Autistic Disorder - Diagnosis

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Diagnosis

Symptoms according to DSM-IV

A. A Total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3).

(1) Qualitative impairment in social interaction,
as manifested by at least two of the following:

a) marked impairments in the use of multiple
nonverbal behaviors such as eye-to-eye gaze,
facial expressiions, body posture, and gestures
to regulate social interaction

b) failure to develop peer relationships
appropriate to developmental level

c) a lack of spontaneous seeking to share
enjoyment, interests, or achievements with other
people (e.g., by a lack of showing, bringing, or
pointing out objects of interest to other people)

d) lack of social or emotional reciprocity (note:
in the description, it gives the following as
examples: not actively participation in simple
social play or games, preferring solitary
activities, or involving others in activities
only as tools or "mechanical" aids)

(2) qualitative impairments in communication as
manifested by at least one of the following:

a) delay in, or lack of, the development of spoken
language (not accompanied by an attempt to
compensate through alternative modes of
communication such as gesture or mime)

b) in individuals with 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

(3) restricted repetitive and stereotyped patterns of
of behavior, interests and activities, as manifested
by at least two of the following:

a) encompassing preoccupation with one or more
stereotyped and restricted patterns of interest
that is abnormal either in intensity or focus

b) apparently inflexible adherence to specific,
nonfunctional routines or rituals

c) stereotyped and repetitive motor mannerisms
(e.g. hand or finger flapping or twisting, or
complex whole-body movements)

d) persistnent preoccupation with parts of
objects

B. Delays or abnormal functioning in at least one of
the following areas, with onset prior to age 3 years:

(1) social interaction

(2) language as used in social communication

(3) symbolic or imaginative play

C. The disturbance is not better accounted for by Rett's
Disorder or Childhood Disintegrative Disorder

The Triad of impairment by Wing and Gold 1979:

(Mesibov, Adams, Klinger, 1997)

1)reciprocal social interaction
2)verbal and nonverbal communication
3)a restricted repertoire of activities and interests

Symptoms

(Koegel, Rincover, Egel, 1982)

1. Autistic Children Exibit a profound failure to relate to other people, which is often apparent from birth
   
   
2. Autistic Children Commonly show various levels of impaired or delayed language aquisition and comprehension
   
   
3. Many Children Show apparent sensory disfuncion, as if they do not see or hear some environmental events
   
   
4. Many Autistic Children show inappropriate and/or flat affect
   
   
5. Typically, Autistic Children will occupy themselves for hours in stereotyped, repetative, self stimulatory behaviors, which serve no apparent purpose other than providing the child with sensory input
   
   
6. Autistic Children often fail to develope normal, appropriate play
   
   
7. Finally, Autistic Children commonly show obsessive, ritualistic behaviors which have been characterized as a profound resistence to change in the environment or normal routines
   

Bizarre Behavior Patterns in Children with Autism

(Turkington, 1999)

- screaming fits
- rhythmic rocking
- arm flapping
- finger twiddling
- crying without tears
- may play with their own saliva, feces, or urine
- may be self-destructive

• biting their own hands
  
• gouging at their eyes
  
• pulling their hair
  
• banging their head
  

A child with autism may ignore objects or become obsessed with them, continually watching the object or the movement of his fingers over it. He may react to sounds by banging his head or flapping fingers. High functioning adults who have written books about their childhood experiences report that sounds were often excruciatingly painful to them, forcing them to withdraw from their environment or try to cope by withdrawing into their own world of sensation and movement (Turkington, 1999). A researcher by the name of Yewchuck commented that "There minds take off on journeys that are beyond their control" (Cash, 1999).

A Child with Autism may not speak at all; if he does, it is often in single words. He may endlessly repeat words or phrases that are addressed to hime and may reverse pronouns ("You go sleep" instead of "I want to go to sleep") (Turkington,, 1999).

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History
Etiology
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References

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Send E-Mail to: Julie.Whiting@houghton.edu

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