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Autism and other pervasive developmental disorders: exploring the dimensional view
1Department of Psychiatry, McGill University, Montreal, Quebec. gmyhr@po-box.megill.ca
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|September 8, 1998
Summary
Children with autistic spectrum disorders may exist on a continuum, with two main groups identified: lower-functioning and higher-functioning. Current diagnostic criteria, like the DSM-IV, may not fully capture these distinctions, especially for higher-functioning pervasive developmental disorder (PDD) presentations.
Area of Science:
- Neurodevelopmental Disorders
- Child Psychiatry
- Developmental Psychology
Background:
- Autistic disorder (AD), Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS) are distinct diagnoses within the autism spectrum.
- Understanding the continuities and distinguishing features among these diagnoses is crucial for accurate classification and intervention.
Purpose of the Study:
- To analyze empirical data on children diagnosed with AD, Asperger's disorder, and PDD-NOS.
- To assess the alignment of Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) criteria with observed clinical data.
- To identify continuities and distinguishing features within the pervasive developmental disorder (PDD) spectrum.
Main Methods:
- Systematic literature search including Medline and hand-searching of the Journal of Autistic and Developmental Disorder.
- Inclusion of studies using cluster analysis for PDD subtypes and empirically derived studies on PDD characteristics.
- Review of references from key articles and identified studies.
Main Results:
- Data suggests two overlapping groups within PDD: a lower-functioning group with greater impairment and autistic symptoms, and a higher-functioning group with better cognitive abilities and prosocial behavior.
- These PDD subtypes appear to exist on a continuum, differing primarily in the degree of impairment.
- The DSM-IV criteria for AD, Asperger's disorder, and PDD-NOS may not fully differentiate these observed groups.
Conclusions:
- Children with the triad of autistic impairments can be viewed as existing on a PDD continuum.
- The DSM-IV adequately identifies a lower-functioning autistic group (AD) but less effectively serves the higher-functioning group.
- Asperger's disorder and PDD-NOS are not clearly distinguishable from AD, and PDD-NOS lacks clear operationalization, necessitating further research for refined diagnostic criteria.