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IN
CHILDREN
Autism Spectrum
Disorders or Pervasive
Developmental Disorder
Types of PDD (ICD-10)
• Childhood autism
autistic ds, infantile autism, infantile psychoses,
Kanner’s syndrome
• Atypical autism
• Rett’s syndrome
• Childhood disintegrative ds
• Overactive ds associated with MR
• Asperger’s syndrome
• PDD- not otherwise specified
Diagnosis: 3 main areas of impairment in
PDD or ASD
• Asperger Syndrome
• 36 per 10,000
• Male preponderance
Differential diagnoses of childhood autism
• Deafness
• Developmental language disorder
• Mental retardation with autistic features
• Mental retardation without autistic
features
• Intense early deprivation
• Pervasive developmental disorders:
Asperger Syndrome, Rett’s syndrome,
Degenerative disorder, atypical
autism, PDD-not otherwise specified
Treatment plan
Establish goals for educational
purposes
Establish target symptoms for
intervention
Co-morbid conditions
Monitoring
Multiple domains of functioning
Medication
The little “ Rascals ”
@
Attention Deficit Hyperactive Disorder
(ADHD)
Hyperkinetic children
“Hyperactive”
– parents
all manner of behaviours
e.g. frequent night awakenings, talking loudly, naughtiness,
exuberance
depends on attitudes and tolerance of parents
MUST always pay attention to the stage of
development
when deciding normality and abnormality
Hyperactive Children
“Hyperactive”
– psychiatrists
more restrictive definition
restlessness
inattentiveness
impulsiveness
Hyperactive Children
Overactive :
increase in amount and tempo of purposeful activity
increase in number of purposeless minor movements
irrelevant to tasks
e.g. wriggle and squirm in seat
fidget with objects
restless
unable to suppress activity when stillness is required
e.g. in classroom or at meal table
Little “ Rascals ”
Core symptoms
• Hyperactivity
– More active than children their age
• Inattentive
– Short attention span
• Impulsive
– Poor impulse control
• Pervasive
– Symptoms occur across all situations
Little “ Rascals ”
Hyperactivity
• Unknown
• Unlikely to be a single etiological factor
• Most likely an interplay
– psychosocial & biological factors
Little “ Rascals ”
Management
– Pharmacological treatment
– Psychological intervention
– Educational support
Little “ Rascals ”
Prognosis
• Hyperactivity wanes in adolescence
• 30% have residual symptoms in adulthood
– Restless & inattentive
• 30% have no symptoms with good functioning
– Choose job which allow freedom of movement
• 30% continuous display of symptom
– Develop other psychopathologies
• E.g. substance abuse & anti-social personality
CONDUCT DISORDER
Conduct Disorder
• Core symptoms characterised by
- persistent failure to control behaviour
appropriately within socially defined rules
• Etiology
* no single factor
* contributing bio-psycho-social
factors
Conduct Disorder
• Biological factors
- proposed neurotransmitter imbalance
- excessive testosterone
- abnormal arousal with failure to calm
down after frustration
Conduct Disorder
• Social factors
- Family
* chaotic home
* verbal aggression
* severe punishment
* marital discord
* child abuse
* parental psychopathology
Conduct Disorder
• Social factors
- Community
* economically deprived
* high criminality
* unsupportive social network
Conduct Disorder
• Psychological factors
- anger
- frustration
- hatred
- dissatisfaction
Conduct Disorder
• negativistic
• hostile
• defiant