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De Guzman, Mary Joyce

Downs Syndrome
Mental retardation
developmental
retardation

1800s
Dr. John Langdon Down

De Guzman, Mary Joyce


autos

Used autism to
describe a
symptom of
schizophrenia

Eugen Bleuler 1900s


De Guzman, Mary Joyce
trouble
generator
Eugene Minkowski

Belief that autism symptoms


are caused by diet
Biochemical treatments, diet
supplements & restrictions
1920s
De Guzman, Mary Joyce
Electroconvulsive therapy was
used
Antisocial & self-constructive
behavior
1930s
De Guzman, Mary Joyce
Emotional and social
Leo Kanner issues
Early Infantile Autism
Aspergers
Syndrome

Hans Asperger
1940s
De Guzman, Mary Joyce
Refrigerator Mother
Theory
Autism was caused
Leo Kanner by cold mothering
style
Autism was an
emotional disorder
due to harm by

1950s
mothers
Bruno
Bettelheim
De Guzman, Mary Joyce
Pain & punishment
were still inflicted
Use of LSD was
implemented
Autism is not related to
the parent child bond
Bernard Autism Society of
Rimland America was

1960s
established

De Guzman, Mary Joyce


Education for individuals with
Autism
Education for All Handicapped
Children Act of 1975
Children with autism were
permitted a free and
appropriate public education

1970s
De Guzman, Mary Joyce
Early forms of behavioral therapy
were used
Autism was separated from
Schizophrenia
Neurosensory therapy
Rain Man
Holding therapy 1980s&
1990s
De Guzman, Mary Joyce
a pervasive developmental disorder
onset prior to age 3
characterized by qualitatively
impaired:
Communication
Social interaction
Behavior

De Guzman, Mary Joyce


Spectrum refers to a wide range of symptoms, skills,
and levels of impairment that a child with ASD can have
ASD varies in the degrees of severity

MILD MODERATE SEVERE


HIGH FUNCTIONING LOW FUNCTIONING
SUBSTANTIAL VERY SUBSTANTIAL
SUPPORT
SUPPORT SUPPORT

De Guzman, Mary Joyce


Intellectual Abilities
Uneven skill development
Verbal skills tend to be weaker
Immediate memory or visual skills

De Guzman, Mary Joyce


SOCIAL SOCIAL
INTERACTION COMMUNICATION

BEHAVIOR

De Guzman, Mary Joyce


Social Communication
Includes nonverbal and verbal elements
Joint attention
Speech may be impaired
ABSENT OVERLY FORMAL

Approximately 25% do not develop functional


speech
Echolalia echo back

De Guzman, Mary Joyce


Tonal quality often unusual or flat with little variation
in pitch/volume
Language skills:
Uneven level of development between cognitive
abilities and receptive and expressive language
skills
Fail to use pronouns in speech
Find it difficult to initiate conversation
Use literal language & concrete thinking

De Guzman, Mary Joyce


Social Interaction Skills
Difficulty establishing and maintaining relationships
Slower in learning how to interpret what others are
thinking and feeling
Significantly abnormal social approach with limited
or no initiation of social interaction
Difficulty in self-regulation

De Guzman, Mary Joyce


Repetitive Speech, Motor Movements, or
Use of Objects
Redundant speech & idiosyncratic language
Stereotypic behavior or self-stimulation
(stimming) may continue
May worsen
Use objects in a stereotypic way
Inability to perform purposeful movements
Dyspraxia or apraxia

De Guzman, Mary Joyce


Rituals and Routines
Intense & rigid adherence
Excessive resistance to change
May lead to meltdowns
Items must be in a symmetrical
fashion
May become panicked or distraught

De Guzman, Mary Joyce


Restricted, Fixated Interests
Restricted interests are fixated on certain topics,
objects, or activities
Abnormally intense and all-consuming
Unusually strong attachment or preoccupation
Perseveration

De Guzman, Mary Joyce


Sensory Processing
Unusual response to sensory input
Affected: vision, hearing, touch, smell,
taste, balance, and pain
Hyperresponsive, hyporesponsive, &
sensory-seeking behaviors

De Guzman, Mary Joyce


Emotional Difficulty

Have difficulty regulating and


expressing their emotions
Prone to anxiety and stress
May exhibit disruptive or aggressive
behavior

De Guzman, Mary Joyce


Other Problems
A third develop seizures
Seizures could produce blackout, body convulsion,
staring spells
Prone to epilepsy
Pain is hard to recognize
Sleep dysfunction
Pica eating non-food
Beyond 24 mos.

De Guzman, Mary Joyce


Possess unusual skills and exceptional abilities
Approximately 10% exhibit savant skills
Savant syndrome:
Music
Art
Calculating
Mathematics
Spatial skills
Memory
De Guzman, Mary Joyce
De Guzman, Mary Joyce
There is no known single cause nor
single cure for ASD

De Guzman, Mary Joyce


GENETIC
INFECTIOUS
NEUROLOGIC
METABOLIC
IMMUNOLOGIC
ENVIRONMENTAL

De Guzman, Mary Joyce


De Guzman, Mary Joyce

De Guzman, Mary Joyce


Autism Spectrum Disorder:
Diagnostic Terms and Criteria & Related Conditions

By: Kristine Grace G. Falguera


3-Psychology 1
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What is Autism?
KGGF
1
Diagnostic Terms
Autism Spectrum Disorder

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Changes in DSM Diagnostic Terms

Schizophrenic Pervasive
reaction, Infantile developmental
childhood type Autism disorders
1952 1980 1994 & 2000
DSM I DSM III DSM IV & IV-TR

DSM II DSM III-R DSM 5


1968 1987 2013
Schizophrenia, Autistic Autism
childhood type disorder spectrum
disorder

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Here will be classified those
schizophrenic reactions occurring
before puberty. The clinical picture
may differ from schizophrenic
Schizophrenic reactions occurring in other age
reaction, periods because of the immaturity
childhood type and plasticity of the patient at the
time of onset of the reaction.
Psychotic reactions in children,
manifesting primarily autism, will be
classified here.

KGGF
This category is for cases in which
schizophrenic symptoms appear
before puberty. The condition may
be manifested by autistic, atypical
and withdrawn behavior; failure to
Schizophrenia, develop identity separate from the
childhood type mother's; and general unevenness,
gross immaturity and inadequacy of
development. These developmental
defects may result in mental
retardation, which should also be
diagnosed.

KGGF
DIAGNOSTIC CRITERIA:
A. Onset before 30 mos. of age
B. [Autism]Pervasive lack of
Infantile responsiveness to other people
Autism C. Gross deficits in language
development
D. If speech is present, peculiar
speech patterns

KGGF
E. Bizarre responses to various
aspects of the environment
(e.g., resistance to change, peculiar
interest in or attachments to
Infantile animate or inanimate objects.)
Autism F. Absence of delusions,
hallucinations, loosening of
associations, & incoherence as
in Schizophrenia.

KGGF
DIAGNOSTIC CRITERIA:
*At least 8 of the sixteen items are present
(2 items from A, 1 from B, & 1 from C)

A. Qualitative impairment in
reciprocal social interaction
Autistic 1. Marked lack of awareness of
the existence/feelings of
Disorder others
2. No/abnormal seeking of
comfort at times of distress
3. No/impaired imitation
4. No/abnormal social play
5. Gross impairment in ability
to make peer friendships
KGGF
B. Qualitative impairment in verbal
& nonverbal communication &
imaginative activity
1. No mode of communication
2. Markedly abnormal nonverbal
communication
Autistic 3. Absence of imaginative activity
Disorder 4. Marked abnormalities in the
production of speech
5. Marked abnormalities in the form
or content of speech
6. Marked impairment in the ability
to initiate/sustain a conversation,
despite adequate speech

KGGF
C. Markedly restricted repertoire of
activities and interests
1. Stereotyped body movements
2. Persistent preoccupation with
parts of objects
3. Marked distress over changes
in trivial aspects of environment
Autistic 4. Unreasonable insistence on
Disorder following routines in precise
detail
5. Markedly restricted range of
interests & a preoccupation
with one narrow interest
D. Onset during infancy/early
childhood
KGGF
These disorders are characterized
by severe and pervasive
Pervasive impairment in several areas of
development: reciprocal social
Developmental interaction skills, communication
Disorders skills, or the presence of
stereotyped behavior, interests,
and activities.

KGGF
Evident in the first years of life
Pervasive Often with some degree of
Mental Retardation (Axis II)
Developmental Sometimes observed with a
Disorders diverse group of other general
medical conditions (Axis III)

KGGF
1. Autistic Disorder
2. Rett's Disorder
Pervasive 3. Childhood Disintegrative
Disorder
Developmental 4. Asperger's Disorder
Disorders 5. Pervasive Developmental
Disorder Not Otherwise
Specified.

KGGF
1. Childhood Autism
2. Asperger Syndrome
3. Atypical Autism
4. Other Pervasive Developmental
Pervasive Disorders
5. Pervasive Developmental
Developmental Disorders, Unspecified
Disorders 6. Overactive disorder associated
with mental retardation &
stereotyped movements
7. Retts Syndrome
8. Childhood Disintegrative Disorder

KGGF
DIAGNOSTIC CRITERIA:
A. Persistent deficits in social
communication & interaction
across multiple contexts
B. Restricted, repetitive patterns of
Autism behavior, interests, activities
Spectrum C. Symptoms must be present in
Disorder the early developmental period
D. Symptoms cause clinically
significant impairment in
important areas of functioning
E. These are not better explained
by intellectual disability

KGGF
Overview of Changes
DSM I DSM II DSM III

onset: before puberty onset: before 2 y.o.


onset: before puberty autistic, atypical, autism, language deficits,
schizophrenic/psychotic withdrawn, no distinct peculiar speech, bizarre
reactions (autism) identity, underdeveloped response
mental retardation no signs of schizophrenia

DSM III-R DSM IV & IV-TR DSM 5

onset: birth to 8 y.o. onset: first years of life onset: early dev. period
3 domains 5 subcategories 1 spectrum
8 out of 16 deficits 3 domains 2 domains
more expansive 6 out of 12 deficits +hyper/hypo reactivity

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2
Diagnostic Criteria
Autism Spectrum Disorder

KGGF
Criterion A

Persistent deficits in social communication and social


interactions across multiple contexts, currently or by
history, as manifested by:
1. Deficits in social-emotional reciprocity

Abnormal Failure to
Reduced
social initiate &
sharing
approach respond

KGGF
Criterion A

2. Deficits in nonverbal communicative


behaviors used for social interaction

Poor verbal Abnormal


Total lack
& body
of
nonverbal language &
nonverbal
integration eye contact

KGGF
Criterion A

3. Deficits in developing, maintaining, &


understanding relationships

Difficulty No
Adjusting
in making interest in
behavior
friends peers

KGGF
Criterion B

Restricted, repetitive patterns of behavior,


interests, or activities, currently or by history, as
manifested by at least two from:
1. Stereotyped or repetitive motor movements,
use of objects, or speech

Simple
Lining up Flipping Idiosyncratic
motor Echolalia
toys objects phrases
stereotypies

KGGF
Criterion B

2. Insistence on sameness, inflexible adherence


to routines, or ritualized patterns of verbal or
nonverbal behavior

Extreme Need to
Difficulties Rigid Eat the
distress at Greeting take the
with thinking same food
small rituals same
transitions patterns everyday
changes route

KGGF
Criterion B

3. Highly restricted, fixated interests that are


abnormal in intensity or focus

Strong
Excessively
attachment or
circumscribed/
preoccupation
perseverative
with unusual
interests
objects

KGGF
Criterion B

4. Hyper- or hyporeactivity to sensory input or


unusual interest in sensory aspects of the
environment

Visual
Apparent Adverse Excessive
fascination
indifference response to smelling or
with lights
to pain or specific touching of
or
temperature stimuli objects
movements

KGGF
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Can you make it to the end?


KGGF
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Diagnostic Criteria for Autism


KGGF
Criterion C
Symptoms must be present in the early
developmental period (but may not come fully
manifested until social demands exceed limited
capacities, or may be masked by learned strategies
later in life).

Criterion D
Symptoms cause clinically significant impairment in
social, occupational, or other important areas of
current functioning.

KGGF
Criterion E
These disturbances are not better
explained by intellectual disability
(intellectual developmental disorder) or
global developmental delay.

Intellectual disability and autism spectrum


disorder often co-occur; to make comorbid
diagnoses of autism spectrum disorder and
intellectual disability, social communication
should be below that expected for general
developmental level.

KGGF
Note:
Individuals with a well-established DSM-IV
diagnosis of autistic disorder, Aspergers disorder,
or pervasive developmental disorder not
otherwise specified should be given the diagnosis
of autism spectrum disorder.
-and-
Individuals who have marked deficits in social
communication, but whose symptoms do not
otherwise meet criteria for autism, should be
evaluated for social (pragmatic) communication
disorder.
KGGF
Specify if:
With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition
or environmental factor
Associated with another neurodevelopmental, mental,
or behavioral disorder
With catatonia (refer to the criteria for catatonia
associated with another mental disorder)

KGGF
Levels of Severity
Social Communication & Restricted Interests &
Interaction Repetitive Behaviors
Without supports in place,
deficits in verbal & nonverbal
social communication cause
LEVEL 1 Rituals and RRBs cause
noticeable impairments.
significant interference with
Requiring functioning in one or more
Has difficulty initiating social
support interactions & demonstrates clear
contexts.
examples of atypical or
Resists attempts by others to
unsuccessful response to social
interrupt RRBs or to be
overtures from others.
redirected from fixated interest.
May appear to have decreased
interest in social interactions.
KGGF
Levels of Severity
Social Communication & Restricted Interests &
Interaction Repetitive Behaviors

RRBs, preoccupations or fixated


Marked deficits in verbal & interests appear frequently
LEVEL 2 nonverbal social communication enough to be obvious to the
skills. casual observer & interfere with
Requiring
functioning in a variety of
substantial Social impairments apparent contexts.
support even with supports in place.
Distress or frustration is apparent
Limited initiation of social when RRBs are interrupted.
interactions & reduced or
abnormal response to social Very difficult to redirect from
overtures from others fixated interest or returns to it
quickly
KGGF
Levels of Severity
Social Communication & Restricted Interests &
Interaction Repetitive Behaviors

LEVEL 3 Severe deficits in verbal & Preoccupations, fixated rituals


nonverbal social and/or RRBs markedly interfere
Requiring
communication skills cause with functioning in all spheres.
very severe impairments in
substantial functioning. Marked distress when rituals or
support routines are interrupted.
Very limited initiation of social
interactions & minimal Very difficult to redirect from
response to social overtures fixated interest or returns to it
from others quickly

KGGF
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Loving Caregiver and with Severely Autistic Adult


KGGF
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James and Autism


KGGF
3
Related Conditions
Autism Spectrum Disorder

KGGF
Anxiety disorders
o For children with ASD, anxiety might show up
as self-stimulating more often, asking questions
over and over again, hurting themselves, or having
trouble getting to sleep
o 84% of people with ASD have anxiety symptoms

KGGF
Attention-deficit
hyperactivity disorder

ASD & ADHD share


common characteristics:
not seeming to listen
when people speak,
interrupting, or intruding
others personal space
66.67% of children with
ASD have behavior very
similar to ADHD

KGGF
Gastrointestinal symptoms

Most common:
chronic constipation,
abdominal pain,
diarrhea and fecal
incontinence
9% - 70% of children
with ASD have
gastrointestinal
problems

KGGF
Intellectual disability

Children with ASD have more trouble with verbal skills


50-60% of people with ASD have an IQ below 70

KGGF
Fragile X syndrome

ASD is relatively
common in children
with Fragile:
25-33%
2% of people with
ASD also have
Fragile X

KGGF
Seizures and epilepsy
20-30% of people with ASD also have epilepsy.
Seizures are most common in children under five
years and in teenagers.

KGGF
Sensory sensitivities

76% of young children


with ASD might have
sensory sensitivities
Most common:
hyperreactivity to
sound &
hyporeactivity to pain

KGGF
Sleep problems

Most common:
insomnias &
parasomnias
2/3 of children with
ASD experience sleep
problem at some time

KGGF
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The World of Autism


KGGF
ASPERGERS SYNDROME
Mary Bernadette M. Cosare
ASPERGERS SYNDROME
History

What is Aspergers Syndrome

Characteristics of Aspergers Syndrome

Causes of Aspergers Syndrome

Aspergers Syndrome vs. High-functioning Autism

Diagnostic Criteria of Aspergers Syndrome

Signs and Symptoms of Aspergers Syndrome


Famous people with Aspergers

Mary Bernadette M. Cosare


HANS
ASPERGER
1940
autism like behaviors
Difficulties with social
and communication
skills
Normal intelligence
and language
development

Milder form of
autism
high functioning
autism
Mary Bernadette M. Cosare
UTA FRITH
Professor
Institute of
Cognitive Neuroscience
of University College
London
Autism and
Asperger Syndrome
having a dash of
autism

Mary Bernadette M. Cosare


WHAT IS
ASPEGERS
SYNDROME
Neurological disorder on the higher-functioning end
of the autism spectrum

Mary Bernadette M. Cosare


WHAT IS
ASPERGERS
SYNDROME
Difficult with social interaction

Range of interest

Repetitive behavior

Mary Bernadette M. Cosare


WHAT IS
ASPEGERS
SYNDROME
ASPIES

Normal to high intelligence

Social and Relationships challenging

Mary Bernadette M. Cosare


WHAT IS
ASPEGERS
SYNDROME
ADHD

Conduct Disorder

Pragmatic Language Disorder

Attachment Disorder

Obsessive Compulsive Disorder


WHAT IS
ASPEGERS
SYNDROME
In DSM 5

Aspergers Syndrome and Autism

Autism Spectrum Disorder

Mary Bernadette M. Cosare


CAUSES OF ASPERGERS
SYNDROME
Genetic (inherited)
Toxic Exposure
Pregnancy or Birth
Prenatal infections

Mary Bernadette M. Cosare


ASPERGERS
SYNDROME
Boys are more
likely to develop
Aspergers
Syndrome than
girls

Mary Bernadette M. Cosare


ASPERGERS SYNDROME
3 years of age
Not later than 5 years old
to 9 years old
Early
language
development
Motor Development
Crawling , walking slowly

Mary Bernadette M. Cosare


ASPERGERS SYNDROME
In the Philippines

Mary Bernadette M. Cosare


ASPERGERS SYNDROME VS.
HIGH-FUNCTIONING AUTISM
according to Gillberg and Ehlers (1998)
ASPGERS SYNDROME HIGH-FUNCTIONING AUTISM

Learning disability and adaptive Learning disability and adaptive


disability is not necessary disability is necessary

Learning disability (Dyslexia) Milder than low-functioning autism

Motor Skills Not all have difficulties with motor


skills
Language Development is not
evident Significant delay in language
development
Hardly diagnose before entering
school Diagnosed before entering school

Mary Bernadette M. Cosare


A. Qualitative impairment in social interaction
B. Restricted, repetitive and stereotyped
patterns of behavior, interests, and activities
C. Disturbance cause clinically significant
impairment in social, occupational, or other DIAGNOSTIC
areas in functioning CRITERIA FOR
D. No clinically significant general delay in ASPERGERS
language SYNDROME
DSM IV
E. No clinically significant delay in cognitive
development, self-help skills, adaptive skills and
curiosity about the environment
F. Criteria are not met for another specific
pervasive developmental disorder or
schizophrenia
Mary Bernadette M. Cosare
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
DIAGNOSTIC
eye-to-eye gaze, facial expression, body
CRITERIA FOR
postures, and gestures to regulate social ASPERGERS
interaction SYNDROME
2. Failure to develop peer relationships DSM IV
appropriate to development level
3. A lack of spontaneous seeking to
share enjoyments, interests, and
achievements with other people
4. Lack of social or emotional reciprocity
Mary Bernadette M. Cosare
B. Restricted, repetitive, and stereotyped
patterns of behavior, interests, activities,
as manifested by at least one of the
following:
1. Encompassing preoccupation with one
DIAGNOSTIC
or more stereotyped or restricted CRITERIA FOR
patterns of interest that is abnormal ASPERGERS
either in intensity or focus SYNDROME
2. Apparently inflexible adherence to DSM IV
specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor
mannerisms
4. Persistent preoccupation with parts of
objects
Mary Bernadette M. Cosare
C. The disturbance causes clinically
significant impairment in social,
occupational, and other important areas
in functioning
D. There is no clinically significant general
DIAGNOSTIC
delay in language CRITERIA FOR
E. There is no clinically significant delay ASPERGERS
in cognitive development, or in the SYNDROME
development of age appropriate self-help DSM IV
skills, adaptive behavior (aside from
social interaction), and curiosity about the
environment in childhood
F. Criteria are not met for another specific
pervasive developmental disorder, or
schizophrenia
Mary Bernadette M. Cosare
A. A lack of any clinically significant general delay
in spoken or receptive language or cognitive
development.

Diagnosis requires that single words should DIAGNOSTIC


have developed by two years of age or earlier and CRITERIA FOR
that communicative phrases be used by three years ASPERGERS
of age or earlier. Self-help skills, adaptive behavior
and curiosity about the environment during the first SYNDROME
three years should be at a level consistent with ICD 10
intellectual development. However, motor milestones
may be somewhat delayed and motor clumsiness is
usual (although not a necessary diagnostic feature).
Isolated special skills, often related to abnormal
preoccupations, are common, but are not required
for diagnosis.

Mary Bernadette M. Cosare


B. Qualitative abnormalities in reciprocal social
interaction (criteria as for autism).
DIAGNOSTIC
C. An unusually intense circumscribed interest or
restrictive, repetitive, and stereotyped patterns of
CRITERIA FOR
behavior, interests and activities (criteria as for ASPERGERS
autism; however, it would be less usual for these to SYNDROME
include either motor mannerisms or preoccupations ICD 10
with part-objects or non-functional elements of play
materials).

Mary Bernadette M. Cosare


D. The disorder is not attributable to other varieties
of pervasive developmental disorder; schizotypal DIAGNOSTIC
disorder (F21); simple schizophrenia (F20.6); CRITERIA FOR
reactive and disinhibited attachment disorder of ASPERGERS
childhood (F94.1 and .2); obsessional personality SYNDROME
disorder (F60.5); obsessive-compulsive disorder
(F42). ICD 10

Mary Bernadette M. Cosare


KATHY
HOOPMAN

All Cats Have


Asperger
Syndrome

Mary Bernadette M. Cosare


Jennifer Cook O'Toole

The Asperkids
Secret Book of
Social Rules

Mary Bernadette M. Cosare


John Edler Robinson
Look me in the
eye
My life with
Aspergers

Mary Bernadette M. Cosare


Social Communication
Social Interaction SIGNS AND
SYMPTOMS
Restricted and Repetitive Patterns of OF ASPERGERS
Behavior , Activities or Interest
SYNDROME
According to National Autistic
Society

Mary Bernadette M. Cosare


Social Communication
Both verbal and non-verbal language

Facial Expressions
Tone of Voice
SIGNS AND
Jokes and Sarcasm
SYMPTOMS
Vagueness OF ASPERGERS
Abstract Concept SYNDROME
According to National Autistic
Society

Mary Bernadette M. Cosare


Social Interaction
Reading other people
Recognizing or understanding others
feelings and intentions
Expressing their own emotions
SIGNS AND
SYMPTOMS
Appear to be insensitive OF ASPERGERS
Seek out time alone SYNDROME
Not seek comfort from other people
According to National Autistic
Act strangely Society

Socially Inappropriate

Mary Bernadette M. Cosare


Repetitive Behavior and Routine
Daily routine
Use of rules SIGNS AND
SYMPTOMS
Not be comfortable with change
OF ASPERGERS
Able to cope if they can prepare in
SYNDROME
advance
According to National Autistic
Society

Mary Bernadette M. Cosare


Focus on Interest
Art or Music
Studying SIGNS AND
SYMPTOMS
Working
OF ASPERGERS
Meaning Occupation SYNDROME
According to National Autistic
Society
Wellbeing and Happiness

Mary Bernadette M. Cosare


Mary Bernadette M. Cosare
Sensory Sensitivity

SIGNS AND
Sound , light , taste , touch , temperature
SYMPTOMS
and pain
OF ASPERGERS
Anxious , Overwhelmed and Stressed SYNDROME
Difficulty in focusing According to National Autistic Society
Difficulty using body awareness

Mary Bernadette M. Cosare


Academic Skills

SIGNS AND
Average to above- average intelligence
SYMPTOMS
Math and Science OF ASPERGERS
Difficulty understand concepts related to SYNDROME
relationships and emotions According to National Autistic Society
Excellent in rote memory and vocabulary

Mary Bernadette M. Cosare


FAMOUS
PEOPLE WITH
ASPERGERS
SYNDROME
James Taylor
FAMOUS
PEOPLE WITH
ASPERGERS
SYNDROME
Susan Boyle
FAMOUS
PEOPLE WITH
ASPERGERS
SYNDROME
Adam Young
FAMOUS FILIPINO
WITH ASPERGERS
SYNDROME

Thristan
Tum-Tum
Mendoza
FAMOUS FILIPINO
WITH ASPERGERS
SYNDROME

Patrick So
FAMOUS FILIPINO
WITH ASPERGERS
SYNDROME

Gabby Atienza
FILIPINO WITH
ASPERGERS
SYNDROME

Isiah Paola
Atienza Lee
FILIPINO WITH
ASPERGERS
SYNDROME

Allen Christian
Garcia
Asperger's Syndrome. (n.d.). Retrieved April 17, 2017, from http://www.autism-society.org/what-is/aspergers-syndrome/

REFERENCES
What is Asperger Syndrome? (n.d.). Retrieved April 17, 2017, from http://aspennj.org/what-is-asperger-syndrome

Stppler, M. M. (n.d.). Asperger's Syndrome (Asperger Syndrome, Asperger Disorder) Symptoms, Treatment, Causes - What are the treatments for
Asperger's syndrome? Retrieved April 17, 2017, from http://www.medicinenet.com/asperger_syndrome/page4.htm

DSM IV Criteria for Asperger's Disorder*. (n.d.). Retrieved April 17, 2017, from
https://iancommunity.org/cs/about_asds/about_asds_dsm_iv_criteria_for_aspergers_syndrome

DSM-IV Diagnostic Classifications. (n.d.). Retrieved April 17, 2017, from http://www.autism-society.org/dsm-iv-diagnostic-classifications/

Aspergers Syndrome on TV. (n.d.). Retrieved April 17, 2017, from http://www.autismsocietyphilippines.org/2010/08/aspergers-syndrome-on-tv.html

(n.d.). Retrieved April 17, 2017, from http://global-disease-burden.healthgrove.com/l/64375/Asperger-Syndrome-in-Philippines

Asperger's vs. High-Functioning Autism: Understanding the Difference. (n.d.). Retrieved April 17, 2017, from
http://www.durham-autism.org/aspergers-high-functioning-autism-difference/

What is Asperger syndrome? (n.d.). Retrieved May 01, 2017, from http://www.autism.org.uk/about/what-is/asperger.aspx

Lisa Jo Rudy - Reviewed by a board-certified physician. (n.d.). Wondering What "High Functioning Autism" Is? You're Not Alone!
Retrieved May 01, 2017, from https://www.verywell.com/what-is-high-functioning-autism-3896828

A. (n.d.). Retrieved May 01, 2017, from


http://www.moduscare.com/knowledge/high-functioning-autism-and-asperger-syndrome-what-s-the-difference.html

Perez, R. (2016, July 14). This Student With Asperger's Syndrome Delivered a Powerful Graduation Speech. Retrieved May 01, 2017, from
http://www.smartparenting.com.ph/life/inspiration/student-with-asperger-s-syndrome-powerful-graduation-speech-a00041-20160714-lfrm
Childhood
Disintegrative
Disorder
Romella Marie I. Elanga
REGRESSION

DEVELOPMENTAL
MILESTONES
Childhood Disintegrative
Disorder
A type of an Autism Spectrum Disorder.

Considered a low-functioning form of


Autism.
CDD
A rare condition characterized by
marked regression in several areas of
functioning after at least 2 years of
NORMAL functioning.
Historical Definition of CDD
1908: Hellers Syndrome
1970s: Disintegrative Psychosis of Childhood'
(ICD-9) and Childhood Pervasive
Developmental Disorder (DSM-III)
1987: DSM-III-R reclassified it as Childhood-Onset
Autism.
Childhood Disintegrative Disorder:
1992 (ICD-10): Pervasive Developmental Disorder
1994 (DSM-IV):
Under the proposed DSM-5
revisions, all PDDs, including
CDD, will be included under the
single diagnostic category of
Autism Spectrum Disorders.
According to Synopsis of
Psychiatry,
The cause of childhood
disintegrative disorder is
unknown, but it has been
associated with other
neurological conditions,
including seizure disorders,
tuberous sclerosis, and
PREVALENCE
Extremely rare with an incidence of
1.7 in 100,000 children.
(boys)
DSM-IV-TR Diagnostic Criteria
for CDD
A. Apparently normal development for at least the first 2 years after birth as manifested by the
(table 42-6)
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:
Expressive or receptive language.
Social skills or adaptive behavior.
Bowel or bladder control.
Play.
Motor skills.
C. Abnormalities of functioning in at least two of the following areas:
Qualitative impairment in social interaction (e.g. impairment in nonverbal behaviors, failure to
develop peer relationships, lack of social or emotional reciprocity).
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).
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 Development
Signs & Symptoms
Onset: between ages 3 to 4 years
old
Insidious or abrupt

Increased activity levels


Irritability
Anxiety
Signs & Symptoms
Abnormal function also occurs in at
least two of:

Social interaction
Communication
Repetitive interests or behavior
Psychological tests that may be performed
include the following:

Childrens Autism Rating Scale (CARS)


Kaufman Assessment Battery for Children (KABC)
Vineland Adaptive Behavior Scale
PDD Behavior Inventory
Intelligence scales
Rett Syndrome

JM Deang
What is Rett Syndrome?

Identified by
Dr. Andreas
Rett

A postnatal
neurodevelopmen
JMD tal disorder
What is Rett Syndrome?

It is marked by apparently normal


development for the first 6-18 months
of life followed by a loss in the
following functions:

Fine and gross motor


skills

JMD Ability to engage in social


What is Rett Syndrome?

There is a wide variability in the


rate of disease progression and
severity

Classical Rett Syndrome and atypical


variants
JMD
Cause of Rett Syndrome

JMD
MeCP2 (Methyl CpG binding protein 2)
Mutations in this gene would cause majority of the cases
Located on the X chromosome
Contains instructions on protein synthesis
Acts like a switch for other genes involved in the
maturation of neurons
Mutations are mostly not inherited

JMD
Symptoms:

Language Hand Apraxia


Problems Movements Inability/impaired
ability to perform
Impaired A loss of purposeful task or movements
communication, use of the hands,
permanent loss of compulsive hand One of the most
speaking ability, movements: disabling features of
alterations in Rett Syndrome
communication and Hand Wringing
language like those
seen in Autism and Hand clasping
JMD other developmental
disorder Hand tapping/clapping
Symptoms:

Breathing Other Others


Irregularitie Neurological Gastrointestinal
s Symptoms Problems

Heart rhythm
Apnea Seizures
abnormality
Hyperventilation Sleep Disruption
Orthopedic problems
Air Swallowing Tremors
Microcephaly

JMD
Excess Salivation
Low Muscle tone
Stages of Rett
Syndrome
Stage 1: Developmental Arrest

Stage 2: Regression

Stage 3: Plateau

Stage 4: Late motor deteriorati

JMD
Stage 1

Normal development for the first 6-18


months
Stagnation phase
There is a gradual onset of gross
motor developmental delay,
deceleration in growth (head, weight,
height), hypotonia, and hand wringing
JMD Lessening in eye contact and interest
Stage 2

Usually begins 1-4


years
Gradual or rapid
decline in development
Hand skills are lost
Hand stereotypes
emerge
Breathing
JMD
irregularities
Stage 3

Usually occurs at ages 2-10


Also known as the pseudo stationary
stage
Apraxia, motor problems, scoliosis,
seizures
Possible improvement in childs
behavior
JMD
Stage 4

Ability to ambulate
ceases
Muscle weakness and
rigidity,
spasticity, and
dystonia.
Less intense hand
JMD stereotypes
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


DSM (2) loss of previously acquired purposeful hand skills between ages
5 and 30 months with the subsequent development of stereotyped
IV-TR hand movements (e.g., 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

Diagnostic (5) severely impaired expressive and receptive language


development with severe psychomotor retardation

Criteria
Types of Rett Syndrome

1. Classic Rett Syndrome


Meets the diagnostic criteria
2. Atypical Rett Syndrome
Begins soon after birth or 18 months
of age
Mild speech and hand skill impairment
Appears in males
JMD 3. Provisional Rett Syndrome
Types of Atypical Rett Syndrome

1. Congenital Onset Rett Syndrome


Delay is shortly noticed post-birth;
no early normal development
2. Late Onset Rett Syndrome
Delays beyond 18 month onset
3. Preserved Speech Rett Syndrome
Milder features

JMD
4. Male Rett Syndrome
Treatment of Rett Syndrome addresses the
symptoms...
Physical
Therapy/Hydrothe
rapy
Occupational
Therapy
Speech and
Language Therapy
JMD Feeding
Prepared by: LJ Cruz
DSM-IV DSM-5

- Autism was divided into five separate


All five of the autism diagnoses from DSM-IV are
diagnostic categories
collapsed into a single diagnostic category: autism
- In the DSM-IV, autism spectrum was another spectrum disorder
name for pervasive developmental disorders
(PDDs), a category of diagnoses with certain
symptomatic similarities

- Atypical autism was another name for one of


the five official autism spectrum diagnoses :
pervasive developmental disorder not
otherwise specified (PDD-NOS)
DSM-IV-TR Criteria
Severe and pervasive impairment in the development of:
- Reciprocal social interaction or
- Verbal and nonverbal communication skills and
- Stereotyped behaviors, interests, and activities

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 at onset, atypical symptomatology, or subthreshold
symptomatology, or all of these.
ICD-10

F84.9 Pervasive developmental disorder, unspecified

This is a residual diagnostic category that should be used for disorders which
fit the general description for pervasive developmental disorders but in which a
lack of adequate information, or contradictory findings, means that the criteria
for any of the other F84 codes cannot be met.
Pervasive Developmental Disorder- Not Otherwise Specified

A PDD-NOS diagnosis is given when a child does not fully meet the criteria for
Autism Spectrum Disorder (ASD), Aspergers Syndrome, Rett Syndrome or
Childhood Disintegrative Disorder, yet clearly shows unusual development in
the areas of communication, social interaction and interests/attention
A child may receive a diagnosis of PDD-NOS if he or she falls into the following
categories:

The child is high-functioning like a person with Asperger syndrome but is


experiencing mild cognitive issues and/or language delay that would prevent an
Asperger diagnosis

The child is similar to a person with Autism but symptoms began at a late age

The child has many symptoms of Autism but has fewer perseverative behaviors
than those with an Autism diagnosis
What is PDD-NOS?

Neurological disorder symptoms can range from mild to severe

No set pattern of symptoms or signs

Often have more intact social skills than individuals diagnosed with other Pervasive
Developmental Disorders

Diagnosis is sometimes given to very young children with limited communication skills who also
show characteristics of autism As the childs communication skills increase, other symptoms
of autism may become more apparent
Age for Diagnosis & Prevalence
Children are generally 3 to 4 years old before they exhibit enough symptoms for a diagnosis

Current estimates are that 3-4 per 1000 individuals may have PDD-NOS

PDD-NOS often occurs with some degree of cognitive impairment

Individuals with PDD-NOS are found in all races, ethnicities, and social statuses
Poor social skills & experience difficulties
interacting meaningfully
Reluctant to give eye contact
Appears to lack desire to share activities with
others
Prefers to be alone
Lacks an understanding of issues from another
persons point of view
May exhibit some of the following Difficulty in taking turns and/or sharing with peers
Difficulty differentiating between familiar and
features: unfamiliar people
May be unintentionally aggressive in an attempt to
be social
Treats people as tools or equipment something
Social and Emotional to use to open a door, get food, get carried by or
lean on
Is limited in their play skills and may become
fixated on only playing with specific toys in a
particular way
Has poor imaginative play skills
Has low self-esteem
Difficulty understanding or using
appropriate forms of communication
Does not always clearly communicate
wants, express concerns or fears, or
answer questions reliably
May exhibit some of the following Limited or no speech and/or lack typical
features: communicative gestures
As babies, a child with PDD-NOS may
not babble or when they do learn words,
Language and they exhibit echolalia
Often take language literally
Communication Speech may develop to varying degrees
but rarely develops to an
age-appropriate level of ability
May experience great difficulty
processing information received from
senses
Over-sensitive to surroundings and
unable to screen out irrelevant stimuli
May appear to ignore some sounds but
May exhibit some of the following
over-react to other sounds
features: May focus intently on the small visual
details of walls, furniture, objects, prints,
pictures or body parts whilst not seeing
the whole picture
Sensory Processing May show intense interest in light or
shiny reflective surfaces
May explore by smelling or mouthing
objects, people and surfaces
Small changes to routine, activity or
surroundings may cause stress and
anxiety
May avoid strangers or new activities
due to fear and anxiety
May exhibit some of the following Develops routines and rituals and may
features: stay involved with them for long periods
or be upset if interrupted
Becomes very concerned about doing
Adapting to the Environment work perfectly and may become
unwilling to attempt work that he/she
feels they cannot do perfectly
May want to be in control of situations
May have learning difficulties
May have poor memory and attention
span resulting in difficulty persisting
May exhibit some of the following
with activities
features: Requires repetition of instructions or
directions and may require time to
process before responding or acting
Cognitive May have difficulty understanding
concepts such as turn taking, sharing or
how to enter into play situations
Common difficulties often (but not always) experienced by those with Pervasive Developmental
Disorder-Not Otherwise Specified (PDD-NOS):

Poor understanding of the conventions of social interaction


Immature play skills/interests
Resistant to change and very rigid in routine
Poor non-verbal communication
Poor understanding of instructions, questions and/or jokes
Difficulty with fine and gross motor skills
Difficulties accessing the school curriculum
Poor conversational skills and may talk too much or too little
Poor listening skills, despite intact hearing
Fails to notice that other people are not interested in what they are saying
Finds it difficult to understand the non-verbal language/cues of others (such as facial expressions,
gestures and/or body movements) or the rules of social behaviour
Causes

The causes of PDD-NOS are still unknown

There is a strong belief in the medical community that that the disabilitys origin is genetic
and/or biological and affects brain function, but specific biological mechanisms remain unclear

There is a possibility that more than one variable could be responsible for the different
symptoms that are present in those individuals with PDD-NOS
Interventions
Interventions










Therapeutic and
Educational
Interventions
Therapeutic & Educational
Interventions



Therapeutic & Educational
Interventions



Evidence-based
Practices
Collaborative Communication
Services



Visual Structure and Support



Enhancing Positive Social
Relationships





Functional Skills




Providing Positive & Creative Educational
Services


1.
2.
3.
4.
Psychological and
Medical Interventions
Psychological Interventions




Medications







Behavioral
Interventions
Behavioral Interventions





Behavioral Interventions