Autistic spectrum disorders (formerly called pervasive developmental disorders) refer to conditions where the individual displays significant delays in development. These occur in the following areas: social interaction, communication, and activities and interests. Symptoms may include early oddities; unusual fears and excessive anxiety; problems with self-control; social relations
impaired by disinterest, detachment, avoidance, withdrawal, and lack of empathy; language and communication deficits; and a very restricted range of interests and activities.
According to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), an autistic spectrum disorder may include persistent deficits in social communication and social interaction across multiple contexts as manifested by the following:
- Deficits in social-emotional reciprocity, such as abnormal social reproach; failure of normal back-and-forth conversation;
reduced sharing of interests, emotions, or affect; failure to initiate or respond to social interactions. - Deficits in nonverbal communication behaviors used for social interaction such as problems in eye contact, understanding body language, or a total lack of facial expression and nonverbal communication.
- Deficits in developing, maintaining, and understanding relationships.
Severity is based on social community impairments and a restricted repetitive pattern of behaviors. Restricted repetitive behavior patterns may include some of the following:
- Stereotyped or repetitive motor movements, use of objects, or speech (lining up toys, flipping objects, repeating things, etc.).
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.
- Highly restricted fixed interests that are abnormal in intensity or focus.
- Hyper or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (sensitive to certain pain or temperature stimuli, sensitivities to certain sounds and textures, excessive smelling or touching of objects, visual fascination with lights or movements).
Making a diagnosis of an autistic spectrum disorder can be a very complicated and time-consuming process. A good mental health history, family history, and interview of other people in the patient’s life are very important. A comprehensive treatment approach usually includes behavioral therapies, other community-based therapies, group therapy, and possible psychiatric medication treatment. Psychopharmacotherapy is usually directed at target symptoms of repetitive behavior, inattentiveness, anxiety, and a restricted range of interests.