UF PSY 4930 - Pervasive Developmental Disorders

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Pervasive Developmental DisordersSlide 2Slide 3Pervasive vs. Specific DisordersWhy this is important to you?The History of Pervasive Developmental DisordersSlide 7Case Example 1Slide 9Slide 10Our DiagnosisRett Syndrome (Rett’s Disorder)DSM-IV: Pervasive Developmental Disorder: 299.80 Rett’s Disorder2002 Revised Diagnostic criteria for Rett SyndromeCourse and Stages of Rett SyndromeSlide 16Slide 17Slide 18RS: Pathogenesis - EtiologyRett SyndromeRett SyndromeCase Example 2: From the Yale Developmental Disabilities ClinicPervasive Developmental Disorders: Childhood Disintegrative DisorderDSM-IV: 299.10 CDDSlide 25Childhood Disintegrative DisorderCDD vs. AutismChildhood Disintegrative Disorder: EtiologyChildhood Disintegrative Disorder: TreatmentPervasive Developmental Disorders: Asperger’s DisorderAsperger’s DisorderSlide 32Slide 33Slide 34Slide 35Slide 36Asperger’s Disorder: PrevalenceAsperger’s Disorder: EtiologyAsperger’s Disorder: Course and PrognosisAsperger’s Disorder: TreatmentPervasive Developmental Disorders: Autistic DisorderAutistic DisorderAutism: Social DeficitsSlide 44Slide 45Slide 46Slide 47Slide 48Autistic Disorder: PrevalenceSlide 50Autistic Disorder: PrognosisSlide 52Slide 53Etiology of AutismSlide 55Slide 56Slide 57Slide 58Autistic Disorder: TreatmentSlide 60Slide 61Slide 62Slide 63Slide 64Living with Autism: Temple Grandin, Ph.D.Pervasive Developmental DisordersSeptember 5, 2006PSYC 4930Pervasive Developmental DisordersSeveral disorders are included under the DSM-IV heading of Pervasive Developmental Disorders:1. Autistic Disorder2. Asperger's Disorder3. Rett's Disorder 4. Childhood Disintegrative Disorder5. Pervasive developmental disorder-not otherwise specified (PDD-NOS) Autism Spectrum Disorders (ASD)Autistic Disorder Asperger's Disorder Rett's Disorder Most is known about autismRelatively early stages of understandingPervasive Developmental DisordersPDDs are characterized by severe and pervasive impairments in several areas of development (DSM-IV)1. Reciprocal social interactions/skills2. CommunicationSpeech, language, & communication 3. Stereotyped or repeated behaviors, interests, activities, or routinesPervasive vs. Specific Disorders PDD are to be distinguished from "Specific Developmental Disorders" (e.g., reading, articulation, arithmetic, and language disorders).This is because they are characterized by severe disturbances in many basic areas of development. They may also be reflected in behaviors having no counterpart in normal development.Thus, children with these conditions often display distorted rather than simply delayed development.E.G., Echolalia is never developmental typicalWhy this is important to you?Prevalence rates for Autism Spectrum Disorders Between 2 and 6 per 1,000 individualsBetween 1 in 500 to 1 in 166 children have an ASD!Center for Disease Control and Prevention (CDC)The History of Pervasive Developmental DisordersHistorically disorders of this type have been referred to by a variety of labels such asatypical psychosischild psychosissymbiotic psychosischildhood schizophrenia infantile autismPervasive Developmental DisordersAt one time, conditions referred to as Pervasive Developmental Disorders were often thought to be reflective of Child PsychosisHowever, PDDs are not related to the psychotic conditions of adulthood (e.g. Schizophrenia), and are now referred to as "developmental" rather than "psychotic" disorders.Case Example 17 years-old female Developmental HistoryMotorSat up without propping at 9 months, walked without assistance at age 3, and showed an early right hand preference. By age 3 ½, she was reportedly able to step over objects, feed herself, and showed a pincer and palmer grip. CommunicationBy age 4, attained about a 25-word vocabulary and used 2-word phrases such as “go home”. Her early vocabulary included words such as “go” and “dada”. SocialAt age 3, she reportedly showed appropriate interest in toys and books. Parent estimated that peak development was at about 4 years of age (Delayed: estimated19-month-old level).Case Example 1By age 7, regressed to level below 12 months old (Loss of previously acquired skills)CommunicationThe only word used at home was “go”. At school she would repeat “good girl” and “good job”, but this was not self-initiated.Expressive language ~ 5 month old level Receptive language ~ 6 month old (not readily follow commands)Motor SkillsLoss of previously acquired purposeful hand skills (i.e., not independently feed herself with fork or spoon, or hold a pencil)Development of stereotyped hand movements (i.e., hand-wringing)Loss of locomotion and motor coordination (i.e., no longer walk up stairs). Lost progress on toilet training previously acquired (i.e., required diapers since 4 years, 9 months old.Case Example 1Social Functioning and other symptomsDiminished interest in previously pleasurable play activities (i.e., playing on a swing, showed no interest when presented with a toy ) Loss of appropriate social engagement (e.g.,limited eye contact). Decreased sensitivity to pain, becomes very hyper in new situations, and recently started playing with her feces prior to wringing her hands.Our DiagnosisDevelopmental consistent with the IRSA’s description of the “Atypical or Borderline” variant phenotype of Rett Syndrome. At least 3 of 6 of the main criteria (i.e., absence or reduction of hand skills, monotonous pattern of hand stereotypies, reduction or loss of communication skills) and a number of the supportive criteria (i.e., teeth grinding, harsh sounding type, abnormal locomotion, diminished response to pain).Rett Syndrome (Rett’s Disorder)First described by Dr. Andreas Rett in 1964, but did not receive worldwide recognition until the first English language publication by Dr. Bengt Hagberg in 1983 Dr. Andreas Rett in Vienna, AustriaNeurodevelopmental disorder Child appears to be born healthy and have a period of “normal” early developmentOnset of symptoms typically occurs as early as 5 months or as late as 48 months. Occurs in 1:10,000 to 1:23,000 female births Much rarer than AutismOften misdiagnosed as autism, cerebral palsy or non-specified developmental delayDSM-IV: Pervasive Developmental Disorder: 299.80 Rett’s DisorderA. All of the following:1.


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UF PSY 4930 - Pervasive Developmental Disorders

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