Pervasive Developmental Disorders

Autism

* Must have 8 out of 16 DSM IV Criteria

•      Must have impairment of Social interaction/does not relate to others

•      Cognitive Impairment – IQ below 70

•      Impairment in Communication

•      Restricted Repertoire of activities or interests - ritualism

Other Features:

     80% are male

     Often are Savants

     Poor prognosis

Treatment of Autism

•      Behavioral Training

     - Focus on skills training

     - Social Skills training

•      Use Reinforcement Rewards

–   Effective for short term

–   Educational Approach – limited

Meds – Only to sedate if agitated

Asperger’s Disorder

Characterized by an inability to:

•      understand the feelings of others

•      consequent impairment of social interaction

•      odd sounding language

•      originality of thought processes

•      restricted and unusual patterns of      interest and behavior

•      Marked impairment of Social Interaction

     1. Eye–to-eye gaze, facial expression...

     2. Failure to develop peer relationships

     3. Lack of seeking to share enjoyment

     4. Lack of social or emotional reciprocity

B. Restricted repetitive stereotyped patterns of behavior, interests, or    activities:(Abnormal intensity or focus)

     1. Preoccupation with one subject

     2. Inflexible adherence to specific, nonfunctional routines or rituals

     3. Repetitive motor mannerisms

     4. Persistent preoccupation w/objects

C. Significant impairment in social occupational functioning

D. No Clinically significant delay in language

E. No clinically Significant delay in cognitive functioning

Etiology

-      Occurs in families with Autism Spectrum disorder or AS traits

-      Suggestive of frontal lobe disorders

-      Neurological basis – developmental abnormality in the right hemisphere of the brain and CNS brain stem pathology

-      –Sensory Integration Dysfunction

     Lack of oxygen at birth

Treatment

•      Behavioral Training

–  Focus on skills training

–  Social Skills training

•      Use Reinforcement Rewards

–  Effective for long term

–  Educational Approach – Not always limited if parents work with teachers

•      Sensory Integration Therapy

–  For neurological impairment

–  Parental training

–  Helps organize the child’s sensory system

–  Child and family develop awareness of deficits and ways to compensate