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Autism Spectrum Disorder (Differential Diagnosis (IDD without ASD - A…
Autism Spectrum Disorder
Specifiers
Severity may fluctuate by context & over time.
Severity of social communication and restricted, repetitive behaviors should be separately rated.
The descriptive categories should not be used to determine eligibility for and provision of services.
Regarding the specifier "with or without accompanying intellectual impairment," understanding the intellectual profile of a child or adult with ASD is necessary for interpreting Dx features. Separate estimates of verbal and nonverbal skill are necessary.
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With or without accompanying:
Intellectual impairment
Language impairment
Catatonia
Ass. with known medical, genetic, environmental or neurodevelopment disorder
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Development and Course
Deficits in developing, maintaining, and understanding relationships should be judged against norms for age, gender, and culture
Onset: early developmental period usually in the second year of life (12-24 months), however symptoms can be seen earlier in more severe cases
Language deficits usually appear first with behavioural/social impairment presenting in early childhood.
Identifying restrictive AND repetitive behaviours can be difficult as most children will engage in repetitive behaviours
In later life, intervention or compensation, as well as current supports, may mask these dif ficulties in at least some contexts
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Differential Diagnosis
IDD without ASD - A diagnosis of autism spectrum disorder in an individual with intellectual disability is appropriate when social communication and interaction are significantly im paired relative to the developmental level of the individual's nonverbal skills
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Rett syndrome - after developmental period, most will develop their social communication skills
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Selective mutism - early development is not typically distributed. I.e. even in times where child is mute, their repetitive behaviours may not be impaired.
Diagnostic Criteria
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B. Restricted, repetitive behavior, interests, activities
- Stereotyped repetitive movements, speech or use of objects
- Insistence on sameness or ritualised behaviours (v&nv)
- Highly restricted, fixated interests
- Hyper- or hyporeactivity to sensory input (e.g. indifference to pain/temperature).
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A. Persistent deficits in social communication and interaction across contexts:
- Deficits in reciprocity (social-emotional)
- Deficits in nonverbal
- Deficits in relationships