Pervasive Developmental

Disorders
By: Espina, Adrianna Faye R.
Definition
Pervasive Developmental Disorders refer to a group of disorders characterized by
delays in the development of socialization and communication skills. Parents may
note symptoms as early as infancy, although the typical age of onset is before 3
years of age. Examples of PDD include:

● Autism
● Asperger’s disorder
● Rett’s disorder
● Childhood disintegrative disorder
Definition
Pervasive Developmental Disorder is now called as Autism Spectrum Disorder.
The name change came in 2013, when the American Psychiatric Association
reclassified autistic disorder, asperger’s syndrome, childhood disintegrative
disorder, and rett’s disorder as autism spectrum disorder. The spectrum concept is
a more medically accurate way of diagnosing children with these disorders.
Etiology
Rett’s disorder is now understood to be caused primarily by a faulty gene. The
causes of most cases of autism, Asperger disorder, and childhood disintegrative
disorder are not yet known. Because autism and Asperger disorder tend to run in
families, it is believed that they are at least partly caused by faulty genes. Some
authorities believe that childhood disintegrative disorder may be the result of
damage to the developing brain, but it is not known how this damage occurs.
Characteristics of Autism
Autism is characterized by marked difficulties in behaviour, social interaction,
communication and sensory sensitivities.
Clinical symptoms of Autism
❏ Does not socially interact well with others, including parents
❏ Shows a lack of interest in, or rejection of, physical contact. Parents describe
autistic infants as "unaffectionate." Autistic infants and children are not
comforted by physical contact. Avoids making eye contact with others,
including parents.
❏ Fails to develop friends or interact with other children
Clinical symptoms of Autism
❏ Does not communicate well with others
❏ Is delayed or does not develop language
❏ Once language is developed, does not use language to communicate with
others
❏ Has echolalia (repeats words or phrases repeatedly, like an echo)
Clinical symptoms of Autism
❏ Demonstrates repetitive behaviors
❏ Has repetitive motor movements (such as rocking and hand or finger
flapping)
❏ Is preoccupied, usually with lights, moving objects or parts of objects.
❏ Does not like noise
❏ Has rituals
❏ Requires routines
Characteristics of Aspergers
Syndrome
The characteristics of Asperger syndrome vary from one person to another, but in
order for a diagnosis to be made, a person will usually be assessed as having had
persistent difficulties with social communication and social interaction and
restricted and repetitive patterns of behaviours, activities or interests since early
childhood, to the extent that these “limit and impair everyday functioning”.
Clinical symptoms of Aspergers
Syndrome
❏ Normal development of speech, self-help skills, thinking skills (cognitive
development) and curiosity about their environment
❏ Difficulty with social interactions such as making friends, sharing ideas,
sharing pleasures or accomplishments, facial expressions (smiles) or eye
contact with others
❏ Repetitive and stereotyped patterns of behavior or play such as strange
routines or rituals (hand or finger flapping, collecting strange objects such as
lint)
❏ Capable of originality and creativity focused on isolated areas of interest
Characteristics of Rett’s Disorder
Rett syndrome is a rare genetic neurological and developmental disorder that
affects the way the brain develops, causing a progressive loss of motor skills.
Over time, children with Rett syndrome have increasing problems with the use of
muscles that control movement, coordination and communication. Rett syndrome
can also cause seizures and intellectual disability. Abnormal hand movements,
such as repetitive rubbing or clapping, replace purposeful hand use.
Clinical symptoms of Rett’s Disorder
❏ Normal pregnancy, birth and newborn growth and development
❏ Normal growth and development during the first 5 to 18 months of life
❏ Normal head circumference at birth
Clinical symptoms of Rett’s Disorder
❏ Following a period of normal development of at least five months, all of the
following changes occur:
❏ Size of the child's head does not grow as much as it should between the
ages of 5 and 48 months.
❏ Loss of previously learned useful hand skills (such as reaching for and
grasping an object) and the development of stereotyped hand movements
that are not useful to the child, such as hand wringing.
Clinical symptoms of Rett’s Disorder
❏ Following a period of normal development of at least five months, all of the
following changes occur:
❏ Loss of socially engaging behaviors, such as smiles and eye contact
(however, these behaviors may be re-developed later)
❏ Loss of coordinated walking or body movements
❏ Expressive (ability to verbally express thoughts) and receptive (the ability to
understand and use language that is heard or seen) language skills become
impaired and severe psychomotor retardation develops.
Clinical symptoms of Childhood
disintegrative disorder
Childhood disintegrative disorder is characterized by at least two years of normal
development, followed by loss of language, social skills, and motor skills before
age ten. Other names for childhood disintegrative disorder are Heller's syndrome,
dementia infantilis, and disintegrative psychosis.
Clinical symptoms of Childhood
disintegrative disorder
❏ At least two years, and usually up to four years, of normal development
including speech, social interactions and relationships and play and adaptive
behavior
❏ Over a short period of time (a few months), severe loss of functioning in
social, communication and behavioral skills occurs. Without any obvious
illness or cause, children experiencing disintegrative disorder become
anxious, irritable, negative and disobedient with frequent temper tantrums and
outbursts for no apparent reason. These children have a complete loss of
speech and language, understanding of language and a decrease in thinking
(cognitive) skills.
Characteristics of Tic Disorder
Tics begin before age 18 yr (typically between ages 4 yr and 6 yr); they increase
in severity to a peak at about age 10 to 12 yr and decrease during adolescence.
Eventually, most tics disappear spontaneously. However, in about 1% of children,
tics persist into adulthood.
Classification of Tic Disorder
Tic disorders are divided into 3 categories by the Diagnostic and Statistical
Manual of Mental Disorders, 5th edition (DSM-5):
● Provisional tic disorder: Single or multiple motor and/or vocal tics have
been present < 1 yr.
● Persistent tic disorder (chronic tic disorder): Single or multiple motor or
vocal tics (but not both motor and vocal) have been present for > 1 yr.
● Tourette syndrome (Gilles de la Tourette syndrome): Both motor and
vocal tics have been present for > 1 yr.
Characteristics of Tic Disorder
Tics tend to vary in type, intensity, and frequency over a period of time. They may
occur multiple times in an hour, then remit or barely be present for ≥ 3 mo.
Typically, tics do not occur during sleep.

Tics can be:

● Motor or vocal
● Simple or complex

Simple tics are a very brief movement or vocalization, typically without social
meaning.
Complex tics last longer and may involve a combination of simple tics.
Clinical symptoms of Tic Disorder
❏ Hallmark signs:
❏ Sudden, brief, intermittent movement or sounds
❏ Motor tics: These include tics, such as head and shoulder movements,
blinking, jerking, banging, clicking fingers, or touching things or other people.
Motor tics tend to appear before vocal tics, although this is not always the
case.
❏ Vocal tics: These are sounds, such as coughing, throat clearing or grunting,
or repeating words or phrases
Clinical symptoms of Tic Disorder
● Simple tics: These are sudden and fleeting tics using few muscle groups.
Examples include nose twitching, eye darting, or throat clearing.
● Complex tics: These involve coordinated movements using several muscle
groups. Examples include hopping or stepping in a certain way, gesturing, or
repeating words or phrases.
Characteristics of Conduct Disorder
Conduct disorder is a repetitive and persistent pattern of behavior in children and
adolescents in which the rights of others or basic social rules are violated. The
child or adolescent usually exhibits these behavior patterns in a variety of
settings—at home, at school, and in social situations—and they cause significant
impairment in his or her social, academic, and family functioning.
Clinical symptoms of Conduct
Disorder
❏ Aggressive behavior, such as cruelty to animals, fighting and bullying, using
a weapon
❏ Destructive behavior, such as arson and vandalism
❏ Deceitful behavior, such as shoplifting and lying, forgery, breaking and
entering
❏ Violation of rules, which may include truancy and running away from home,
drug and alcohol use, skipping school
Characteristics of ADHD
Three primary characteristics of ADHD:

● Inattention
● Hyperactivity
● Impulsivity

These behaviors often present in the following ways: inattention: getting

distracted, having poor concentration and organizational skills.
Clinical symptoms of ADHD
Symptoms of children with inattention:

1. Has trouble staying focused; is easily distracted or gets bored with a task
before it’s completed
2. Appears not to listen when spoken to
3. Has difficulty remembering things and following instructions; doesn’t pay
attention to details or makes careless mistakes
4. Has trouble staying organized, planning ahead, and finishing projects
5. Frequently loses or misplaces homework, books, toys, or other items
Clinical symptoms of ADHD
Symptoms of children with hyperactivity:

1. Constantly fidgets and squirms

2. Has difficulty sitting still, playing quietly, or relaxing
3. Moves around constantly, often runs or climbs inappropriately
4. Talks excessively
5. May have a quick temper or “short fuse”
Clinical symptoms of ADHD
Symptoms of children with impulsivity:

1. Acts without thinking

2. Guesses, rather than taking time to solve a problem or blurts out answers in
class without waiting to be called on or hear the whole question
3. Intrudes on other people’s conversations or games
4. Often interrupts others; says the wrong thing at the wrong time
5. Inability to keep powerful emotions in check, resulting in angry outbursts or
temper tantrums
History of Child and Adolescent
Psychiatry
The history of child psychiatry—a term that can mean a collection of services, a
body of knowledge, and a profession—is inextricably linked to the history of
childhood; recognising childhood as a distinct period of development is a
prerequisite to acknowledging child psychiatry as a discipline. Thus, the history of
child psychiatry is interlocked with our understanding of development, child-
rearing practices, the place of children in society, and with non-medical fields such
as juvenile justice and education. For example, some historians date the
beginnings of child psychiatry in the US to 1899 when the state of Illinois
established the nation’s first juvenile court in Chicago (Schowalter, 2003).