Pervasive developmental disorders

Definition

Pervasive developmental disorders are a group of conditions originating in childhood that involve serious impairment in several areas, including physical, behavioral, cognitive, social, and language development.

Description

Pervasive developmental disorders (PDDs) are thought to be genetically based, with no evidence linking them to environmental factors; their incidence in the general population is estimated at 1%. The most serious PDD is autism , a condition characterized by severely impaired social interaction, communication, and abstract thought, and often manifested by stereotyped and repetitive behavior patterns. Many children who are diagnosed with PDDs today would have been labeled psychotic or schizophrenic in the past.

The handbook used by mental health professionals to diagnose mental disorders such as PDDs is the Diagnostic and Statistical Manual of Mental Disorders . The 2000 edition of this manual (fourth edition, text revised) is known as the DSM-IV-TR. Published by the American Psychiatric Association, the DSM contains diagnostic criteria, research findings, and treatment information for mental disorders. It is the primary reference for mental health professionals in the United States.

Besides autism, the DSM lists several other conditions as PDDs:

Rett's disorder

Characterized by physical, mental, and social impairment, this syndrome appears between the ages of five months and four years in children whose development has been normal up to that point. Occurring only in girls, it involves impairment of coordination, repetitive movements, a slowing of head growth, and severe or profound mental retardation , as well as impaired social and communication skills.

Childhood disintegrative disorder

This disorder is marked by the deterioration of previously acquired physical, social, and communication skills after at least two years of normal development. More common in males than females, it first appears between the ages of two and 10 (usually at three or four years of age), and many of its symptoms resemble those of autism. Other names for this disorder are Heller's syndrome, dementia infantilis, and disintegrative psychosis . It sometimes appears in conjunction with a medical condition such as Schilder's disease, but usually no organic cause can be found.

Asperger's disorder

Children with this disorder have many of the same social and behavioral impairments as autism, except for difficulties with language. They lack normal tools of social interaction, such as the ability to meet someone else's gaze, use appropriate body language and gestures, or react to another person's thoughts and feelings. Behavioral impairments include the repetitive, stereo-typed motions and rigid adherence to routines that are characteristic of autism. Like childhood disintegrative disorder , Asperger's disorder is more common in males than females.

Prognosis

In general, the prognosis in each of these conditions is tied to the severity of the illness.

The prognosis for Asperger's syndrome is more hopeful than the others in this cluster. These children are likely to become functional, independent adults, but will always have problems with social relationships. They are also at greater risk for developing serious mental illness than the general population.

The prognosis for autistic disorder is not as good, although great strides have been made in recent years in its treatment. The higher the patient's intelligence quotient (IQ) and ability to communicate, the better the prognosis. However, many patients will always need some level of custodial care. In the past, most of these individuals were confined to institutions, but many are now able to live in group homes or supervised apartments. The prognosis for childhood disintegrative disorder is the least favorable. These children will require intensive and long-term care.

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth edition, text revised. Washington DC: American Psychiatric Association, 2000.

Volkmar, Fred R., ed. Autism and Pervasive Developmental Disorders. New York: Cambridge University Press, 1998.

Waltz, Mitzi, and Linda Lamb. Pervasive Developmental Disorders: Finding a Diagnosis & Getting Help. Cambridge: O'Reilly & Associates, Incorporated, 1999.

ORGANIZATIONS

Autism National Committee (AUTCOM). P.O. Box 6175, North Plymouth, MA 02362-6175. Web site: <http://www.autcom.org/> .

Autism Research Institute. 4182 Adams Avenue, San Diego, CA 92116. Telephone: (619) 281-7165. Web site: <http://www.autism.com/ari> .

New Jersey Center for Outreach and Services for the Autism Community (COSAC). 1450 Parkside Avenue Suite 22, Ewing, NJ 08638. Telephone: (609) 883-8100 or (800) 4-AUTISM (428-8476). Web site: <http://www.njcosac.org> .