AUTISM SPECTRUM DISORDERS

Autism Spectrum Disorders

Table of Contents

Introduction3

Discussion3

Clinical Features4

Epidemiology6

Clinical Course6

Etiology and Pathogenesis8

Assessment8

Differential Diagnosis and Comorbidity9

Treatment9

Complementary and Alternative Treatments10

Conclusions10

References12

Appendix13

Autism Spectrum Disorders

Introduction

Autism is a developmental disorder of the human mind. People with autism have problems interacting socially and communicating with others. In 1943, Kanner described 11 children who manifested “extreme affective aloneness” and gave them the label of “autism,” meaning “withdrawn into the self,” a term derived from Bleuler's initial use of the word in describing schizophrenia. For a period of time, childhood schizophrenia and autism were thought to comprise the same disorder. Subsequently, these severe disorders have been conceptualized as two different syndromes based upon research showing that schizophrenia and autism do not aggregate in the same families, have different core symptomatology, and have different times of onset. Classic autism is one of many disorders classified as “Autism Spectrum Disorders” (ASD). Other ASD's include childhood disintegrative disorder, Rett syndrome, pervasive developmental disorder, and Asperger syndrome.

Discussion

In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), autism is one of five disorders that fall under the broad category of pervasive developmental disorders (PDD). The other disorders include Asperger disorder, pervasive developmental disorder not otherwise specified (PDD, NOS), childhood disintegrative disorder, and Rett disorder. The term “pervasive developmental disorder” is used synonymously with “autism spectrum disorder” (ASD) in different settings. As the term ASD is commonly used in school settings and in the recent pediatric literature, it will be preferentially used in this chapter instead of the DSM-IV-TR diagnostic term PDD. (Baron 2000)

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Clinical Features

The essential feature of ASD is abnormal relatedness and social development. In infancy and toddlerhood, this is manifested by abnormal eye contact, failure to orient to name, failure to use gestures to point or show things, aloofness, lack of sharing or seeking comfort, and lack of interest in peers. Parents usually express concern about social development between the ages of 18 months and 4 years. However, Osterling and Dawson's research shows that videotapes made as early as 1 year of age and viewed later in life show that these abnormalities in communication and relatedness are evident in the first year of life. The other essential feature of ASD is a delay in language acquisition and communication. With the exception of Asperger disorder, ASDs always present with abnormal language development, or in severe cases, the lack of any language. When delays or regression of both language and social relatedness are present, prompt evaluation and early intervention are indicated. (Bauman 2008)

The cardinal features of autism include marked deficits in relatedness and social abilities and problems with communication. At 6 months, concerns regarding autism are raised by the infant's lack of babbling, not making eye contact with parents during interaction, and not smiling reciprocally when parents smile. Parents should not have to touch the baby to elicit a smile. Autistic infants do not participate in vocal “turn-taking,” in which the baby makes a sound, the parent imitates the baby, the baby makes the sound again, and so ...