Pervasive Developmental Disorders

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) defines Pervasive Developmental Disorders as severe and pervasive impairment in several areas of development including reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests, and activities.

The DSM-IV-TR goes into further detail by describing in further detail four (4) different types of Pervasive Developmental Disorders: Autistic Disorder; Rett’s Disorder, Childhood Disintegrative Disorder, and Asperger’s Disorder. The following paragraphs will attempt to briefly describe each of these disorders. 

Autistic Disorder

Autistic Disorder is characterized by the presence of very abnormal or impaired development in social interaction and communication, and a very restricted repertoire of activity and interests.

Symptoms of autism vary greatly. There may be impairment in the use of nonverbal behaviors such as eye-to-eye contact. There may also be a failure to develop peer relationships appropriate to the developmental level of the child. The child may not actively participate in group games or activities; instead, preferring to be alone. The child may be completely oblivious to other children, including siblings, and often seems to have no concept of others needs.

Communication is affected both verbally and nonverbally. There may either be a delay in the development of speech, or there may be a complete lack in the development of speech. When speech does develop, it is often characterized by monotone, inappropriate context or question-like rises as the end of statements. Children with autism, who do speak, are often unable to initiate or sustain a conversation with others. They may also exhibit a stereotyped repetitive use of language. Language comprehension in the autistic child is often delayed and the child may only be able to understand very simple questions and directions.

The patterns of behavior, interests, and activities of the autistic child are extremely restrictive, repetitive, and stereotyped. Often times, there is also an inflexible adherence to very specific and nonfunctional routines or rituals such as following the exact same route to school every day. The autistic child may also display a preoccupation with the parts of objects and be fascinated with buttons or parts of the body, for example. Often times a single interest manifests itself; for instance, an obsession with dates, phone numbers, or radio station call letters. The autistic child may also exhibit distress in times of change, whether big or small; for instance, the rearrangement of furniture or the use of a different set of utensils at dinnertime may result in a catastrophic reaction. 

Rett’s Disorder

Rett’s Disorder is the development of multiple specific deficits following a period of normal development after birth. A child with Rett’s Disorder will begin to lose previously acquired hand skills from between 5-30 months of age. Subsequently, a characteristic hand movements resembling hand wringing or hand washing develop. The child may also lose interest in his social environment. There may also be severe impairment in the expressive and receptive language development of the child. 

Childhood Disintegrative Disorder

Childhood Disintegrative Disorder is a regression in multiple areas of a child’s functioning following at least two years of seemingly normal development in areas such as verbal and nonverbal communication, social relationships, play, and adaptive behavior. Childhood Disintegrative Disorder is seen between the ages of 2-10. Children experiencing this disorder often display social and communication deficits and behavioral features that are associated with autism. 

Asperger’s Disorder

Asperger’s Disorder involves severe and sustained impairment in social interaction along with parallel development of restricted and repetitive patterns of behavior, interests, and activities; the development of these interests and activities are oftentimes pursued with incredible intensity and with other activities being forgotten about. These disturbances cause significant impairment in social and occupational functioning. For instance, the child may have impairment in the use of nonverbal behaviors used to help with social interaction such as eye-to-eye contact, facial expressions, posture, etc. Unlike the autistic child who is indifferent to social and emotional cues, the child with Asperger’s Disorder often displays eccentric and one-sided approaches to social interaction.

Unlike with autism, children with Asperger’s Disorder may not experience any significant delays in communication or language; however, more subtle aspects of communication skills may be affected, such as the give-and-take in conversations, preoccupation with certain topics, and talkativeness. Many of the difficulties in communication may be a result of the failure to appreciate and utilize nonverbal cues or due to a limited capacity for self-monitoring.

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