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  • DSM-IV Criteria for Autistic Disorder ASSUME WE NEED PERMISSION TO USE???? At least 6 items from Categories 1, 2, and 3. AND at least two items from category 1. AND at least one item from category 2 and category 3 Category 1 – Qualitative impairment in social interaction as shown by at least two (2) of the following: Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gase, facial expression, body postures, and gestures to regulate social interaction. Failure to develop peer relationships appropriate to developmental level Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people ( e.g., lack of showing, bringing, or pointing out objects of interest to other people) Lack of social or emotional reciprocity Category 2- Qualitative Impairment in communication as manifested by at least one of the following: Delay in, or total lack of , the development of spoken language (not accompanied by an attempt to compensate thorugh alternative means of communication, such as gestures or mime) In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others Stereotyped and repetitive use of language or idiosyncratic language Lack of varied spontaneous make-believe paly or social imitative play appropriate to developmental level. Category 3 – Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that are abnormal either in intensity or focus Apparently compulsive adherence to specific, nonfunctional routines or rituals Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole body movements) Persistent preoccupation with parts of objects

Transcript

  • 1. Autism Update M. Ellen Gellerstedt, MD, FAAP Eastern Maine Medical Center May 12, 2009
  • 2. Autism
      • Complex neurobehavioral disorder characterized by:
      • Impairment in social interaction
      • Impairment in communication
      • Restricted, perseverative behaviors, interests, and activities
  • 3. Autism: DSM-IV
      • Qualitative impairment in social interaction as shown by at least two (2) of the following:
        • Marked impairment in nonverbal behaviors
        • Failure to form developmentally appropriate relationships
        • Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
        • Lack of social or emotional reciprocity
  • 4. Autism Diagnosis DSM-IV
    • Qualitative Impairment in communication as manifested by at least one of the following:
      • Spoken language or gesture
      • Ability to initiate or sustain a conversation
      • Stereotyped and repetitive use of language or idiosyncratic language
      • Lack of varied make-believe play or social imitative play appropriate to developmental level.
  • 5. Autism Diagnosis DSM-IV
    • Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
      • Stereotyped and restricted patterns of interest
      • Adherence to specific, nonfunctional routines or rituals
      • Stereotyped and repetitive motor mannerisms
      • Preoccupation with parts of objects
  • 6. Pervasive Developmental Disorders
    • Autistic Disorder (299.00)
    • Asperger’s Disorder (299.80)
    • Pervasive Developmental Disorder, NOS (299.80)
    • Rett Syndrome (299.80)
    • Childhood Disintegrative Disorder (299.10)
  • 7. Autism Spectrum Disorders – confusing terminology
    • PDD vs. PDD, NOS
    • Asperger vs High Functioning Autism
    • Autism with or without mental retardation
    • Autism Spectrum Disorder
  • 8. Explanatory Models
    • Theory of Mind
    • Mind Blindness
    • Others
  • 9. Etiology of Autism
    • Probably no single etiology
    • Approximately 10% may be behavioral profile associated with specific condition – e.g. Tuberous Sclerosis, Fragile X syndrome, untreated phenylketonuria, others
    • Probably more than one gene responsible for vulnerability
  • 10. Etiology of Autism
    • Likely interplay of genetic predisposition and precipitating event(s)
    • Environmental Infectious Immunologic Other
    • Large multisite studies underway to further investigate causes
  • 11. What you are looking for
    • Atypical use of non-verbal behaviors
      • Eye gaze
      • Gestures
      • Facial expression
  • 12. What you are looking for
    • Impaired Spontaneous seeking to share enjoyment
    • Joint Attention
  • 13. What you are looking for
    • Restricted interests, stereotypies, and repetitive behaviors
  • 14. What you are looking for
    • Atypical development of spoken language
        • Language regression
        • Echolalia
        • Not turning to name
  • 15. What you are looking for
    • Atypical social and emotional reciprocity
      • Responding to name
      • Orient toward people
  • 16. Specifically
    • Does the child respond to parental attention
    • Does the child watch the parent for social cues
    • Does the child respond to his/her name
  • 17. www.firstsigns.org On the Spectrum
  • 18.  
  • 19. Thank You