Autistic Disorder Fatima AlHaidar Professor, Child & Adolescent Psychiatrist KSU

Definition: Childhood autism is one of the PDDs that is characterized by early onset (before 3 years of age) of delay and deviation in three critical areas of development : 1- the ability to form social relationships and to share interest and emotions. 2- the use of language and communication ( both verbal and non-verbal). 3- the presence of severely incapacitating ritualistic tendencies.

Clinical Picture : A. Behavioral Features, 1- social relationships. 2- speech and language development. 3- mannerisms. 4- resistance to change. 5- attachment to particular objects. 6- acute emotional reactions. 7- other behavioral symptoms.

Clinical Picture cont. B. Intellectual development, 1- general intelligence. 2- specific deficit. 3- special abilities. C. Physical conditions

Background Factors : 1- Overview. 2- Genetic factors. 3- Underlying physical conditions. 4- Parents and family factors. 5- Link with schizophrenia.

ASSESSMENT : 1- Overview. 2- Differential diagnoses ; 1- MR and learning disabilities. 2- Asperger’s disorder. 3- Childhood disintegrative disorder. 4- Rett’s disorder. 5- Language developmental disorders. 6- Childhood schizophrenia. 7- ADHD 8- Attachment disorders.

Management : # Explain to the parents the nature of the diagnosis and its probable cause and the way the child can be helped and the likely outcome. # Neither medications nor interpretive form of psychotherapy directed to the patient have a significant place in management. # Behavioral and educational methods have been shown to be helpful.

Management cont. # Goals for treatment: 1- fostering of normal development; - parental counseling - behavioral methods - special schooling. 2- reduction of rigidity and stereotypy. 3- removal of maladaptive behavior. 4- alleviation of family distress.

Outcome A life-long condition; - 66% ---- total dependence. - 50% ---- linguistic impairment. - 10% ---- slight improvement. - <10% ----working. - 16% ----epilepsy. - 50%---- deterioration during adolescence. - 10% ---- psychiatric disturbance. Important factors relevant to outcome: - IQ - quality of parental care and education. - slow progress.