pervasive developmental disorder spectrum

#Pervasive Developmental Drder Spectrum Manual Left Many

Pervasive Developmental Drder Spectrum Manual Left Many

It defined three essential features of autism: a lack of interest in people, severe impairments in communication and bizarre responses to the environment, all developing in the first 30 months of life.The DSM-III was revised in 1987, significantly altering the autism criteria. The DSM-III, published in 1980, established autism as its own separate diagnosis and described it as a “pervasive developmental disorder” distinct from schizophrenia.Prior versions of the manual left many aspects of the diagnostic process open to clinicians’ observations and interpretations, but the DSM-III listed specific criteria required for a diagnosis. During the 1950s and 1960s, autism was thought to be rooted in cold and unemotional mothers, whom Bruno Bettelheim dubbed ‘refrigerator mothers.’When was autism recognized as a developmental disorder?The ‘refrigerator mother’ concept was disproved in the 1960s to 1970s, as a growing body of research showed that autism has biological underpinnings and is rooted in brain development. In keeping with his perspective, the second edition of the DSM, the DSM-II, published in 1952, defined autism as a psychiatric condition — a form of childhood schizophrenia marked by a detachment from reality. Along with these shifting views, its diagnostic criteria have changed as well.In many ways PDD is the catch-all category to describe a group of disorders that cause delays in a childs development of basic social and communication skills.Here is how the “Diagnostic and Statistical Manual of Mental Disorders” (DSM), the diagnostic manual used in the United States, has reflected our evolving understanding of autism.Why was autism initially considered a psychiatric condition?When Leo Kanner, an Austrian-American psychiatrist and physician, first described autism in 1943, he wrote about children with “extreme autistic aloneness,” “delayed echolalia” and an “anxiously obsessive desire for the maintenance of sameness.” He also noted that the children were often intelligent and some had extraordinary memory.As a result, Kanner viewed autism as a profound emotional disturbance that does not affect cognition. Autism was originally described as a form of childhood schizophrenia and the result of cold parenting, then as a set of related developmental disorders, and finally as a spectrum condition with wide-ranging degrees of impairment.

It became clear that finding genetic underpinnings and corresponding treatments for the five conditions specified in the DSM-IV wouldn’t be possible. After the Human Genome Project was completed in 2003, many studies tried to zero in on a list of ‘ autism genes.’ They found hundreds, but could not link any exclusively to autism. The breakdown echoed the research hypothesis at the time that autism is rooted in genetics, and that each category would ultimately be linked to a set of specific problems and treatments.Why did the DSM-5 adopt the idea of a continuous spectrum?Throughout the 1990s, researchers hoped to identify genes that contribute to autism. In addition to autism and PDD-NOS, it added ‘ Asperger’s disorder,’ also at the mild end of the spectrum ‘ childhood disintegrative disorder (CDD),’ characterized by severe developmental reversals and regressions and Rett syndrome, affecting movement and communication, primarily in girls. Adding PDD-NOS allowed clinicians to include children who didn’t fully meet the criteria for autism but still required developmental or behavioral support.When was autism first presented as a spectrum of conditions?The DSM-IV, released in 1994 and revised in 2000, was the first edition to categorize autism as a spectrum.This version listed five conditions with distinct features.

Released in the 1990s, that manual’s current and 10 th edition groups autism, Asperger syndrome, Rett syndrome, CDD and PDD-NOS together in a single ‘Pervasive Developmental Disorders’ section, much as the DSM-IV did.What does the future look like for diagnosing autism?Experts continue to view autism as a continuous spectrum of conditions. A growing body of evidence, however, shows that its criteria do exclude more people with milder traits, girls and older individuals than the DSM-IV did.Clinicians in many countries, including the United Kingdom, use the International Classification of Diseases. And experts disagreed on whether the DSM-5’s more stringent diagnostic criteria would block services for those with milder traits or adequately curb surging prevalence rates.Five years later, it’s clear the DSM-5 did not cut services for people already diagnosed with an autism spectrum condition. Those who identified themselves as having Asperger syndrome said the diagnosis gave them a sense of belonging and an explanation for their challenges they feared that removing the diagnosis was synonymous to losing their identity. Many were concerned that after their diagnosis disappeared from the book, they would lose services or insurance coverage.

Pervasive Developmental Disorder Spectrum