Autism classification: Difference between revisions

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Revision as of 05:36, 1 April 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

DSM 5 categorized autism under autistic spectrum disorders/pervasive developmental disorders (PDD). Autistic spectrum of disorders are characterized by widespread abnormalities of social interactions, communication associated with severely restricted interests and repetitive behavior and can be classified into 5 types.

Classification

DSM 5 categorized autism under autistic spectrum disorders/pervasive developmental disorders (PDD). Autistic spectrum of disorders are characterized by widespread abnormalities of social interactions, communication associated with severely restricted interests and repetitive behavior.^[1]^[2]^[3]

Autistic spectrum disorder

Autistic disorder

Retts disorder

Childhood disintegrative disorder

Pervasive developmental disorder

Asperger's disorder

Based on the degree of severity and level of support ASD are classified into 3 types^[2]^[4]^[5]

Severity level		Social communication	Restricted, repetitive behaviors
Level 3	Requiring very substantial support	Severe deficits in verbal and non-verbal communication skills Severe impairment in functioning Very limited initiation of social interactions Minimal response to social overtures from others	Inflexibility of behavior Extreme difficulty in coping with change Repeated behavior markedly interferes with functioning in all spheres Great distress/difficulty changing focus or action
Level 2	Requiring substantial support	Marked deficits in verbal and non-verbal communication skills Marked impairment in functioning Limited initiation of social interactions	Difficulty in coping with change Distress/difficulty changing focus or action Repetitive behaviors occur frequently
Level 1	Requiring support	Without support, deficits in verbal and non-verbal communication skills Atypical and unusual social responses	Interference with functioning in one or more context Problems of organization and planning hamper independence

References

↑ Geschwind DH, Levitt P (2007). "Autism spectrum disorders: developmental disconnection syndromes". Curr Opin Neurobiol. 17 (1): 103–11. doi:10.1016/j.conb.2007.01.009. PMID 17275283.
↑ ^2.0 ^2.1 Piven J, Palmer P, Jacobi D, Childress D, Arndt S (1997). "Broader autism phenotype: evidence from a family history study of multiple-incidence autism families" (PDF). Am J Psychiatry. 154 (2): 185–90. PMID 9016266.
↑ Cohen D, Pichard N, Tordjman S; et al. (2005). "Specific genetic disorders and autism: clinical contribution towards their identification". J Autism Dev Disord. 35 (1): 103–16. doi:10.1007/s10803-004-1038-2. PMID 15796126.
↑ Freitag CM (2007). "The genetics of autistic disorders and its clinical relevance: a review of the literature". Mol Psychiatry. 12 (1): 2–22. doi:10.1038/sj.mp.4001896. PMID 17033636.
↑ Stephan DA (2008). "Unraveling autism". Am J Hum Genet. 82 (1): 7–9. doi:10.1016/j.ajhg.2007.12.003. PMID 18179879.

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[1] Geschwind DH, Levitt P (2007). "Autism spectrum disorders: developmental disconnection syndromes". Curr Opin Neurobiol. 17 (1): 103–11. doi:10.1016/j.conb.2007.01.009. PMID 17275283.

[:0-2] 2.0 ^2.1 Piven J, Palmer P, Jacobi D, Childress D, Arndt S (1997). "Broader autism phenotype: evidence from a family history study of multiple-incidence autism families" (PDF). Am J Psychiatry. 154 (2): 185–90. PMID 9016266.

[Cohen-3] Cohen D, Pichard N, Tordjman S; et al. (2005). "Specific genetic disorders and autism: clinical contribution towards their identification". J Autism Dev Disord. 35 (1): 103–16. doi:10.1007/s10803-004-1038-2. PMID 15796126.

[Freitag-4] Freitag CM (2007). "The genetics of autistic disorders and its clinical relevance: a review of the literature". Mol Psychiatry. 12 (1): 2–22. doi:10.1038/sj.mp.4001896. PMID 17033636.

[5] Stephan DA (2008). "Unraveling autism". Am J Hum Genet. 82 (1): 7–9. doi:10.1016/j.ajhg.2007.12.003. PMID 18179879.

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[2]

[3]

[4]

[5]

@@ Line 4: / Line 4: @@
 == Overview ==
+DSM 5 categorized autism under autistic spectrum disorders/[[pervasive developmental disorder]]s (PDD). Autistic spectrum of disorders are characterized by widespread abnormalities of social interactions, communication associated with severely restricted interests and repetitive behavior and can be classified into 5 types.
 ==Classification==
-DSM 5 categorized autism under autistic spectrum disorders/[[pervasive developmental disorder]]s (PDD). Autistic spectrum of disorders are characterized by widespread abnormalities of social interactions, communication associated with severely restricted interests and repetitive behavior.<ref>{{cite journal |journal= Curr Opin Neurobiol |date=2007 |volume=17 |issue=1 |pages=103–11 |title= Autism spectrum disorders: developmental disconnection syndromes |author= Geschwind DH, Levitt P |doi=10.1016/j.conb.2007.01.009 |pmid=17275283}}</ref><ref name=":0" /><ref name="Cohen" />
+DSM 5 categorized autism under autistic spectrum disorders/[[pervasive developmental disorder]]s (PDD). Autistic spectrum of disorders are characterized by widespread abnormalities of social interactions, communication associated with severely restricted interests and repetitive behavior.<ref>{{cite journal |journal= Curr Opin Neurobiol |date=2007 |volume=17 |issue=1 |pages=103–11 |title= Autism spectrum disorders: developmental disconnection syndromes |author= Geschwind DH, Levitt P |doi=10.1016/j.conb.2007.01.009 |pmid=17275283}}</ref><ref name=":0">{{cite journal |author= Piven J, Palmer P, Jacobi D, Childress D, Arndt S |title= Broader autism phenotype: evidence from a family history study of multiple-incidence autism families |journal= Am J Psychiatry |date=1997 |volume=154 |issue=2 |pages=185–90 |pmid=9016266 |url=http://ajp.psychiatryonline.org/cgi/reprint/154/2/185.pdf |format=PDF}}</ref><ref name="Cohen">{{cite journal |journal= J Autism Dev Disord |date=2005 |volume=35 |issue=1 |pages=103–16 |title= Specific genetic disorders and autism: clinical contribution towards their identification |author= Cohen D, Pichard N, Tordjman S ''et al.'' |doi=10.1007/s10803-004-1038-2 |pmid=15796126}}</ref>
 {{family tree/start}}
 {{family tree | | | | | | | | | | A01 | | | | | | | | | |A01= Autistic spectrum disorder}}
@@ Line 14: / Line 15: @@
 {{family tree/end}}
-Based on the degree of severity and level of support ASD are classified into 3 types<ref name=":0" /><ref name="Freitag" /><ref>{{cite journal |journal= Am J Hum Genet |date=2008 |volume=82 |issue=1 |pages=7–9 |title= Unraveling autism |author= Stephan DA |doi=10.1016/j.ajhg.2007.12.003 |pmid=18179879}}</ref>
+Based on the degree of severity and level of support ASD are classified into 3 types<ref name=":0" /><ref name="Freitag">{{cite journal |author=Freitag CM |title= The genetics of autistic disorders and its clinical relevance: a review of the literature |journal= Mol Psychiatry |volume=12 |issue=1 |pages=2–22 |date=2007 |doi=10.1038/sj.mp.4001896 |pmid=17033636}}</ref><ref>{{cite journal |journal= Am J Hum Genet |date=2008 |volume=82 |issue=1 |pages=7–9 |title= Unraveling autism |author= Stephan DA |doi=10.1016/j.ajhg.2007.12.003 |pmid=18179879}}</ref>
 {| class="wikitable"
@@ Line 24: / Line 25: @@
 |Requiring very substantial support
 |
-* Sever deficits in verbal and non-verbal communication skills
+* Severe deficits in verbal and non-verbal communication skills
-* Sever impairment in functioning
+* Severe impairment in functioning
-*
+* Very limited initiation of social interactions
+* Minimal response to social overtures from others
 |
+* Inflexibility of behavior
+* Extreme difficulty in coping with change
+* Repeated behavior markedly interferes with functioning in all spheres
+* Great distress/difficulty changing focus or action
 |-
 |Level 2
 |Requiring substantial support
 |
+* Marked deficits in verbal and non-verbal communication skills
+* Marked impairment in functioning
+* Limited initiation of social interactions
 |
+* Difficulty in coping with change
+* Distress/difficulty changing focus or action
+* Repetitive behaviors occur frequently
 |-
 |Level 1
 |Requiring support
 |
+* Without support, deficits in verbal and non-verbal communication skills
+* Atypical and unusual social responses
 |
+* Interference with functioning in one or more context
+* Problems of organization and planning hamper independence
 |}
-The terminology of autism can be bewildering, with autism, Asperger's and PDD-NOS often called the ''autism spectrum disorders'' (ASD) or sometimes the ''autistic disorders'',<ref name="Freitag">{{cite journal |author=Freitag CM |title= The genetics of autistic disorders and its clinical relevance: a review of the literature |journal= Mol Psychiatry |volume=12 |issue=1 |pages=2–22 |date=2007 |doi=10.1038/sj.mp.4001896 |pmid=17033636}}</ref> whereas autism itself is often called ''autistic disorder'', ''childhood autism'', or ''infantile autism''. In this article, ''autism'' refers to the classic autistic disorder, while other sources sometimes use ''autism'' or ''the autisms'' to refer to ASD, or equate ASD with PDD. ASD, in turn, is a subset of the broader autism [[phenotype]] (BAP), which describes individuals who may not have ASD but do have autistic-like [[Trait (biology)|traits]], such as avoiding eye contact.<ref name=":0">{{cite journal |author= Piven J, Palmer P, Jacobi D, Childress D, Arndt S |title= Broader autism phenotype: evidence from a family history study of multiple-incidence autism families |journal= Am J Psychiatry |date=1997 |volume=154 |issue=2 |pages=185–90 |pmid=9016266 |url=http://ajp.psychiatryonline.org/cgi/reprint/154/2/185.pdf |format=PDF}}</ref>
-The manifestations of autism cover a wide [[Spectrum disorder|spectrum]], ranging from individuals with severe impairments—who may be silent, [[mentally disabled]], and locked into hand flapping and rocking—to less impaired individuals who may have active but distinctly odd social approaches, narrowly focused interests, and verbose, pedantic communication.<ref>{{cite journal |author=Happé F |title= Understanding assets and deficits in autism: why success is more interesting than failure |journal=Psychologist |volume=12 |issue=11 |pages=540–7 |date=1999 |url=http://www.thepsychologist.org.uk/archive/archive_home.cfm/volumeID_12-editionID_46-ArticleID_133-getfile_getPDF/thepsychologist/psy_11_99_p540-547_happe.pdf |format=PDF}}</ref> Sometimes the syndrome is divided into low-, medium- and [[high-functioning autism]] (LFA, MFA, and HFA), based on [[IQ]] thresholds, or on how much support the individual requires in daily life; these subdivisions are not standardized and are controversial. Autism can also be divided into [[syndrome|syndromal]] and non-syndromal autism, where the former is associated with severe or profound [[mental retardation]] or a congenital syndrome with physical symptoms, such as [[tuberous sclerosis]].<ref name="Cohen">{{cite journal |journal= J Autism Dev Disord |date=2005 |volume=35 |issue=1 |pages=103–16 |title= Specific genetic disorders and autism: clinical contribution towards their identification |author= Cohen D, Pichard N, Tordjman S ''et al.'' |doi=10.1007/s10803-004-1038-2 |pmid=15796126}}</ref> Although individuals with Asperger's tend to perform better cognitively than those with autism, the extent of the [[Diagnosis of Asperger syndrome#Differences from high-functioning autism|overlap between Asperger's, HFA, and non-syndromal autism]] is unclear.<ref>Validity of ASD subtypes:
-*{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}
-*{{cite journal |journal= J Autism Dev Disord |date=2008 |title= Examining the validity of autism spectrum disorder subtypes |author= Witwer AN, Lecavalier L |doi=10.1007/s10803-008-0541-2 |pmid=18327636}}</ref>
-Some studies have reported diagnoses of autism in children due to a loss of language or social skills after 14 months of age, as opposed to a failure to make progress. Several terms are used for this phenomenon, including [[regressive autism]], setback autism, and developmental stagnation. The validity of this distinction remains controversial; it is possible that regressive autism is a specific subtype.<ref name="Volkmar">{{cite journal |author= Volkmar F, Chawarska K, Klin A |title= Autism in infancy and early childhood |journal= Annu Rev Psychol |date=2005 |volume=56 |pages=315–36 |doi=10.1146/annurev.psych.56.091103.070159 |pmid=15709938}} A partial update is in: {{cite journal |journal= World Psychiatry |date=2008 |volume=7 |issue=1 |pages=19–21 |title= Autism in infants: an update |author= Volkmar FR, Chawarska K |pmid=18458791 |pmc=2366821}}</ref>
-The inability to identify biologically meaningful subpopulations has hampered research into causes.<ref>{{cite journal |journal=Pediatrics |date=2008 |volume=121 |issue=6 |pages=1225–9 |title= Autism and the environment: challenges and opportunities for research |author= Altevogt BM, Hanson SL, Leshner AI |doi=10.1542/peds.2007-3000 |pmid=18519493}}</ref> It has been proposed to classify autism using genetics as well as behavior, with the name ''Type 1 autism'' denoting rare autism cases that test positive for a mutation in the gene [[contactin associated protein-like 2]] (CNTNAP2).
 ==References==

Autism classification: Difference between revisions

Revision as of 05:36, 1 April 2018

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