Autism spectrum disorder - DSM (Diagnostic and Statistical Manual of Mental

Disorders)
-

Diagnosis and classifications

o Kanner - 1943
Clinical description (social isolation, resistance to change,
communication dysfunction)
Recognized biological base for disorder
Noticed parents particularly successful educationally or
academically
Did not feel children were intellectually challenged
o Heller 1900
Noted normal development for a few years and then regressed
o Asperger 1944
Viennese doctor described a group of children very similar to
Kanners description
o Rett
Group of girls: short period of normal development and then
profound motor and intellectual regression

Temple Grandin ted talk has autism. Thinks in piuctures and videos rather
than words

Pervasive Developmental Disorders

o Autistic Disorder
o Rett Syndrome
o Childhood Disintegrative Disorder
o Pervasive Developmental Disorder Not Otherwise Specified
o Asperger Syndrome

Core characterises of ASD :

o Impairment in social interaction (e.g., difficulty relating to others)
o Impairments in communication (e.g., speech and language delays)
o Restricted repetitive and stereotyped patterns of behaviour
Diagnostic and Statistical Manual of Mental Disorders (DSM) - 5
o Intellectual disability (Intellectual developmental disorder:
Relies more on adaptive functioning rather than on specific IQ
scores.Replaces the term mental retardation with Intellectual
disability (Intellectual developmental disorder).
o Communication Disorders
Changed from expressive and mixed receptive-expressive
language disorders to include:
language disorder
speech sound disorder
childhood-onset fluency disorder
social(pragmatic) communication disorder
o Autism spectrum disorder (ASD)

Eliminates pervasive developmental disorder and its

subcategories (autistic disorder, Retts disorder, childhood
disintegrative disorder, Aspergers disorder, pervasive
developmental disorder-not otherwise specified). Instead,
children meeting the criteria will be given a diagnosis of autism
spectrum disorder with varying degrees of severity.
Omits criterion related to the development of spoken language.
Specific Learning Disorder
Combines diagnoses of reading disorder, disorder of written
expression, mathematics disorders, and learning disorder not
otherwise specified.
Recognizes the need to use a variety of culturally and
linguistically appropriate assessment tools and strategies and
does not require use of a standardized measure.
Does not include oral language.
No reference to modalities of language

Changes in the DSM-5 file as of may 13

o Asperger Syndrome and PDD-NOS no longer are diagnostic labels
o Aspergs are now called Social Communication Disorder
o Presence of ritualistic/repetitive behaviours and interests will be
deciding factor in diagnosis of ASD
o Rett Syndrome eliminated (due to genetic test now being available)
o Childhood Disintegrative Disorder falls under Autism Spectrum
Disorder (as age of possible regression will be raised)

Aspergers Syndrome : neurological (in the brain, they look normally)

(communications social interactions and imagination is hard, hard to
imagibe emotion )
o Qualitative impairment in social interaction
Marked impairment in multiple nonverbal behaviours e.g. eye
contact, facial expression, body postures, etc.
Failure to develop peer relationships with other people
o Lack of social or emotional reciprocity (give to get back )
o Restricted, repetitive behaviours and sensory concerns(severity must
be specified)
o Symptoms occur during early development (but may only become
apparent as social demands increase)

o Normal IQ
o Often have normal to advanced language form and content (not
use/sociopragmatics)
o Specialized interests
o Catatonic- movement is hard , sometimes stiffness,
o Onset in early development but may become apparent only when
social demands increase

Speech sound disorders (not structural e.g. cleft palate, due to hearing
loss, selective mutism or dysarthria)
o Language disorders (receptive, expressive, mixed
o ADHD
o Intellectual disability
o Fluency disorders
o Social phobia
o 3 or 4:1 boys to girls, Dramatic increase in diagnosis in last ten years
o Usually associated (co-morbidity) ADHD , ADD, or anxiety .
Potential causes
o Genetic male 3X more than female, pre-puberty Associated with
serotonin, oxytocin production
o Neurological component,
Abnormal regulation of brain growth in autism results in early
overgrowth followed by abnormally slow growth
Overgrowth of white matter compared to grey matter with
differences in connectivity between the hemispheres and
cortical areas within each hemisphere
Damage to the prefrontal cortex, limbic regions and brainstem
Cerebellar deficits (loss of neurons early in development)
Increased cell density (nerve cells not pruned back as happens
in typical brain development)
Excess dopamine
Abnormal connectivity between brain cells responsible for
imitation, facial expression and sensory processing
Atypical development of mirror neurons
Evidence of autoimmune processes affecting brain development
o course of development S
seizures
Difficult delivery
Delayed breathing
o environmental influence : prenatal or pesticides, antdepresent, or
chemicals, age of mother, high stress, older father Testosterone,
Alcohol, Infections e.g. Rubella, CMV, environmental pollution
start with moter difference
o