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Unformatted text preview: PERVASIVE DEVELOPMENTAL DISORDERS DSM-IV 299.00 Autistic disorder 299.80 Retts disorder 299.80 Aspergers 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 Retts 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 normal....
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.
- Spring '10