Transcript Autistic Spectrum Disorders (pervasive developmental

Autistic Spectrum Disorders
(a.k.a. Pervasive Developmental Disorders)
Thomas Nichols
Autistic Spectrum Disorders
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"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
– >60% concordance in mono-zygotic twins
Disease Development
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More common in boys 3:1 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
IQ<70 = poor prognosis
Link with Schizophrenia has been disproved
The Clinical Triad
Deficit in three fields:
 Impaired Social Relationships
 Language Abnormalities
 Repetitive activities
Autism
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Impaired Social Relationships
 gaze aversion
 minimal facial expression
 fail to smile
 prefers toys to people
 appear aloof
Autism
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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
Autism
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Repetitive activities
 ritualistic behaviour patterns
 repetitive movements such as flicking
fingers in front of eyes, rocking, whirling
objects, head banging
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
Rett's Syndrome
Described above
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
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.