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P e r v a s iv e P e r v a s iv e D e v e lo p m e n t aD e v e lo p m e n t a

l D is o r d e r sl D is o r d e r sClinical Science IIIClinical Science III

Karen R. Voogt, DPTKaren R. Voogt, DPTFall 2011Fall 2011

P e r v a s iv e P e r v a s iv e D e v e lo p m e n t a l D e v e lo p m e n t a l

D is o r d e r sD is o r d e r s Class of disordersClass of disorders Common Characteristics: Impairments in Common Characteristics: Impairments in

social interaction, imaginative activity, social interaction, imaginative activity, verbal and nonverbal communication skills verbal and nonverbal communication skills and a limited number of interests and and a limited number of interests and activities that tend to be repetitive.activities that tend to be repetitive.

P D DP D D DSM-IV-TR 2000DSM-IV-TR 2000 Five disorders:Five disorders:

Autistic Disorder Autistic Disorder Rett’s DisorderRett’s Disorder Childhood Disintegrative DisorderChildhood Disintegrative Disorder Asperger’s DisorderAsperger’s Disorder PDDNOS (not otherwise specified)PDDNOS (not otherwise specified)

P D DP D D In general, these children have difficulty in In general, these children have difficulty in

talking, playing with other children, talking, playing with other children, relating to others, including the family.relating to others, including the family.

Severe and pervasive impairment in Severe and pervasive impairment in several areas of development:several areas of development:

Social interaction skillsSocial interaction skills Communication skillsCommunication skills The presence of stereotyped behavior, The presence of stereotyped behavior,

interests and activitiesinterests and activities

A u t is t ic A u t is t ic D is o r d e rD is o r d e r 4 times more 4 times more

common in boys common in boys than girls.than girls.

Moderate to Moderate to severe range of severe range of communication, communication, socialization, socialization, and behavior and behavior problems. Many problems. Many are mentally are mentally retarded. retarded.

R e t t ’ s R e t t ’ s D is o r d e rD is o r d e r

Primarily in females. Primarily in females. Development proceeds apparently normal Development proceeds apparently normal

from first 6 to 18 months. from first 6 to 18 months. Noted change in behavior, regression or Noted change in behavior, regression or

loss of abilities (walking, moving) loss of abilities (walking, moving) Followed by speech, reasoning and hand Followed by speech, reasoning and hand use.use.

Repetitive, meaningless gestures-hand Repetitive, meaningless gestures-hand wringing, washing.wringing, washing.

R e t t ’ s S y n d r o m eR e t t ’ s S y n d r o m e

C h i ld h o o d C h i ld h o o d D is in t e g r a t iv e D is in t e g r a t iv e

D is o r d e rD is o r d e r Extremely rare.Extremely rare. Clear regression in functioning-Clear regression in functioning-

mobility, bowel and bladder control, mobility, bowel and bladder control, social and language skills social and language skills F O L L O W IN GF O L L O W IN G at least 2 years of at least 2 years of N O R M A LN O R M A L development. development.

Onset of decline prior to age 10.Onset of decline prior to age 10.

A s p e r g e r ’ s A s p e r g e r ’ s D is o r d e rD is o r d e r

Lack of social skills, difficulty with social Lack of social skills, difficulty with social relationships, poor coordination, poor relationships, poor coordination, poor concentration, restricted range of interests concentration, restricted range of interests but normal or above normal intelligence, but normal or above normal intelligence, adequate language skills in vocabulary adequate language skills in vocabulary and grammar.and grammar.

P e r v a s iv e P e r v a s iv e D e v e lo p m e n t a l D e v e lo p m e n t a l

D is o r d e r N o t D is o r d e r N o t O t h e r w is e S p e c i f ie d O t h e r w is e S p e c i f ie d

P D D N O SP D D N O S Do not fully meet criteria of symptoms to Do not fully meet criteria of symptoms to diagnose other 4 specific types of PDD; diagnose other 4 specific types of PDD; and/or do not have the degree of and/or do not have the degree of impairment described in the other 4 impairment described in the other 4 disorders. disorders.

Not schizophrenia or avoidant personality Not schizophrenia or avoidant personality disorder.disorder.

D ia g n o s in g P D DD ia g n o s in g P D D Medical assessment (can include Medical assessment (can include

chromosome study, EEG, MRI)chromosome study, EEG, MRI) Interview with parents, teacher, childInterview with parents, teacher, child Behavior rating scalesBehavior rating scales Direct behavior observationsDirect behavior observations Psychological assessmentPsychological assessment Educational assessment Educational assessment Communication and occupational therapy Communication and occupational therapy

assessmentsassessments

Tr e a t m e n t o f Tr e a t m e n t o f P D DP D D

Behavioral treatment ABA-Applied Behavioral treatment ABA-Applied Behavioral AnalysisBehavioral Analysis

Appropriate educational settingAppropriate educational setting Facilitated communicationFacilitated communication Sensory integration therapySensory integration therapy Auditory integration therapyAuditory integration therapy Vitamin/nutrition therapyVitamin/nutrition therapy

S o u r c e : N IC H C Y S o u r c e : N IC H C Y N a t io n a l C e n t e r f o r N a t io n a l C e n t e r f o r

C h i ld r e n w it h C h i ld r e n w it h D is a b i l i t ie sD is a b i l i t ie s

Briefing paper 1998, updated Briefing paper 1998, updated 20052005

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