Autistic Spectrum Disorders (a.k.a. Pervasive Developmental Disorders) Thomas Nichols

Autistic Spectrum Disorders "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 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

Autism

Autism

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

Management Establish routines Sleeping tablets if associated sleep problem Brain imaging important - asymmetry in cerebellum and cerebral cortex Behavioural training

Other Autistic Spectrum Disorders AutismDescribed above Rett's Syndrome 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.