Autism Spectrum Disorder (ASD) is a pervasive developmental disorder characterized by a combination of mild to severe deficits in social interaction and communication, and by the presence of restricted and repetitive patterns of behaviour, interests, and activities.

ASD includes:

• Autistic Disorder (Autism)

• Asperger’s Disorder

• PDD-NOS (Pervasive Developmental Disorder – Not Otherwise Specified)

• Childhood Disintegrative Disorder

Some Facts about ASD

• It was first described by Leo Kanner in the 1940’s

• It is more common in boys (4 boys for every 1 girl)

• The cause(s) of ASD are still not known

• There is no cure but there are treatment options

• No two children with an ASD are the same

• ASD is an umbrella disorder – it ranges from mild to severe

• It can co-exist with other diagnoses

How Common is ASD?

 In 1976, it was estimated at 4 to 5 in 10,000 births.  Now, it is estimated to effect 1 in 150 people.  This translates into approximately 326 children and adults living with an Autism Spectrum Disorder in Northumberland County.

Criteria from DSM-IV --- American Psychiatric Association

299.00 Autistic Disorder

(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 impairment in the use of                              multiple  nonverbal behaviors such                          as eye-to-eye gaze,  facial expression,                     body postures, 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)

       (d)  Lack of social or emotional reciprocity

 2.   Qualitative impairments in communication             as manifested by at least one of the                         following:

       (a)   Delay in, or total lack of, the development                of spoken language (not accompanied                    by an attempt to compensate through                    alternative modes of communication                        such as gestures 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 behavior, interests, and activities,         as manifested by at least one of the                        following:

       (a)   Encompassing preoccupation with one                or more stereotyped 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)   Persistent 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, or

        (3)   Symbolic or imaginative play.

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

Criteria from DSM-IV --- American Psychiatric Association

299.10 Childhood Disintegrative Disorder

(A)     Apparently normal development for at least           the first 2 years after birth as manifested by           the presence of age-appropriate verbal and           nonverbal communication, social                             relationships,  play, and adaptive behavior.

(B)      Clinically significant loss of previously                    acquired skills (before age 10 years) in at            least two of the following areas:

1. Expressive or receptive language
2. Social skills or adaptive behavior
3. Bowel or bladder control
4. Play
5. Motor skills

(C)      Abnormalities of functioning in at least two            of the following areas:

1. Qualitative impairment in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity)
2. Qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play)
3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms

(D)      The disturbance is not better accounted                 for by another specific Pervasive                             Developmental Disorder or by                                 Schizophrenia.

Criteria from DSM-IV --- American Psychiatric Association

299.80 Asperger's Disorder

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

1. Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
2. Failure to develop peer relationships appropriate to developmental level
3. 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)
4. Lack of social or emotional reciprocity.

(B)      Restricted repetitive and stereotyped                        patterns of behavior, interests, and                            activities, as manifested by at least one of            the following:

1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. Apparently inflexible adherence to specific, non-functional routines or rituals
3. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
4. Persistent preoccupation with parts of objects

(C)     The disturbance causes clinically                            significant impairment in social,                                occupational, or other important areas of                functioning.

(D)     There is no clinically significant general                delay in language (e.g., single words used            by age 2 years, communicative phrases                used by age 3 years)

(E)     There is no clinically significant delay in                    cognitive development or in the                                development of age-appropriate self-help            skills, adaptive behavior (other than in                    social interaction), and curiosity about the            environment in childhood.

(F)      Criteria are not met for another specific  Pervasive  Developmental  Disorder or  Schizophrenia  

Criteria from DSM-IV --- American Psychiatric Association

299.80 Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism)

This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes atypical autism --- presentations that do not meet the criteria for Autistic Disorder because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

Criteria from DSM-IV --- American Psychiatric Association

299.80 Rett's Disorder

(A)      All of the following:

1. Apparently normal prenatal and perinatal development
2. Apparently normal psychomotor development through the first 5 months after birth
3. Normal head circumference at birth

(B)      Onset of all of the following after the period             of normal development:

1. Deceleration of head growth between ages 5 and 48 months
2. Loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (e.g., hand-wringing or hand washing)
3. Loss of social engagement early in the course (although often social interaction develops later)
4. Appearance of poorly coordinated gait or trunk movements
5. Severely impaired expressive and receptive language development with severe psychomotor retardation