Developmental Disorders

The DSM–5’s classification involves a shift from the categorical approach to ASD to a dimensional approach (American Psychiatric Association, 2013).

Autism Spectrum and Related Disorders

Developmental disorders are an umbrella term covering intellectual disability and pervasive developmental disorders including autism.

Developmental disorders usually have a childhood onset but tend to persist into adulthood, causing impairment or delay in functions related to the central nervous system maturation.

They generally follow a steady course rather than the periods of remissions and relapses that characterize many other mental disorders:

Intellectual disability is characterized by impairment of skills across multiple developmental areas such as cognitive functioning and adaptive behavior. Lower intelligence diminishes the ability to adapt to the daily demands of life.
Symptoms of pervasive developmental disorders, such as autism, include impaired social behavior, communication and language, and a narrow range of interests and activities that are both unique to the individual and are carried out repetitively. Developmental disorders often originate in infancy or early childhood. People with these disorders occasionally display some degree of intellectual disability.

-World Health Organization

Signs and Symptoms of ASD

According to NIMH, not all people with ASD will show classic behaviors, but there’re some common features. Social communication /interaction behaviors may include:

Making little or inconsistent eye contact
Tending not to look at or listen to people
Rarely sharing the enjoyment of objects or activities by pointing or showing things to others
Failing to, or being slow to, respond to someone calling their name or to other verbal attempts to gain attention
Having difficulties with the back and forth of conversation
Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond
Having facial expressions, movements, and gestures that do not match what is being said
Having an unusual tone of voice that may sound sing-song or flat and robot-like
Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions

Restrictive/repetitive behaviors may include:

Repeating certain behaviors or having unusual behaviors. For example, repeating words or phrases, a behavior called echolalia
Having a lasting intense interest in certain topics, such as numbers, details, or facts
Having overly focused interests, such as with moving objects or parts of objects
Getting upset by slight changes in a routine
Being more or less sensitive than other people to sensory input, such as light, noise, clothing, or temperature

Although people with ASD can face many challenges, they may also have exceptional strengths, including:

Being able to learn things in detail and remember information for long periods of time
Being strong visual and auditory learners
Excelling in math, science, music, or art

Possible Etiology

Overall, scientists aren’t sure what causes autism but risk factors include family history, having older parents, and very low birth weight. Other causes include DNA coding errors and other genetic factors that can also cause disorders. Hopefully, more research will be conducted and find more solutions. The latest research is treating autism as an autoimmune disorder, which I don’t agree with because steroids can cause more physical/mental issues and the treatment remains unclear.

About Treatment

No medications are FDA approved for autism’s core symptoms. Medications are often used to treat related symptoms, such as depression, anxiety, and aggression. Treatment for ASD should be soon as possible to improve behaviors, life skills, and the quality of life.

Assessment & Screening Tools

The American Academy of Pediatrics (AAP) recommends that all children be screened for developmental delays and disabilities during regular well-child doctor visits at 9 months, 18 months, and 24 (or 30) months. Additional screening might be needed if a child is at high risk for developmental problems because of preterm birth or low birth weight. In addition, all children should be screened specifically for ASD during regular well-child doctor visits at 18 months and 24 months, with additional screening needed if a child is at high risk for ASD (e.g., having a sibling with an ASD) or if symptoms are present:

Parent report (SCREENING)

Modified Checklist for Autism in Toddlers (M-CHAT-R/F) w/ follow-up
Ages and Stages Questionnaires (ASQ)
Communication and Symbolic Behavior Scales (CSBS)
Parents’ Evaluation of Developmental Status (PEDS)
CSBS DP Infant-Toddler Checklist (ages 3 – 24 months)
Autism Behavior Checklist (ABC)
Social Communication Questionnaire (SCQ)
Autism Treatment Evaluation Checklist (ATEC) – free

The Clinician (SCREENING)

MCHAT and MCHAT official website screening (16 – 48 mo)
MCHAT-R/F Modified Checklist for Autism in Toddlers – Revised with Followup (2013); official website

The Clinician (DIAGNOSTIC & OTHER)

Autism Diagnosis Interview-Revised (ADI-R): 18 months and older
Autism Diagnostic Observation Schedule – Generic (ADOS-G)
Childhood Autism Rating Scale (CARS): 2 years old and older
Gilliam Autism Rating Scale – Second Edition (GARS-2): Ages 3-22 years
Autism Screening Instrument for Educational Planning (ASIEP-3)
Childhood Autism Rating Scale (CARS)
Autism Research Institute’s Form E-2 Checklist

–DBMH Resource

Developmental Disorder Support

External Links

The Arc
Autism Society
Autism Speaks
Autism Spectrum Disorder: This brochure provides information about the symptoms, diagnosis, and treatment of ASD.

Research

Many research studies supported by the National Institutes of Health (NIH) and the National Institute of Mental Health (NIMH) focus on gaining a better understanding of ASD and on finding the best diagnosis and treatment options for this disorder. The links below provide information about NIH and NIMH support for ASD research: