Pervasive developmental disorder are characterized by severe and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests, and activities.

1. AUTISM SPECTRUM DISORDER

2. Autism spectrum disorder/pervasive
developmental disorder
 PDD are characterized by severe and pervasive
impairment in several areas of development:
reciprocal social interaction skills, communication
skills, or the presence of stereotyped behavior,
interests, and activities.
 Impairment noticeable at early stage of life.
 E.g. Austistic Disorder, Asperger’s disorder, Rett’s
disorder, Childhood disintegrative disorder, PDD-
NOS

3. Rett's Disorder:
 Diagnosed only in females.
 Has characteristic pattern of:
• head growth deceleration
• loss of previously acquired purposeful
hand skills
• The appearance of poorly coordinated
gait or trunk movements.
• May
• exhibit difficulties in social interaction
but these tend to be more transient
than those observed in Autistic
Disorder

4.  Childhood Disintegrative
Disorder:
 Has a distinctive pattern of
developmental regression
following at least 2 years of
normal development while
in Autistic Disorder,
developmental
abnormalities are usually
noted within the first year of
life.
 When information on early
development is unavailable,
the diagnosis of Autistic
Disorder should be made.
 Asperger's Disorder :
 can be distinguished from
Autistic Disorder by the lack
of delay in language
development.
 Asperger's Disorder is not
diagnosed if criteria are met
for Autistic Disorder.

5. Epidemiology
 Occurs in 2-5 cases per 10,000 individuals.
 4-5 times more common in males: females
disorder are more likely to have more severe
mental retardation
 Onset before age of 3

6. Etiology
 Familial/Genetic factors:
 High rate among siblings of individuals with the
disorder.
 Higher rate in monozygotic than dizygotic twins.
 Neurobiologic factors:
 (EEG) abnormalities and seizure disorders are
observed in as many as 20 to 25% of individuals with
autism.

7. Behavioral Characteristics
• At early age, many lack a social smile, Poor eye contact, Do not
acknowledge or differentiate the most important persons in their
lives ,Show extreme anxiety when their usual routine is
disrupted, Not react overtly to being left with a stranger.
• School age: deficit in ability to play with peers and to make
friends, Their social behavior is awkward and may be
inappropriate
• Difficulties in responding to another's interests, emotions, and
feelings, Experience sexual feelings, but their lack of social
competence and skills prevents many of them from developing
sexual relationships
Qualitative
impairment in
social
relationship
• Deficits in language development and difficulty using
language to communicate
•Language deviance and language delay , odd voice,
monotonous
•Language is superficially good,but too formal,stilted or
pedantic
•Awkward or odd posture and body language
Disturbances
of
Communicat
ion
and
Language

8. • much of expected spontaneous exploratory
play is absent.
• The activities and play of these children are
often rigid, repetitive, and monotonous
• Children often spin, bang, and line up objects
and may exhibit an attachment to a particular
inanimate object
• Resistant to transition and change; change is
often upsetting
Stereotyped
Behavior

9. DSM-IV TR criteria
A. A total six or more from (1), (2), and (3) with at least 2
from (1) and one each from (2) and (3)
1. Qualitative impairment in social interaction, as manifested by at
least 2 of following
1. Marked impairment in the use of multiple non-verbal
behaviors such as eye-to-eye gaze, facial expression, body
postures, and gestures to regulate social interaction
2. Failure to develop peer relationship appropriate to
developmental level
3. Lack of spontaneous seeking to share enjoyment, interests
or achievement with other people ( e.g.: by a lack of
showing,bringing, or pointing out subjects of interest)
4. Lack of social or emotional reciprocity

10. 2. Qualitative impairments in communication as
manifested by at least one of following :
a) Delay in, or total lack of, development of spoken language
(not accompanied by an attempt to compensate through
alternative modes of communication such as gesture or mime)
b) In individuals in adequate speech, marked impairment in
the ability to initiate or sustain a conversation with others
c) Stereotyped and repetitive use of language or idiosyncratic
language
d) Lack of varied, spontaneous make-believe play or social
imitative play appropriate to developmental level

11. 3. Restricted, repetitive and stereotyped
patterns of behaviour, interests, and
activities, as manifested by at least one of
following:
a) Encompassing preoccupation with one or more
streotyped and restricted patterns of interest
that is abnormal either in intensity or focus
b) Apparently inflexible adherence to specific,
non-functionals routine or rituals.
c) Stereotyped and repetitive motor mannerism
d) Persistent preoccupation with parts of objects

12. B. Delays or abnormal functioning in at least one of
following, with onset prior to age 3:
1. Social interaction
2. Language as used in social communication or
3. Symbol or imaginative play
C. The disturbance is not better accounted for by
Rett’s disorder or childhood disintegrative disorder

13. DSM V vs DSM IV
A single diagnosis (ASD) replaces the different
subdivision.
ASD diagnosis based on 2 areas (deficit in social
communication and fixated interests and repetitive
behaviour)
The restriction of onset age has also been loosened
from 3 years of age to "early developmental period”
New severity ranking.

16. TREATMENT: Psychosocial
 BEHAVIOURAL:
Applied Behavior Analysis (ABA)
 The goals of ABA are to shape and reinforce new behaviors, such as
learning, speaking, playing and reduce undesirable ones.
 ABA-based interventions include:
 Verbal Behavior—focuses on teaching language using a sequenced
curriculum that guides children from simple verbal behaviors (echoing) to more
functional communication skills
 Pivotal Response Training—aims at identifying pivotal skills, such as initiation
and self-management, that affect a broad range of behavioral responses. This
intervention incorporates parent and family education aimed at providing skills
that enable the child to function in inclusive settings.

17.  COMMUNICATION:
 The Picture Exchange Communication System (PECS)
 EDUCATIONAL:
 TEACCH (Treatment and Education of Autistic and
related Communication handicapped Children)
 Early Start Denver Model (ESDM)
 OTHER INTERVENTIONS:
 Developmental, Individual Difference, Relationship-
based(DIR)/Floortime Model
 Occupational therapy
 Speech Therapy

18. TREATMENT: BIOLOGY
Antipsychotic
medications
Antidepressant
medications
Stimulant
medications
These medicines may
help reduce
aggression, repetitive
behaviors,
hyperactivity, and
attention problems.
The only medications
approved by the FDA
to treat aspects of ASD
are the antipsychotics
risperidone
(Risperdal) and
aripripazole (Abilify).
Prescribed to reduce
repetitive behaviors,
control aggression and
anxiety in children
with ASD.
Example of drugs
include fluoxetine
(Prozac) or sertraline
(Zoloft)
Methylphenidate
(Ritalin) has been
shown to effectively
treat hyperactivity in
children with ASD.

19. THANK YOU