The fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) lists Asperger’s Syndrome and Autism in the category of Pervasive Developmental Disorders (PDDs), or Autism Spectrum Disorders (ASDs). All of the disorders in the PDD category are characterized by significant developmental delays in social interaction, sensory processing, balance and movement, and imagination, play, and behavior. Asperger's syndrome is often regarded as the mildest form in this category, with children demonstrating higher levels of language and intellectual development and more interest in social/peer interaction and activities, although they still lack the necessary skills for success. Early signs of Pervasive Developmental Disorders can include: Language: o Early language development followed by a sudden loss or lack of progress in the previously acquired skill o Inability to understand or utilize emotional expression in verbal or non-verbal communication o Difficulty initiating, maintaining, and ending conversations. o Inability to interpret or use subtle differences in speech tone, pitch, and accent that can alter the meaning of speech (sarcasm, irony, humor, emotion, etc.,) o Obsessive use of vocabulary and context well advanced for age. o Expression of internal thoughts through ‘invisible friends’ o Echoing of their own or other’s speech, usually in whispers o Inability to translate thought into writing Social Skills: o Actively avoiding eye contact or interaction with both familiar and unfamiliar people o Obsessive use of peripheral vision to view objects o Exaggerated startle or panic response to both expected and unexpected social interaction o Use of social interaction only to accomplish a task or as a means to an end. o Inability to understand or engage in interactive communication or play (sharing objects or take turns) o Unusual attachment or obsession with certain objects or topics o Unusual or inappropriate response to distress in other children o Inability to comprehend multiple points of view. o Intellectually aware of social rules for appropriate interaction but unable to implement those rules o Inability to understand or respect personal space Sensory Processing:
o Actively avoiding and resisting imposed physical contact o Unusual preference or aversion for smells / tastes / textures o Unusually stiff or awkward movement patterns with rigid protection stances o Unusual walking preferences involving specific areas of the foot (balancing or ‘perching’ on toes, sides of feet, or heels) o Significant anxiety with uncontrolled physical movement or placement of their head, especially inclined (upward/downward) or inverted (upside-down) o Significantly delayed motor development, especially for balance and fine motor tasks Imagination/Play: o Unusual preference for highly ritualized, solitary, repetitive activities o Unusual attachment to inanimate, often non-toy objects o Unusual dependence on highly predictable, precise schedules and ordered routines for all activities of daily living. o Unusual obsession with patterns and arrangements of objects o Unable to understand or engage in abstract or imaginative play Behavior: o Unusual repetitive actions (hand flapping, spinning, bouncing) increasing in speed and intensity in response to internal stress or external/environmental activity level o Significant distress to changes in preferred orders, routines, patterns or arrangements o Significant distress to certain sounds, smells, tastes, &/or textures o Unusual obsession with mirror reflection of facial expressions or postures. o Unusual obsession highly predictable, structured, concrete, often non-childhood interests More age specific symptoms of Pervasive Developmental Disorders can be found at www.autism-help.org: INFANT & TODDLER SYMPTOMS o Overly shy or ‘frightened’ with familiar people (avoids eye contact, runs away, hides) o Avoids, rarely initiates, and seldom returns imposed physical contact (hugs, kisses, etc.,) o Seldom seeks or indifferent to attention from significant family members unless as a means to an end. o Prefers solitary, passive activity o Over- or under-reactive response to certain objects and activities. o Limited gesturing or other non verbal communication of wants or needs o Limited or lack of interest in other children o Increasing repetitive behaviors such (hand flapping, toe tapping, bouncing) especially in response to stress o Early language development followed by a loss or lack of progress in previously acquired skill o Limited emotion or inflection in speech o Unable to share objects or take turns when talking o Unusual or awkward movement patterns PRESCHOOL SYMPTOMS o Unusual walking preferences (toe-walking, walking on sides of feet, heel-walking) o Unusual anxiety with ascending or descending stairs (unable to talk while climbing stairs, always leading with the same foot, clinging to safety rail with both hands) o Unusual reaction to the distress of other children o Unable to understand or engage in pretend play or games o Unusual attachment or obsession with certain objects, toys and games o Unable to function without specific order of routine and/or arrangement of objects o Over reactive to changes in said orders, routines or arrangements o Repetitive movements begin to include entire body (rocking, spinning) instead of just specific muscle groups (hand flapping, head shaking) o Over-reactive response to sounds that don't disturb other children o Hyper-sensitivity to imposed tactile (touch/clothing fabric/texture), olfactory (smell) and gustatory (taste/texture/temperature) input. o Unable to correctly read or use body language and other non-verbal communication o Difficulty starting, maintaining, and ending conversations. o Unable to comprehend multiple points of view. o Unable to correctly interpret or use subtle differences in speech tone, pitch, and accent that can alter the meaning of speech (sarcasm, irony, humor, emotion, etc.,) o Use of vocabulary and context well advanced for age. o Tendency to either avoid eye contact or openly stare at others. o Unable to understand or respect personal space o Unusual facial expressions or postures. o Tendency for compulsive behaviors o Preoccupation with amassing a great deal of knowledge on limited, usually non-childhood interests o Insists on only speaking about favorite subjects o Constantly expresses internal thoughts in different voices, often as ‘invisible friends’ o Echoes own speech, usually in whispers o Significantly delayed motor development, especially for balance and fine motor tasks o Unable to translate thought into writing o Intellectually aware of social rules for appropriate interaction but unable implement those rules, especially in reciprocal interaction o Inappropriate emotional response due to inability to interpret emotional climate |