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PERVASIVE DEVELOPMENTAL DISORDERS DSM-IV 299.00 Autistic disorder 299.80 Rett’s disorder 299.80 Asperger’s disorder 299.10 Childhood disintegrative disorder 299.80 Pervasive developmental disorder NOS (including atypical autism) The category of pervasive developmental disorders is organized in terms of the qualitative degree of  impairment in social and communicative functioning. Autism comprises extremely varied manifestations  that encompass deficits in cognition, social awareness, communication, affective expression, and motor  control. Because of the continuity of the symptomatology, the term  autistic spectrum disorder (ASD)  is  recognized in the current literature. ASD may occur with or without a neurological substrate, as in the case  of  idiopathic autism.  Age of onset and whether the child developed normally from birth through the first 5  years of life are factors that help differentiate between Rett’s disorder or childhood disintegrative disorder.  The intractable anxiety, mood liability, perseveration of thought and behavior, and odd social presentation  of these children  may mimic other psychiatric disorders,  including anxiety disorders,  schizophrenia,  obsessive-compulsive disorder, and the manic phase of bipolar affective disorder. When neurological  impairment coexists with the diagnosis, the individual is often low functioning. ETIOLOGICAL THEORIES Psychodynamics Autistic children are fixed in the presymbiotic stage of development. These children do not achieve a  symbiotic attachment, nor do they differentiate self from mother. Psychotic-like behaviors are based on  abnormal primary development rather than on a regression from a higher level of functioning. Children  with autism lack the intuitive skills to engage in and sustain meaningful social contact, particularly in new  situations, and they have a marked inability to generalize. Biological Neurological evaluation, including family history, electroencephalogram (EEG), magnetic resonance  imaging (MRI), karyotyping, and positron emission tomography (PET), reveals strong evidence of a  familial   pattern   of  organic   neurological   impairment   and  psychiatric   illness.  Several   research   studies  estimate the coexistence of neuropsychiatric illness in extended family members to be as high as 50% in  individuals with ASD. Research to confirm brain anatomical abnormalities suggests that neurons in the amygdala (the area  responsible   for   processing   emotions   and   behavior)   and   the   hippocampus   (involved   in   learning   and  memory) are smaller, more densely packed in some areas, and have shorter, less-developed branches than  normal. Low blood circulation in some parts of the cerebral cortex during certain intellectual functions and 
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  • Spring '10
  • toole
  • eye contact, Pervasive developmental disorder, childhood disintegrative disorder, Outcomes/Evaluation Criteria— Client, organic brain dysfunction

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