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THE EVOLVING NOMENCLATURE OF AUTISM 1943 Kanners autism 1944 Aspergers syndrome Need for international classification DSM and ICD systems 1988 Autistic.

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Presentation on theme: "THE EVOLVING NOMENCLATURE OF AUTISM 1943 Kanners autism 1944 Aspergers syndrome Need for international classification DSM and ICD systems 1988 Autistic."— Presentation transcript:

1 THE EVOLVING NOMENCLATURE OF AUTISM 1943 Kanners autism 1944 Aspergers syndrome Need for international classification DSM and ICD systems 1988 Autistic Disorder/ Pervasive Developmental Disorder (DSM III-DSM III R) 1994 Autistic Disorder/PDD (DSM IV- ICD 10) 1995 Autistic Spectrum Disorders

2 Autistic Spectrum Disorders A group of biologically based disorders which comprise a number of different medically diagnosed conditions The shared behavioral characteristics include a triad of impairments There is a neurologic dysfunction and genetic factors are involved

3 AUTISTIC SPECTRUM DISORDERS

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5 Definition of terms Autistic Spectrum Disorder (ASD) termed Pervasive Developmental Disorders [PDDs] in the DSM 4 th 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

6 THE AUTISTIC SPECTRUM Prevalence How many individuals with autism are there? 1- 6 per 1000 Fombonne 2004

7 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

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9 Autism /Autistic Disorder Substantial social impairment, poor peer interaction Moderate to profound language impairments Restricted and repetitive behaviors

10 Asperger Syndrome/ Disorder To 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

11 Pervasive Developmental Disorder Not Otherwise Specified PDDNOS This diagnosis is used for milder problems. An individual with PDDNOS may exhibit behavior similar to those diagnosed with autism or Asperger Syndrome but does not meet the criteria for one of 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

12 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

13 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

14 Parental concerns that should be addressed as soon as possible Delayed or deviant language Poor social interaction ( lack of eye contact, no peer relations) Delayed language and poor social interaction Inappropriate/unusual, self injurious or aggressive behaviors + language delay Knowledge of normal development is important !

15 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 Blaxill M.F

16 Increasing prevalence: Is it better detection or better awareness ? U.S. DATA Population data CDC/NCHS PHILIPPINE DATA Hospital records PGH/PCMC

17 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

18 Social Development in ASD Lack of awareness of others feelings Difficulties in imitation Poor eye contact No interest in playmates Pulls hand for needs

19 The Nature of Communication in ASD Lacks communicative intent (can learn to request and protest) Lack of joint attention (cannot direct attention to things, poor pointing, use of here vs there, my vs yours) Lack of awareness of shared knowledge or experience Lacks reason for communicating

20 Communication in ASD VERBAL Language delay and loss Echolalia and odd use of language Pragmatics NON VERBAL Gestures Gaze Use of space Expression of emotions


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