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Autistic Disorder
Autism is a developmental disorder that typically appears during the first three years of life and may be the result of a neurological disorder that affects the brain. Autism is classified by the American Psychiatric Association as a Pervasive Development Disorder (APA, 1994). It is defined by symptoms that appear before the age of three which reflect delayed or abnormal development in Language, Social Skills and Behavioral Repertoire. Autistic disorder symptoms manifest themselves as follows: The person fulfills a total of at least 6 criteria from the following 3 lists, distributed as indicated: Impaired social interaction (at least 2): Markedly deficient regulation of social interaction by using multiple non-verbal behaviors such as eye contact, facial expression, body posture and gestures. Lack of peer relationships that are appropriate to the developmental level. Doesn't seek to share achievements, interests or pleasure with others. Lacks social or emotional reciprocity. Impaired communication (at least 1): Delayed or absent development of spoken language for which the patient doesn't try to compensate with gestures. In person's who can speak, inadequate attempts to begin or sustain a conversation. Language that is repetitive, stereotyped or idiosyncratic. Appropriate to developmental stage, absence of social imitative play or spontaneous, make-believe play. Activities, behavior and interests that are repetitive, restricted and stereotyped (at least 1 of): Preoccupation with abnormal (in focus or intensity) interests that are restricted and stereotyped (such as spinning things). Rigidly sticks to routines or rituals that don't appear to have a function. Has stereotyped, repetitive motor mannerisms, such as hand flapping. Persistently preoccupied with parts of objects. Before age three, the person shows delayed or abnormal functioning in 1 or more of these areas: Social interaction. Language used in social communication. Imaginative or symbolic play. These symptoms are not better explained by Childhood Disintegrative Disorder or Rett's Disorder. Associated Features: Learning Problem Dysarthria or Involuntary Movement Hypoactivity Psychosis Odd or Eccentric or Suspicious Personality Anxious or Fearful or Dependent Personality Differential Diagnosis: Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Rett's Disorder; Childhood Disintegrative Disorder; Asperger's Disorder; Schizophrenia; Selective Mutism; Expressive Language Disorder; Mixed Receptive-Expressive Language Disorder; Mental Retardation; Stereotypic Movement Habit Disorder. Cause: The exact cause or causes of autism is/are still not known but research shows that genetic factors are important. It is also evident from research that autism is associated with a variety of conditions affecting brain development which occur before, during, or very soon after birth.
Developmental Coordination Disorder
Developmental Coordination Disorders (DCD) also know as developmental dyspraxia, are characterized as being "clumsy" or "awkward". Children with developmental coordination disorder have difficulties with motor coordination as compared to other children of the same age. These children have difficulties in mastering gross motor coordination tasks such as crawling, walking, jumping, standing on one foot, catching a ball and fine coordination task such as tying shoelaces. Some children also demonstrate expressive speech problems. The essential feature of Developmental Coordination Disorder is a marked impairment in the development of motor coordination. Performance in daily activities that require motor coordination is substantially below that expected given the person's chronological age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (e.g., walking, crawling, sitting), dropping things, "clumsiness," poor performance in sports, or poor handwriting. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living. The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet criteria for a Pervasive Developmental Disorder. If Mental Retardation is present, the motor difficulties are in excess of those usually associated with it. Group of Disorders which include: Dyspraxia Aspeger's Disorder Phonological Disorder Expressive Language Disorder Mixed Receptive-Expressive Language Disorder Associated Features: Problems commonly associated with Developmental Coordination Disorder include delays in other non-motor milestones. Associated disorders may include Phonological Disorder, Expressive Language Disorder, and Mixed Receptive-Expressive Language Disorder. Prevalence of Developmental Coordination Disorder has been estimated to be as high as 6% for children in the age range of 5 -11 years. Course Recognition of Developmental Coordination Disorder usually occurs when the child first attempts such tasks as running, holding a knife and fork, buttoning clothes, or playing ball games. The course is variable. In some cases, lack of coordination continues through adolescence and adulthood. Differential Diagnosis: Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Mental Retardation. Attention Deficit Hyperactivity Disorder (ADHD). Traumatic Brain Injury. Mild Cerebral Palsy. Congenital Chorea. Decreased Visual Acuity. Orthopedic Abnormality. Cause: The etiology is unknown but several lines of evidence suggest that it arises as a result of some form of central nervous system pathology.
Rett's Disorder
An inherited disorder that affects only females, the syndrome causes mental retardation and developmental degeneration. The following suggest normal early development: Prenatal and perinatal development appear normal. Psychomotor development appears normal at least until month 6 old. Head circumference is normal at birth. After this period of normal development, all of: Head growth slows abnormally between 5 and 48 months. Between 5 and 30 months, the child loses already acquired purposeful hand movements and develops stereotyped hand movements such as handwashing or handwringing. Early in the course, the child loses interest in the social environment. However, social interaction often develops later. Gait or movements of trunk are poorly coordinated. Severe psychomotor retardation and impairment of expressive and receptive language. Associated Features: Rett's Disorder is typically associated with Severe or Profound Mental Retardation. Differential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Autistic Disorder. Childhood Disintegrative Disorder. Cause: Rett's Syndrome a neurological disorder. During development, a multitude of genes are "expressed" (translated into proteins) in different tissues of the body at different times and at different levels. The gene for Rett's Syndrome, MECP2, encodes a protein (MeCP2) involved in one of the many biochemical switches needed to control the complex expression patterns of other genes by telling them when to turn off. In Rett's Syndrome this malfunction means that certain genes are turned "on" or "off" inappropriately.
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