1. THE EVOLVING NOMENCLATURE OF AUTISM
Kanner’s “ autism”
Asperger’s syndrome
Need for international classification
DSM and ICD systems
Autistic Disorder/ Pervasive Developmental
Disorder (DSM III-DSM III R)
Autistic Disorder/PDD
(DSM IV- ICD 10)
Autistic Spectrum Disorders

2. Autistic Spectrum Disorders
A group of biologically based disorders which comprise a number of different medically diagnosed conditions
The “shared” behavioral characteristics include a triad of impairments
There is a neurologic dysfunction and genetic factors are involved

3. AUTISTIC SPECTRUM DISORDERS

5. Definition of terms
Autistic Spectrum Disorder (ASD) termed Pervasive Developmental Disorders [PDDs] in the DSM 4th edition (text revision) DSM-IV-TR
This refers to developmental disorders of varying clinical
presentations that share a core feature of pervasive and
qualitative impairments in reciprocal social interaction.
Source: Carr and Le Blanc, ASDs in Early Childhood, Primary Care Clin Office Pract, 2007

6. THE AUTISTIC SPECTRUM Prevalence
How many individuals with
autism are there?
1- 6 per 1000
Fombonne 2004

7. Autism or Autistic Disorder
To qualify for a diagnosis, they
must meet 6 criteria
at least 2 in social interaction
one each in communication
and restrictive, repetitive behavior
Notes for Parents :
Good sources on diagnostic criteria:
DSM IV-TR
The World of the Autistic Child by Bryna Siegel , p. 18
Autism Spectrum Disorders by Chantal Sicile –Kira, 2004 p. 21

9. Autism /Autistic Disorder
Substantial social impairment , poor
peer interaction
Moderate to profound language
impairments
Restricted and repetitive behaviors

10. Asperger Syndrome/ Disorder
To qualify for a diagnosis,
there should be at least
2 characteristic criteria in
social interaction
1 characteristic criteria in
restricted, repetitive behavior
* No language delay/cognitive
impairment
Notes for Parents:
Good sources: Asperger Syndrome by Tony Attwood
The Oasis Guide to Asperger Syndrome by
Bashe and Kirby , 2005

11. Pervasive Developmental Disorder Not Otherwise Specified PDDNOS
This diagnosis is used for “milder” problems.
An individual with PDDNOS may exhibit behavior
similar to those diagnosed with autism or Asperger
Syndrome but does not meet the criteria for one
of these disorders
Food for thought
Some doctors use PDDNOS provisionally when the child
is so young and some criteria are felt too difficult to see

12. The Diagnostic Evaluation Process
Medical Examination
Should be performed by
qualified health professional
* Regression or if with
clinical neurologic
abnormalities like
microcephaly or
neurologic asymmetries
Physical Exam
dysmorphisms
growth
impairments
neurocutaneous
Neurologic exam
neurologic
abnormalities
Laboratory tests
as needed
Genetic tests
High resolution
karyotype
Fragile X
Neurological tests
EEG *
MRI/CT scan *
Newsweek December 4, 2006

13. Screening and Referral
Screening for ASD should be conducted in conjunction with routine developmental surveillance
RED FLAG INDICATORS
No babbling by 12 months
No gestures like pointing, showing, reaching or waving
by 12 months
No words by 16 months
No 2 word meaningful phrases by 24 months
ANY loss of speech, babbling and social skills at ANY age

14. Parental concerns that should be addressed as soon as possible
Delayed or deviant language
Poor social interaction ( lack of eye contact, no peer relations)
Delayed language and poor social interaction
Inappropriate/unusual , self injurious or aggressive behaviors + language delay
Knowledge of normal development is important !

15. Prevalence Data “One child in 100 in the UK”
“Autism is the fastest growing childhood developmental condition in the USA with 1 child in 166 affected”
US Centre for Disease Control 2004
“One child in 100 in the UK”
Office of National Statistics 2004
Rates for autism in 50 prevalence reports reported 50 to 80 per 10000
Blaxill M.F

16. Increasing prevalence: Is it better detection or better awareness ?
U.S. DATA
Population data
CDC/NCHS
PHILIPPINE DATA
Hospital records
PGH/PCMC

17. THE AUTISTIC SPECTRUM a BEHAVIORAL syndrome
There is a cluster of unusual behavior patterns
“ The triad of impairments”
poor social interaction
poor social communication
restricted activities and interests

18. Social Development in ASD
No interest in playmates
Pulls hand for needs

19. The Nature of Communication in ASD
Lacks communicative intent
(can learn to request and protest)
Lack of joint attention
(cannot direct attention to things, poor
pointing , use of here vs there, my vs
yours)
Lack of awareness of shared knowledge or experience
Lacks reason for communicating

20. Communication in ASD VERBAL Gestures Language delay and loss Gaze
Echolalia and odd use of language
Pragmatics
NON VERBAL
Gestures
Gaze
Use of space
Expression of
emotions