![]() Diagnosis requires that the individual exhibit autistic-like social difficulty along with impairment in either communication or restricted/repetitive interests or behaviors. 9 PDD-NOS denotes a sub-threshold form of autism, or a manifestation of PDD that is atypical in terms of onset patterns or symptomatology such that defining features of other PDDs are not met. Furthermore, a precedence rule indicates that, to meet criteria for Asperger’s Disorder, one cannot meet criteria for another specific PDD. Asperger’s Disorder differs from Autistic Disorder in (a) omission of diagnostic criteria in the communication domain (b) absence of a requirement for onset prior to age three and (c) addition of criteria specifying harmful dysfunction, absence of a language delay, and absence of deficits in cognitive development or non-social adaptive function. ![]() Asperger’s Disorder is identical to Autistic Disorder in terms of requiring two symptoms from the social domain and one from the stereotyped behavior domain. Contrasting the disorder from more general intellectual impairment, these social and communicative deficits are considered with respect to overall developmental level. Diagnosis of Autistic Disorder requires a minimum of six behavioral criteria, at least two from the domain of social impairment and one from each of the other two areas of impairment (communication and restricted/repetitive behaviors). The class of PDDs includes five disorders, with the term, ASD, applied to Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), excluding Rett’s syndrome and Childhood Disintegrative Disorder. The current DSM diagnostic taxonomy 8 places ASDs in the category of pervasive developmental disorders (PDDs). 6 Considering the possibility that increased prevalence reflects improved recognition and increased awareness, higher prevalence might reflect that individuals likely to benefit from intervention are being identified and provided access to therapeutic services. For example, inclusion of Asperger’s Disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) 5, likely contributed to subsequent impressions of increased prevalence by encouraging explicit identification of higher functioning children with significant social disabilities whose language, in many respects, was less impaired than in classic autism. 4 Changes in diagnostic criteria have also played a role. Multiple factors other than a true increase in incidence likely influence this number: greater recognition due to growing public and professional awareness of ASDs, use of the label in educational settings to establish service eligibility, and a broadening of the diagnostic construct beyond strictly defined autistic disorder. 1 Estimates from individual epidemiological studies have ranged as high as 2.64 percent, 2 raising public concerns about an autism “epidemic.” 3 Although current estimates represent an increase from prior estimates, the nature of this change is unclear. ![]() Autism spectrum disorders (ASDs) are one of the most common neurodevelopmental disorders, with an estimated prevalence of 1 in 110 children. ![]()
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