Autistic Disorder
Bridging The Gap ...
A pervasive developmental disorder defined by the presence of abnormal and/or impaired development that is
manifest before the age of 3 years, and by the characteristic type of abnormal functioning in all three areas of social
interaction, communication, and restricted, repetitive behavior. The disorder occurs in boys three to four times more
often that in girls.

Diagnostic Guidelines
Usually there is no prior of unequivocally normal development but, if there is, abnormalities become apparent before
the age of 3 years. There are always qualitative impairments in reciprocal social interaction. These take the form of an
inadequate appreciation of socio-emotional cues, as shown by a lack of responses of other people's emotion's
and/or a lack of modulation of behavior according to social context; poor use of social signals and a weak integration
of social, emotional, and commutative behaviors; and, especially, a lack of socio-emotional reciprocity. Similar,
qualitative impairments in communications are universal. These take the form of a lack of social usage of whatever
language skills are present; impairment in make-believe and social imitative play; poor synchrony and lack of
reciprocity in conversational interchange; lack of emotional response to other people's verbal and nonverbal
overtures; impaired use of variations in cadence or emphasis to reflect communicative modulation; and a similar lack
of accompanying gesture to provide emphasis or aid meaning in spoken communication.

The condition is also characterized by restricted, repetitive, and stereotyped patterns of behavior, interests, and
activities. These take the form of a tendency to impose regidity and routine on a wide range of aspects of day-to-day
functioning; this applies to novel activities as well as to familiar habits and play patterns. In early childhood
particularly, there may be specific attachment to usual, typically non-soft objects. The children may insist on the
performance of particular routines in rituals of nonfunctional character; there may be stereotyped preoccupations with
interests such as dates, routes or timetable; often there are motor stereotypes; a specific interest in nonfunctional
elements of objects (such as their smell or feel) is common; and there may be a resistance to changes in routine or
in details of the personal environment (such as the movement of ornaments or furniture in the family home).

In addition to these specific diagnostic features, it is frequent for children with autism to show a range of other
nonspecific problems such as fear/phobias, sleeping and eating disturbances, temper tantrums, and aggression.
Self-injury (e.g. by wrist-biting) is fairly common, especially when there is associated severe mental retardation. Most
individuals with autism lack spontaneity, initiative, and creativity in the organization of their leisure time and have
difficulty applying conceptualizations in decision-making in work (even when the tasks themselves are well within
their capacity). The specific manifestation of deficits characteristic of autism change as the children grow older, but
the deficits continue into and through adult life with a broadly similar pattern of problems in socialization,
communication, and interest pattern. Developmental abnormalities must have been present in the first 3 years for the
diagnosis to be made, but the syndrome can be diagnosed in all are groups.

All levels of IQ can occur in association with autism, but there is significant mental retardation in some three-quarters
of cases.

Includes:

Apart from the other varieties of pervasive developmental disorder it is important to consider: specific developmental
disorder of receptive language with secondary socio-emotional problems; reactive attachment disorder or
disinherited attachment disorder; mental retardation with some associated emotional/behavioral disorder;
schizophrenia of unusually early onset; and Rett's syndrome.