The DSM-IV criteria for diagnosing autism, PDD-NOS, Asperger's Syndrome, Rett's Disorder, and Childhood Disintegrative Disorder are posted. These are the criteria that doctors use to determine autism and related disorders. More…
DSM-IV Criteria, Pervasive Developmental Disorders
299.00 Autistic Disorder
A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors, such as eye-to- eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity
(2) qualitative impairments in communication, as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level
(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex whole-body movements)
(d) persistent precoccupation with parts of objects
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.
C. The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.
299.80 Pervasive Developmental Disorder, Not Otherwise Specified
This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. For example, this category includes “atypical autism” –presentations that do not meet the criteria for autistic disorder because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these.
299.80 Asperger's Disorder
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to developmental level
(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
(4) lack of social or emotional reciprocity
B. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
(4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
F. Criteria are not met for another specific pervasive developmental disorder or schizophrenia.
299.80 Rett's Disorder
A. All of the following:
(1) apparently normal prenatal and perinatal development
(2) apparently normal psychomotor development through the first 5 months after birth
(3) normal head circumference at birth
B. Onset of all of the following after the period of normal development:
(1) deceleration of head growth between ages 5 and 48 months
(2) loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of stereotyped hand movements (i.e., hand-wringing or hand washing)
(3) loss of social engagement early in the course (although often social interaction develops later)
(4) appearance of poorly coordinated gait or trunk movements
(5) severely impaired expressive and receptive language development with severe psychomotor retardation
299.10 Childhood Disintegrative Disorder
A. Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal communication, social relationships, play, and adaptive behavior.
B. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
(1) expressive or receptive language
(2) social skills or adaptive behavior
(3) bowel or bladder control
(5) motor skills
C. Abnormalities of functioning in at least two of the following areas:
(1) qualitative impairement in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional reciprocity)
(2) qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play)
(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms
D. The disturbance is not better accounted for by another specific pervasive developmental disorder or by schizophrenia.
Diagnostic and Statistical Manual, 4th Edition, ©1994, American Psychiatric Association
This was posted today on MSN. I don't know the particulars about this case, but I think it certainly deserves a look. Chelation is a therapy that is quite experimental, and one of the reasons we didn't try it was because we didn't know what the long-term side effects would be on the other organs of the body versus the possible positives. However, I never imagined that it could cause cardiac arrest. See Story — Sandra Sinclair
One of the most difficult things for me along this journey is sifting through the mountain of information about autism.
I felt from the beginning that there was no place to pull it all together, to show which approaches were valid, which worked, how to do them, and how to customize them for our individual child. There also seems to be a lot of old and rigid ideas out there.That's why I started this website.
As a parent, I started by writing about what has worked for us. But I'm always looking for new ideas about what works for others as well. We can all learn from each other.
Take what you can from this site and the many other resources and sites out there, and use whatever parts are relevant to your child and your family. All of our children and families are different. Not the same approach works for every child or for every family.-
That being said, next on the rigid, old ideas. –Sandra Sinclair
One of the things that really helped us was to find out about special needs trusts. It's something that an estate planning attorney can help you with, and you don't have to be wealthy for it to greatly benefit your children. Often it results in tax savings, privacy, and ease of transition for the family, as well as possibly keeping your child from being disqualified for government benefits as a result of having inherited money, propery, etc from you in their name. Of course, I'm not an attorney, and this type of setup is not for everyone, but it's a good thing to investigate further with an estate planning attorney for your family to see if it would benefit. Suze Orman has something called Protection Portfolio, and more recently, has a will and trust-making kit. However, I'm not sure if the kit covers special needs trusts, tax savings trusts, or any other more specific trusts or not. Also SuzeOrman.com has a resource link to will and trust attorneys. — Sandra Sinclair
I think the idea of a “critical period” for learning and brain development is a silly, outdated notion, so I was very happy to see Dr Gutstein's quotable on the rdiconnect newsletter this week. In it, he said that he and most modern neurological researchers don't accept the idea of the 'critical period'. “We outright reject the myth that if certain abilities are not developed by a certain age it is too late. There is no evidence in autism to support this.” You can read further on www.rdiconnect.com.
Isn't that amazing? It's incredible to me how these ideas get started and just spread around, like urban myths. I don't know who said we had reached our brain potential by the age of five, but boy, that's an idea whose time came and went about 30 years ago. Just let it go, please!
By the way, how could a stroke victim possibly rebuild a new brain pathway if this was the case? We all know that stroke victims can rebuild new brain pathways through therapy and special exercises well into old age. (aka over the age of five). -Sandra Sinclair