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Autistic
disorder, as defined by the World Health Organization in the ICD-10
Classification of Mental and Behavioural Disorders (1992) is distinguished
into two types.
http://www.mentalhealth.com/icd/p22-ch06.html
- Childhood
Autism, a pervasive developmental disorder defined by the presence of
impaired development before the age of 3 years, with abnormal functioning
in all three areas of social interaction, communication, and restricted,
repetitive behaviour.
- Atypical
Autism, which differs from Childhood Autism in later age of onset or
in insufficient clear evidence of abnormalities in one or two of the
areas of impaired development.
North American
professionals follow the American Psychiatric Association’s Diagnostic
and Statistical Manual of Mental Disorders (DSM), with the 4th
edition (DSM IV, 1994) being the current authority. www.autism-biomed.org/dsm-iv.htm
DSM IV distinguishes
five subtypes within the broader category it calls Pervasive Developmental
Disorders, and prescribes the diagnostic criteria and associated features
for each type:
- Autistic
Disorder or classic autism, for children with severe qualitative deficits
in all three areas
- Rett’s
Syndrome (see section below)
- Childhood
Disintegrative Disorder (or Heller’s Syndrome) which affects previously
normal children who undergo massive regression between 2 and 10 years,
resulting in severe acquired autism, usually with loss of cognitive
skills—but not because of schizophrenia or degenerative disease of the
brain
- Asperger’s
Disorder (see section below)
- PDDNOS
(Pervasive Developmental Disorders Not Otherwise Specified) including
Atypical Autism—the label for children with autistic behaviour who do
not fit any of the other specific types in the spectrum.
The category
term Pervasive Developmental Disorders has been adopted by some professionals
in Ontario and Canada. But many professionals, parents and caregivers
are not satisfied with the labels and language of DSM IV. Dr Bernard Rimland,
founder of the Autism Research Institute in San Diego, CA and the most
influential professional in the field of autism in the United States,
prefers the term autism spectrum disorder, which is now more commonly
used outside North America. Rimland bluntly declares that "the label
PDD is poorly understood, uninformative, confusing, disliked, and should
be abandoned." http://www.autism.org/pdd.html
For another critique, based on social justice, see Autism National
Committee http://www.autcom.org/statement.html.
Two useful
diagnostic tools are noted. The first was developed by Rimland in the
1960s and helped in identifying autism in thousands of autistic children
in North America. Participating families may respond to the Autism Research
Institute’s Form E-2 Check List questionnaire, and receive a score that
indicates their child’s general position on the autism spectrum; they
thus also contribute to the largest database about autistic people. Form
E-2 is posted at www.autism.com/ari/e23.html
The Childhood Autism Rating Scale (CARS) was devised by Eric Schopler
at the University of North Carolina; see details at www.parinc.com/achieve/CARS9h.html
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