Disorder

• Severe impairment of
• Social skills communication
• Activities interests
• Self-care
• Often have stereotyped movements
• Usually evidenced w/i 1st 5 years
• CDC estimate 1 in 110 kids

2
Autism

• Main features
• Impaired social/communicative functioning
• Eye contact
• Body language (cuddling in infants)
• Lack of social reciprocity (games)
• Lack of sharing/showing
• Disinterest in others
• Language delays
• Echolalia
• Restricted repertoire of activities/interests
• Routines/rituals
• Self-stimulatory behaviors
• Odd postures/hand flapping/etc

3
Associated features

• Age of onset usually by age 3
• Theory of mind
• Moderate MR
• Uneven profile
• Receptive language often better than expressive
• Temper tantrums
• Aggressive/self-injurious
• Sensitivity to light/sounds
• Undersensitivity to pain
• Mood/sleep disturbances
• More common (4-5x) in males, more severe in
  females
• Autistic savant
• Rate 2.5 per 10000
• Generally poor prognosis

4
Retts Disorder

• Normal prenatal and initial infancy
• Deceleration of head circumference growth
• Loss of hand coordination
• Repetitive hand wringing motions
• Gait/movement problems
• Interest in social environment low
• Severe/Profound MR, language problems
• Females only (spon. Abor. In male fetuses)
• X-chromosome linked

5
Childhood Disintegrative Disorder

• 2 years normal development
• Includes normal social/language/motor dev.
• After 2 years, regression to autistic symptoms
• Loss of previous abilities
• Seizures common
• More common in boys
• Rare overall

6
Aspergers Disorder

• Significant social delays
• Lack of interest in others, impaired social
  skills
• Restricted pattern of behavior
• Circumscribed interests
• Repetitive behavior
• routines
• Cognitive/language skills normal
• More common in males
• Better prognosis than other disorders

7
Autism etiology

• No single cause
• 33 cause identifiable
• Genetic disorder or toxin exposure
• Frontal lobe/limbic system deficits
• 66 no identifiable cause
• Polyvalent viral vaccines no evidence
• Mercury possible

8
Attention Deficit Hyperactivity Disorder

• One of most common childhood disorders diagnosed
• Symptoms have been expanded in DSM-IV
• Some controversy
• School funding and diagnosis
• Must be evident by age 7
• Interference in multiple settings (e.g. home,
  school, etc.)

9
ADHD (part 2)

• Inattention
• Poor attention to detail, frequent mistakes
• Easily distracted, forgetful
• Does not listen to directions
• Poor sustained task orientation
• But often can play video games for hours
• Hyperactivity
• Fidgets, cant sit still
• Difficulty engaging in quiet play
• Impulsivity
• Doesnt wait turn, blurts out answers
• Poor social skills, touch others, poor problem
  solving

10
ADHD Part 3

• ADHD No H
• Theories of ADHD
• Moderate heritability
• Associated with birth complications
• dopamine
• Treatment Ritalin, Cylert, Adderal
• XR versions
• Behavioral treatment
• Prevalence rates vary (1-7), more common in boys
  (3x)

11
Oppositional Defiant

• In short Child can be a jerk but is not a
  serious threat/psychopath
• 6 months of defiant/negative/disobedient
• Looses temper easily, particularly with adults
• Blames others for mistakes (rationalization)
• Feels adults are picking on them
• spiteful/vindictive
• Stubborn resistant to punishment (and often
  positive reinforcement)
• Dont like to compromise with authority
• Verbal aggression
• May get into fights but fights fair
• May be well liked by peers
• 8 prevalence, more common in boys

12
Conduct disorder

• More severe conduct problems
• Serious rule/law breaking
• Violent/cruel behavior
• Sexually aggressive
• Damage to property/arson
• Often leads to adult Antisocial Personality
  Disorder
• Which cant be diagnosed until age 18

13
Subtypes

• Childhood onset (Unsocialized)
• Solitary bullying behavior
• Isolated, unliked by peers
• Very poor social skills
• Very poor prognosis
• Adolescent onset (Socialized)
• Associated with gang activity
• Better (but far from perfect) prognosis
• May burn out in adulthood

14
Conduct Disorder Continued

• Genetic and environmental contributors
• 1-4 prevalence, much more common in boys
• Girls and indirect aggression
• Token economies
• Various drugs attempted SSRIs atypicals,
  Lithium, anti-convulsants, anti-psychotics
• Very poor prognosis

15
Tourettes Disorder

• Combination of motor and vocal tics
• Onset before age 18
• Occurs at least 1 year (no more than 3 month
  break in symptoms)
• Tics tend to change location, intensity, etc.
  over time
• Coprolalia (about 10 of cases)
• Eye-blinking is often (50) first tic
• May progress to complex motor tics, including
  complex facial movements, or hopping/squatting/jum
  ping
• Associated with OCD and learning disorders
• May result in physical problems due to strain or
  skin picking
• Made worse by stimulant medications
• Usually lifelong, resistant to Treatment

16
Pica/Rumination

• Pica eating non-food substances
• Paint, string, insects, sand, leaves, feces, etc.
• Common w/ MR, neglect
• Can lead to perforated intestines, hair balls,
  gastric blockage
• Rumination regurgitating reconsuming food
• Occurs w/o vomiting reaction or disgust
• Neglect, stress, more common in males
• May damage esophagus, teeth, cause malnutrition
• Leads to death in 25 of cases