Developmental Milestones and Autism Spectrum Disorder

General Developmental Milestones

• Language and communication
• Socializing
• Cognitive skills (e.g., problem-solving)
• Physical milestones (e.g., walking, crawling, fine motor skills)
• Progression is tied to brain development.

Neurodevelopmental Disorders

• Occur when developmental milestones do not proceed as scheduled.
• Autism: A type of neurodevelopmental disorder affecting social interaction and communication.
• Origin of 'autism': From 'auto' meaning self, indicating isolation from social interaction.

Historical Context

• DSM-IV (pre-2013): Described various pervasive developmental disorders (PDDs):
  • Autism
  • Asperger's Syndrome
  • Childhood Disintegrative Disorder
  • Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)

Asperger's Syndrome

• Characteristics: Difficulties in social interaction and nonverbal communication without significant delays in language or cognitive development.
• Often referred to as a “high-functioning” form of autism.

Childhood Disintegrative Disorder

• Late onset of developmental delays after a period of normal development (ages 2-10).

PDD-NOS

• Catch-all category for patients meeting some but not all features of autism, Asperger's, or Childhood Disintegrative Disorder.

DSM-5 Changes (2013 and after)

• Replaced previous PDD terms with Autism Spectrum Disorder (ASD)
• ASD Spectrum: Differentiates based on the severity of two major areas:
  1. Social communication and interaction deficits
  2. Restrictive or repetitive behaviors, interests, and activities

Social Communication and Interaction Deficits

1. Social reciprocity: How children respond or reciprocate in social interactions.
2. Joint attention: Sharing an interest with others.
3. Nonverbal communication: Using and interpreting nonverbal cues.
4. Social relationships: Developing and maintaining relationships.

Restrictive and Repetitive Behaviors

• Examples: Lining up toys, hand flapping, imitating words/phrases, following rigid routines, having specific interests.

Diagnosis and Observation

• Behavior observations by clinicians, parents, or teachers.
• Severity scores indicate support levels:
  • Level 1: Needs some support (e.g., speaks in full sentences, but struggles with normal conversation).
  • Level 3: Needs very substantial support (e.g., few intelligible words, highly resistant to change).

Genetic and Environmental Factors

• Autism is believed to have a genetic cause affecting brain development.
• No clear environmental risk factors identified.

Treatment and Management

• No cure for Autism Spectrum Disorder.
• Treatment is tailored to each child: specialized education, behavior therapy.
• Goals: Maximize quality of life and functional independence.