A group of conditions involving serious impairment in several areas of development, including physical, behavioral.Music Therapy in the Treatment of Pervasive Developmental Disorders Dr. In this article the terms pervasive developmental disorder (PDD) and autism spectrum disorders (ASD) are used interchangeably to refer to the spectrum.Pervasive Developmental Disorder (PDD). Thus, the term autism spectrum disorders has gained support since it reflects the range in both type and severity of symptoms seen in children with autism. At present, there is no clear distinction between autistic disorder and pervasive developmental disorder NOS, nor is there clear diagnostic criteria for them. Asperger disorder will also not be discussed further since it is a mild form of high-functioning autism that manifests later, so would not be considered in very young children.The term Pervasive Developmental Disorder (PDD) was once used to refer to a category of developmental delays that included autism and four similar disorders.Prevalence figures vary according to diagnostic criteria used. The model and concept of multisystem developmental disorder lack a research base, however, and have not gained widespread support. This description may be applicable to a small group of children with autistic symptoms. The latter, proposed by Zero to Three: National Center for Infants, Toddlers and Families, suggests that in some cases autistic socialization and communication difficulties are secondary to "regulatory dysfunctions" and the categories of pervasive developmental disorder/ autism spectrum disorders should only be used if the "deficits appear fixed." These attempts at new definitions reflect the difficulty of describing children who may not be clearly autistic, who are very young and have not grown into their autism, or for whom the relationship difficulties are related to difficulties in motor planning, auditory and visual processing deficits, or in regulating emotions. However, regardlessIt has been suggested that these disorders be reclassified using terms such as social communication spectrum disorder or multisystem developmental disorder. Not all children with exceptionalities will respond to the same model in the same manner.Qualitative impairment in social interaction Boys are affected 4 to 5 times more often than girls, and more than 70% of autistic children also have some degree of mental retardation.Children with autism show characteristics in three core areas: This means that over 100 babies may be born in BC each year with autism spectrum disorders.
Even when language develops it is often rote, repetitive, and lacking communicative intent. The communication difficulties are seen with delayed development of speech and language. This trait is often present very early, with poor eye contact, disinterest or dislike in being held, and being "in his or her own world." A lack of showing and sharing interests is often present and there is less desire to play with other children. Restricted, repetitive, and stereotyped patterns of behavior, interests, or activitiesThe lack of social relatedness is considered to be the main symptom and handicap in autism. Thus, when a parent approaches a physician with a concern about a child’s development, "wait and see" is not the best response. Indeed, the confusion and stress experienced by families is often replaced by remarkable coping once a diagnosis is reached and parents are provided with recommendations for intervention.Early intervention programs differ in their relative emphasis on language, social skill development, or behavioral management, but common characteristics of successful programs are that they are offered early and intensively. Further, early intervention provides support for parents. The influence of the environment on brain structure and function is greatest during the first few years of life, and intervention may prevent the development of maladaptive behaviors. In very young children, behavioral rigidity may result in tantrums and distress.There has been increasing interest in identifying autism and related disorders as early as possible to allow for early intervention. Diverse factors complicate early identification. Children with autism can be distinguished from normal children or from those with mental handicaps or language disorders at 2 to 3 years of age by experienced clinicians. They all concur that monitoring language and behavior in very young children, assisted by screening tools or checklists, then referral to an experienced team, constitute best practice.Identification and diagnosis of autism in very young children has been considered to be difficult, but there is increasing evidence that it is possible. How can the physician differentiate between this group, and those who are understandably anxious about their child’s abnormal development?Recent reports have made recommendations for the early identification of autism. Thus, to identify autism in very young children, and assist in distinguishing them from children who are only developmentally delayed, look for differences in four key areas of behavior: Motor stereotypies and language delays are common in all developmental disabilities, and behaviors such as the need for sameness or sensory disturbances either may develop later or are not common enough in autism to be diagnostic at a young age. The items that distinguish children with autism from others with developmental delays focus less on early speech and language delays or repetitive behavior and more on abnormal play and social isolation, including poor eye contact and lack of sharing interests or lack of imitation. The focus must be shifted from looking for typical speech/language problems to identifying abnormal perceptual and social dysfunctions. About 25% report normal development up to 18 months, with increasing concern when language is slow to develop.What should the physician do when a parent comes with concerns? First, it is important to check the developmental milestones of the child and ensure that vision and hearing are normal (see Table 2). Windows reloader 33 downloadHere is a brief description of the most widely used or readily available questionnaires or checklists to assist with screening for autism in very young children. There exist a number of screening tools, and reference to one of them is important when a diagnosis of autism spectrum disorder is being considered. Table 3 indicates the parental concerns that should be red flags and prompt further investigation. Difference in eye contact described as "abnormal gaze" or "difficulty getting or sustaining eye contact."If any child has a combination of a lack in pretend or social play, joint attention, and pointing out interests at 18 months, it makes good clinical sense to refer him or her for a specialist assessment for autism. Lack of joint attention, or a lack of "showing," "sharing," "commenting," "directing other’s attention," or "protodeclarative pointing." (The goal of protodeclarative pointing is to indicate objects of interest rather than to obtain an object.) Abnormal play, either "absence of pretend play," "playing only with parts of objects" or "playing only with a few things," "inappropriate relating to toys." This checklist has been endorsed by the Ministry for Children and Families and has been widely circulated in BC. The word autism was not included in this checklist in order to avoid overdiagnosis and unnecessary heightened parental anxiety. Wording of items can be interpreted differently, memory can affect judgment, and some parents may have difficulty describing behaviors in English or have low literacy for reading questionnaires.The BCMA published a developmental checklist for parents in the Winter 1997 edition of Head to Toe, which encouraged parents to discuss deviations in their child’s development with their family doctor or pediatrician.
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