Autism Spectrum Disorders

2. Asperger's Syndrome
Asperger's syndrome, also called Asperger's disorder, is a type of pervasive
developmental disorder (PDD). PDDs are a group of conditions that involve
delays in the development of many basic skills, most notably the ability to
socialize with others, to communicate, and to use imagination.
Although Asperger's syndrome is similar in some ways to autism -- another,
more severe type of PDD -- there are some important differences. Children
with Asperger's syndrome typically function better than do those with
autism. In addition, children with Asperger's syndrome generally have normal
intelligence and near-normal language development, although they may
develop problems communicating as they get older.
Asperger's syndrome was named for the Austrian doctor, Hans Asperger,
who first described the disorder in 1944. However, Asperger's syndrome was
not recognized as a unique disorder until much later.

What Are the Symptoms of Asperger's Syndrome?

The symptoms of Asperger's syndrome vary and can range from mild to
severe. Common symptoms include:

Problems with social skills: Children with Asperger's syndrome

generally have difficulty interacting with others and often are awkward in
social situations. They generally do not make friends easily. They have
difficulty initiating and maintaining conversation.

Eccentric or repetitive behaviors: Children with this condition may

develop odd, repetitive movements, such as hand wringing or finger twisting.

Unusual preoccupations or rituals: A child with Asperger's syndrome

may develop rituals that he or she refuses to alter, such as getting dressed in
a specific order.

Communication difficulties: People with Asperger's syndrome may not

make eye contact when speaking with someone. They may have trouble
using facial expressions and gestures, and understanding body language.
They also tend to have problems understanding language in context and are
very literal in their use of language.


Limited range of interests: A child with Asperger's syndrome may
develop an intense, almost obsessive, interest in a few areas, such as sports
schedules, weather, or maps.

Coordination problems: The movements of children with Asperger's

syndrome may seem clumsy or awkward.

Skilled or talented: Many children with Asperger's syndrome are

exceptionally talented or skilled in a particular area, such as music or math.
What Causes Asperger's Syndrome?
The exact cause of Asperger's syndrome is not known. However, the fact that
it tends to run in families suggests that a tendency to develop the disorder
may be inherited (passed on from parent to child).

How Common Is Asperger's Syndrome?

Asperger's syndrome has only recently been recognized as a unique disorder.
For that reason, the exact number of people with the disorder is unknown.
While it is more common than autism, estimates for the United States and
Canada range from 1 in every 250 children to 1 in every 10,000. It is four
times more likely to occur males than in females and usually is first
diagnosed in children between the ages of 2 and 6 years.

How Is Asperger's Syndrome Diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a
complete medical history and physical and neurological exam. Many
individuals with Asprgers have low muscle tone and dyspraxia, or
coordination issues. Although there are no tests for Asperger's syndrome, the
doctor may use various tests -- such as X-rays and blood tests -- to
determine if there is a physical disorder causing the symptoms.
If no physical disorder is found, the child may be referred to a specialist in
childhood development disorders, such as a child and adolescent psychiatrist
or psychologist, pediatric neurologist, developmental-behavioral pediatrician,
or another health professional who is specially trained to diagnose and treat
Asperger's syndrome. The doctor bases his or her diagnosis on the child's
level of development, and the doctor's observation of the child's speech and
behavior, including his or her play and ability to socialize with others. The

doctor often seeks input from the child's parents, teachers, and other adults
who are familiar with the child's symptoms.

How Is Asperger's Syndrome Treated?

Right now, there is no cure for Asperger's syndrome, but treatment may
improve functioning and reduce undesirable behaviors. Treatment may
include a combination of the following:

Special education: Education that is structured to meet the child's

unique educational needs.

Behavior modification: This includes strategies for supporting positive

behavior and decreasing problem behaviors.

Speech, physical, or occupational therapy: These therapies are

designed to increase the child's functional abilities.

Social skills therapies: Run by a psychologist, counselor, speech

pathologist, or social worker, these therapies are invaluable ways to build
social skills and the ability to read verbal and non-verbal cues that is often
lacking in those with Asperger's.

Medication: There are no medications to treat Asperger's syndrome

itself, but drugs may be used to treat specific symptoms such as anxiety,
depression, hyperactivity, and obsessive-compulsive behavior.

What Is the Outlook for People With Asperger's Syndrome?

Children with Asperger's syndrome are at risk for developing other
conditions, such asdepression, ADHD, schizophrenia, and obsessivecompulsive disorder. But, there are various treatment options available for
these conditions.
Because the level of intelligence often is average or higher than average,
many people with Asperger's syndrome are able to function very well. They

may, however, continue to have problems socializing with others through

adulthood.

Can Asperger's Syndrome Be Prevented?

Asperger's syndrome cannot be prevented or cured. However, early
diagnosis and treatment can improve function and quality of life.

http://www.webmd.com/brain/autism/mental-health-aspergers-syndrome?page=2

3. Pervasive Development Disorder-Not Otherwise

Specified (PDD-NOS), defined
Children with PDDNOS have some symptoms similar to those associated
with Autistic disorder and Asperger syndrome. Usually, these involve delays
in the development of many basic skills concerned with understanding the
social world; the ability to socialize, to communicate, to empathize in the
right way and at the right moment, and to use imagination.
To complicate matters somewhat, PDDNOS is also be referred to as 'atypical
personality development,' 'atypical PDD,' or 'atypical Autism'. There seems
to be a myth that when a child is identified with PDD-NOS it means that they
also have autism. This is where it gets complicated. To explain this
complication, a child may display mild symptoms of a Pervasive
Developmental Disorder and still qualify for the PDD-NOS label. Yet, they may
present with very severe language and communication skill delays, but still
not qualify for an autism diagnosis.
Typically, the symptoms are observed in children before they are 3 years old
(this is why it is considered a Pervasive Development Disorder). Parents often
notice problems in their toddler because they are not walking, talking, or
developing as well as other children the same age. Another difficulty here is
that although a toddler's behavior might seem to fit the criteria, the
behaviours could just be part of his or her developing personality. It is wise to
understand that the boundaries between PDDNOS and non-autistic
conditions have never been fully resolved. It is not unusual to see a PDD
NOS diagnosis followed up by an autism diagnosis a few years later.

Interestingly, in the proposed DSM-V, PDDNOS would disappear and be

replaced by Autism Spectrum Disorder.
While some argue that PDDNOS is a catch-all diagnosis it is described as an
impairment in one or two of the three areas usually required for an Autism
Spectrum Disorder diagnosis (namely social interaction, communication and
restrictive/ compulsive/ repetitive behaviours). Though, not all of the features
of Autism Spectrum Disorder are apparent.

Indicators usually include;

1. Social interaction

social 'reserve' or 'distance' that leads to a failure to develop

friendships

will seek the company of others without engaging in a two-way social

interaction (e.g. poor reciprocal skills

and one-sided conversations which tend to be repetitive, with the

same question or phrase repeated)

poor eye contact

difficulties grasping basic social rules resulting in unintentional socially

embarrassing comments / moments

difficulty understanding the motivation, perspectives and feelings of

others

increased use of non-verbal communication behaviours, such as facial

expressions and gestures

2. Communication

difficulty starting and maintaining conversation with others

a stereotyped use of language (e.g. using statements they have heard

others use without really understanding its meaning)

seen as a 'loner' who has difficulties with social interaction. Tends to

enjoy solitary activities

3. Restrictive / compulsive / repetitive behaviours

Repetitive behaviours may be seen as hand flapping, making sounds,

head rolling, or body rocking

Typical compulsive or ritualistic behaviours - must follow rules, must do

it the same way such as arranging objects in stacks or lines, sticking to
a rigid pattern of daily activities, such as same food or same dressing
ritual, even insisting drawing outlines on the floor so that the furniture
will not be moved

Restricted behaviour limited focus, interest, or activity, such as

obsessed by a single television programme, toy, or game.

What interventions are worth considering?

To achieve the best possible progress children identified with PDDNOS need
focused support and intervention early on. And, the intervention programme
must be tailored to suit the child's specific needs. The overriding aim is to
promote better socialising and communication, and reduce behaviors that
can interfere with learning and functioning.
Aprogram of intervention addresses the child's needs at home and at school.
The best intervention plan always involves a cooperative effort between
parents, health care professionals and educators. Elements may include;

Special Education - this is the concept of tailoring or adapting day to

day education to specifically meet a child's unique learning needs. This
may include modified curriculum and modified reporting systems. It is
obligatory in most developed countries.

Establish an Individualised Educational Plan (IEP) or a

Negotiated Educational Plan (NEP) - this is a plan formulated by
school staff, specialists and parent input. This plan lays the groundwork
for necessary therapies and academic training. IEPs and NEPs can be
developed as funded or unfunded options.

Behavior Modification - the development of positive strategies to

support the behaviour of the child to improve their learning and
functioning (Applied Behavior Analysis makes use of reinforcements so
that the child learns to respond in a particular manner. It rewards
positive behaviours and ignores the undesirable ones. The desired
outcomes are broken down into attainable, success-based tasks. This

teaches the child how to learn so that they can then move on to
academic work)

Teaching and learning - quite often, these children simply require a

little more time to learn and respond. Their learning is always buoyed
by additional visual input. Never underestimate the positive impact on
learning when a student and teacher (and parents) have the best of
relationship.

Develop visual aids; schedules, planners and timetables - these

children often resist change to their routines. It is important to provide
them with a plan so they know what activities are first, next, and last.
If they are unable to read, then use picture cues on the schedule.
These kids are reliant on advanced notice of imminent changes.

Speech Therapy - this specialized additional work is often needed to

correct specific letter and word pronunciations. When necessary,
language skills are addressed to help the child learn how to respond
appropriately to certain phrases and questions. This type of therapy is
often administered on an individualized basis, by a speech therapist. It
is very appropriate for therapy to occur during the course of the school
day.

Occupational Therapy - offers designs to increase the child's day to

day and classroom functional abilities (sensory integration therapy).
Sensory problems often cause children to be overly sensitive to
textures, noises, smells and sounds. If the child has problems with fine
motor skills that hinder writing and other class tasks, therapy can be
used to address these problems as well. Again, it is very appropriate
for therapy to occur during the course of the school day.

Medication - considered to treat specific secondary symptoms such as

anxiety, depression, hyperactivity and highly aggressive or reactive
behaviours

Social Skills Training - where children are explicitly taught pro-social

behaviours; how to interact with their peers in specific situations

Complementary Therapies - martial arts, gymnastics and music

therapy, assist children flex their muscles, literally and figuratively, as
they learn how to function in a group setting away from school

http://www.whatsthebuzz.net.au/whatsthebuzz/pervasivedevelopmentdisordernototherwise
specifiedpddnos