With DSM-5 considered a continuum model Specifiers
Deficits in social communication & restricted and repetitive Intellectual impairment behaviors Language impairment Formerly 5 separate disorders Medical or genetic condition or environmental factor Autistic disorder Other neurodevelopmental, mental, or behavioral disorder Aspergers disorder Catatonia Childhood disintegrative disorder DDx: Rhett syndrome Social communication disorder Pervasive developmental disorder NOS Childhood onset Schizophrenia Epidemiology: Intellectual Disability with Behavioral Symptoms Prevalence 1% in US Language Disorder Onset: Early developmental period 2-3yo Congenital Deafness or Hearing Impairment Diagnosed 4X Males > Females Psychosocial Deprivation Girls with ASD more likely to have intellectual disability Tx: Etiology: Psychosocial Interventions Heritable contribution Early intensive behavioral & developmental 15% associated with a known gene mutation Social Skills rates (up to 50%) when siblings with diagnosis of autism Specific behavioral interventions & CBT for petitive Biomarkers influence: 5-HT (serotonin) in platelets behaviors Immunologic factors: Maternal ABs Interventions addressing comorbid symptoms Prenatal & Perinatal factors Educational interventions Adv maternal & paternal age, maternal gestational Pharmacological Interventions bleeding, gestational DM, 1st born baby Course & Prognosis: Umbilical cord complications, birth trauma, fetal Lifelong disorder distress, small gestational age, low birth weight, low 5 Highly variable severity & prognosis min Apgar score Best prognosis with Comorbidities: IQ > 70 EEG abnormalities and grand mal seizures more common in Average adaptive skills patients with autism spectrum disorder Develop communicative language by age 5-7yo No specific EEG finding consistent with autism spectrum disorder Possible failed cerebral lateralization DSM-5 & ICD-10 Dx: Rett Syndrome A. Persistent deficits in social communication and social interaction Nl development 6 months, then developmental across multiple contexts deterioration 1. Deficits in social-emotional reciprocity Exclusive to female diagnosis 2. Deficits in nonverbal communicative behaviors used Childhood Disintegrative Disorder for social interaction Nl development for 2 years, then regression in several 3. Deficits in developing, maintaining, and understanding areas which ends up similar to autism relationships Aspergers Disorder B. Restricted, repetitive patterns of behavior, interests or activities as Impairment and oddity of social interaction and manifested by at least two of the following restricted interest and behavior 1. Stereotyped or repetitive motor movements, use of Pervasive Developmental Disorder NOS objects, or speech Condition with severe pervasive impairment in 2. Insistence on sameness, inflexible adherence to communication skills or the presence of restricted and routines, or ritualized patters of verbal or nonverbal repetitive activities and associated impairment in social behavior interactions 3. Highly restricted, fixated interests that are abnormal in intensity or focus 4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment C. Symptoms must be present in the early developmental period D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning E. These disturbances are not better explained by intellectual disability or global developmental delay