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Subtyping Pervasive Developmental Disorder

Issues of Validity and Implications for Child Psychiatric Diagnosis

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Asperger Syndrome or High-Functioning Autism?

Part of the book series: Current Issues in Autism ((CIAM))

Abstract

The use of the diagnostic term pervasive developmental disorders (PDD), as well as the value and purpose of subtyping the PDD has been a controversial issue. Such subtyping has been particularly relevant to disorders that are considered to be in the higher-functioning range of PDD. This chapter presents the author’s own development of thought on this topic, and is divided into four main sections. The first is a selective review of opinion regarding the diagnosis of children with severe social withdrawal prior to the initial efforts of the American Psychiatric Association (1980,1987) to provide diagnostic criteria for this clinical spectrum. Focusing on some of the findings from a study addressing the validity of PDD subtypes, the second section considers the prevailing diagnostic system (APA, 1994). The third section discusses research findings and clinical examples that support or contradict the presently accepted subtyping. The chapter concludes with a brief review of the present state of knowledge with some consideration of the ongoing research questions and how this can enhance clinical practice for those assessing and treating young people with severe developmental/psychiatric disorders.

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References

  • Adams, P. L. (1973). Obsessive children: A sociopsychiatric study. London: Butterworths.

    Google Scholar 

  • Alaghbad-Rad, J., McKenna, K., Gordon, C. T., Albus, K. E., Hamburger, S. D., Rumsey, J. M., Frazier, J. A., Lenane, M. C., & Rapoport, J. L. (1995). Childhood-onset schizophrenia: The severity of premorbid course. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1273–1283.

    Article  Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (rev. 3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Bishop, D. V. M. (1993). Autism, executive functions and theory of mind: A neuropsychologic perspective. Journal of Child Psychology and Psychiatry, 34, 279–293.

    Article  PubMed  Google Scholar 

  • Bolton, P., MacDonald, H., Pickles A., Rios, R, Goode, S., Crowson, M., Bailey, A., & Rutter, M. (1994). A case—control family history study of autism. Journal of Child Psychology and Psychiatry, 35, 877–900.

    Article  PubMed  Google Scholar 

  • Brook, S. L., & Bowler, D. M. (1992). Autism by another name? Semantic and pragmatic impairments in children. Journal of Autism and Developmental Disorders, 22, 61–81.

    Article  PubMed  Google Scholar 

  • Childers, A. T. (1931). A study of some schizoid children. Mental Hygiene, 15, 106–134.

    Google Scholar 

  • Cull, A., Chick, J., & Wolff, S. (1984). A consensual validation of schizoid personality in childhood and adult life. British Journal of Psychiatry, 144, 646–648.

    Article  PubMed  Google Scholar 

  • DiLavore, P. C., Lord, C., & Rutter, M. (1995). The pre-linguistic autism diagnostic observation schedule. Journal of Autism and Developmental Disorders, 25, 355–379.

    Article  PubMed  Google Scholar 

  • Eaves, L. C., Ho, H. H., & Eaves, D. M. (1994). Subtypes of autism by cluster analysis. Journal of Autism and Developmental Disorders, 24, 3–22.

    Article  PubMed  Google Scholar 

  • Ehlers, S., Nyden, A., Gillberg, C., Dahlgren, S.-O., Sandberg, A., Hjelmquist, E., & Oden, A. (1997). Asperger syndrome, autism and attention disorders: A comparative study of the cognitive profiles of 120 children. Journal of Child Psychology and Psychiatry, 37, 207–217.

    Article  Google Scholar 

  • Fein, D., Waterhouse, L., Lucci, D., & Snyder, D. (1985). Cognitive subtypes in developmentally disabled children: A pilot study. Journal of Autism and Developmental Disorders, 15, 77–95.

    Article  PubMed  Google Scholar 

  • Fennig, S., Pomeroy, J. C., Stephens, L., Fennig, S., & Friedman, C. (1994). Stony Brook PDD study: Validation of sub-categories of PDD-Asperger’s disorder. Poster presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry, New York.

    Google Scholar 

  • Freeman, B. J., Lucas, J. C., Forness, S. R., & Ritvo, E. R. (1985). Cognitive processing of high functioning autistic children: Comparing the K-ABC and the WISC-R. Journal of Psychoeducational Assessment, 4, 357–362.

    Article  Google Scholar 

  • Frith, U. (Ed.). (1991). Autism and Asperger syndrome. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Gillberg, C. (1989). Asperger syndrome in 23 Swedish children. Developmental Medicine and Child Neurology, 31, 520–531.

    Article  PubMed  Google Scholar 

  • Gillberg, C. (1991). Clinical and neurobiological aspects of Asperger syndrome in six family studies. In U. Frith (Ed.), Autism and Asperger syndrome (pp. 122–146). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Gillberg, I. C., & Gillberg, C. (1989). Asperger syndrome - some epidemiological considerations: A research note. Journal of Child Psychology and Psychiatry, 30, 631–638.

    Article  PubMed  Google Scholar 

  • Happé, F. G. E. (1994). Current psychological theories of autism: The “theory of mind” account and rival theories. Journal of Child Psychology and Psychiatry, 35, 215–239.

    Article  PubMed  Google Scholar 

  • Heston, L. L. (1970). The genetics of schizophrenia and schizoid disease. Science, 167, 249–255.

    PubMed  Google Scholar 

  • Honda, H., Shimizu, Y., Misumi, K., Niimi, M., & Ohashi, Y. (1996). Cumulative incidence and prevalence of childhood autism in children in Japan. British Journal of Psychiatry, 169, 228–235.

    Article  PubMed  Google Scholar 

  • Jenkins, R. L., & Glickman, S. (1946). Common syndromes in child psychiatry. American Journal of Orthopsychiatry, 16, 244–256.

    Article  PubMed  Google Scholar 

  • Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.

    Google Scholar 

  • Kaufman, A. S., O’Neil, M. R., Avant, A. H., & Long, S. W. (1987). Introduction to the Kaufman Assessment Battery for Children (K-ABC) for pediatric neuroclinicians. Journal of Child Neurology, 2, 3–16.

    Google Scholar 

  • Kerbeshian, J., Burd, L., & Fisher, W. (1990). Asperger’s syndrome: To be or not to be? British Journal of Psychiatry, 156, 721–725.

    Article  PubMed  Google Scholar 

  • Kety, S. S., Rosenthal, D., Wender, P. H., & Schulsinger, F. (1968). The types and prevalence of mental illness in the biologic and adoptive families of adopted schizophrenics. In D. Rosenthal & S. S. Kety (Eds.), The transmission of schizophrenia (p. 345). London: Pergamon Press.

    Google Scholar 

  • Klin, A., Volkmar, F. R., Sparrow, S. S., Cicchetti, D. V., & Rourke, B. P. (1995). Validity and neuropsychological characterization of Asperger syndrome: Convergence with nonverbal learning disabilities syndrome. Journal of Child Psychology and Psychiatry, 36, 1127–1140.

    Article  PubMed  Google Scholar 

  • Kolvin, I., Ounsted, C., Humphrey, M., & McNay, A. (1971). II. The phenomenology of childhood psychoses. British Journal of Psychiatry, 118, 385–395.

    Article  PubMed  Google Scholar 

  • Le Couteur, A., Bailey, A., Goode, S., Pickles, A., Robertson, S., Gottesman, I., & Rutter, M. (1996). A broader phenotype of autism: The clinical spectrum in twins. Journal of Child Psychology and Psychiatry, 37, 785–801.

    Article  PubMed  Google Scholar 

  • Lord, C. (1995). Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36,1365–1382.

    Article  PubMed  Google Scholar 

  • Mayes, L., Volkmar, F., Hooks, M., & Cicchetti, D. (1993). Differentiating Pervasive Developmental Disorder Not Otherwise Specified from autism and language disorder. Journal of Autism and Developmental Disorders,23, 79–90.

    Article  PubMed  Google Scholar 

  • McArthur, D., & Adamson, L. B. (1996). Joint attention in preverbal children: Autism and develop-mental language disorder. Journal of Autism and Developmental Disorders, 26,481–496.

    Article  Google Scholar 

  • Mednick, S. A. (1970). Breakdown in individuals at high risk for schizophrenia: Possible predisposi-tional perinatal factors. Mental Hygiene, 54,50–63.

    Google Scholar 

  • Mednick, S. A., & Schulsinger, F. (1970). Factors related to breakdown in children at high risk for schizophrenia. In M. Roft & D. F. Ricks (Eds.), Life history research in psychopathology. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Miller, J. N., & Ozonoff, S. (1997). Did Asperger’s cases have Asperger disorder? A research note. Journal of Clinical Psychology and Psychiatry, 38,247–251.

    Article  Google Scholar 

  • Minshew, N. J., Goldstein, G., & Siegel, D. J. (1995). Speech and language in high-functioning autistic individuals. Neuropsychology,9, 255–261.

    Article  Google Scholar 

  • Nagy, J., & Szatmari, R (1986). A chart review of schizotypal personality disorders in children. Journal of Autism and Developmental Disorders, 16,351–367.

    Article  PubMed  Google Scholar 

  • Paul, R., Cohen, D. J., & Caparulo, B. K. (1983). A longitudinal study of patients with severe developmental disorder of language learning. Journal of American Academy o fChild Psychiatry, 22,525–534.

    Article  Google Scholar 

  • Paykel, E. S. (1981). Have multivariate statistics contributed to classification? British Journal of Psychiatry, 139,357–362

    Article  PubMed  Google Scholar 

  • Petti, T. A., & Vela, R. M. (1990). Borderline disorder of childhood: An overview. Journal of the American Academy of Child and Adolescent Psychiatry, 29,327–337.

    Article  PubMed  Google Scholar 

  • Pomeroy, J. C. (1984). Non-autistic psychosis and severe developmental disorders in children. Unpublished manuscript, J. Franklin Robinson Award.

    Google Scholar 

  • Pomeroy, J. C., & Friedman, C. (1987). Asperger syndrome-a clinical subtype of PDD: The neuropsychologic evidence. Poster presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry, Washington, DC.

    Google Scholar 

  • Pomeroy, J. C., Friedman, C., & Stephens, L. (1990). Further thoughts on autistic tendencies [Letter to the editor]. Developmental Medicine and Child Neurology, 32,832–833.

    PubMed  Google Scholar 

  • Pomeroy, J. C., Friedman, C., & Stephens, L. (1991). Autism and Asperger’s: Same or different? [Letter to the editor]. Journal of the American Academy of Child and Adolescent Psychiatry,30, 152–153.

    Article  PubMed  Google Scholar 

  • Pomeroy, J. C., Stephens, L., Fennig, S., & Friedman, C. (1994). Stony Brook PDD study: Validation of PDD sub-categories - atypical autism. Poster presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry, New York, NY.

    Google Scholar 

  • Quitkin, F., & Klein, D. F. (1969). Two behavioral syndromes in young adults related to possible minimal brain dysfunction. Journal of Psychiatric Research, 7, 131–142.

    Article  PubMed  Google Scholar 

  • Rapin, I. (1996). Practitioner review: Developmental language disorders: A clinical update. Journal of Child Psychology and Psychiatry, 37,643–655.

    Article  PubMed  Google Scholar 

  • Rescorla, L. (1988). Cluster analytic identification of autistic preschoolers. Journal of Autism and Developmental Disorders, 18,475–492.

    Article  PubMed  Google Scholar 

  • Robinson, J. F., & Vitale, L. J. (1954). Children with circumscribed interest patterns. American Journal of Psychiatry,24, 755–767.

    Google Scholar 

  • Rourke, B. P. (1989). Nonverbal learning disabilities. New York: Guilford Press.

    Google Scholar 

  • Rumsey, J. M. (1992). Neuropsychological studies of high-level autism. In E. Schopler& G. B. Mesibov (Eds.), High functioning individuals with autism (pp. 41–64). New York: Plenum Press.

    Google Scholar 

  • Rutter, M. (1971). The description and classification of infantile autism. In D. W. Churchill, G. D. Alpern, & M. K. DeMyer (Eds.), Infantile autism. Springfield, IL: Thomas.

    Google Scholar 

  • Rutter, M., & Schopler, F. (1987). Autism and pervasive developmental disorders: Concepts and diagnostic issues. Journal of Autism and Developmental Disorders, 17, 159–186.

    Article  PubMed  Google Scholar 

  • Sevin, J. A., Matson, J. L., Coe, D., Love, S. R., Matese, M. J., & Benavidez, D. A. (1995). Empirically derived subtypes of pervasive developmental disorders: A cluster analytic study. Journal of Autism and Developmental Disorders, 25, 561–578.

    Article  PubMed  Google Scholar 

  • Shapiro, T., & Hertzig, M. (1995). Applied behavioral analysis: Astonishing results? [Letter to the editor]. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1255.

    Article  PubMed  Google Scholar 

  • Shea, V., & Mesibov, G. B. (1985). Brief report: The relationship of learning disabilities and higher-level autism. Journal of Autism and Developmental Disorders, 15, 425–435.

    Article  PubMed  Google Scholar 

  • Sherman, M., Shapiro, T., & Glassman, M. (1983). Play and language in developmentally disordered preschoolers: A new approach to classification. Journal of the American Academy of Child and Adolescent Psychiatry, 22, 511–524.

    Article  Google Scholar 

  • Siegel, B., Anders, T. F., Ciaranello, R. D., Bienenstock, B., & Kraemer, H. C. (1986). Empirically derived subclassification of the autistic syndrome. Journal of Autism and Developmental Disorders, 16, 275–293.

    Article  PubMed  Google Scholar 

  • Siegel, D. J., Minshew, N. J., & Goldstein, S. (1996). Wechsler IQ profiles in diagnosis of high functioning autism. Journal of Autism and Developmental Disorders, 26, 389–406.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Archer, L., Fisman, S., Streiner, D. L., & Wilson, F. (1995). Asperger’s syndrome and autism: Differences in behavior, cognition and adaptive functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1662–1671.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Tuff, L., Finlayson, M. A. J., & Bartolucci, G. (1990). Asperger’s syndrome and autism: Neurocognitive aspects. Journal of the American Academy of Child and Adolescent Psychiatry. 29, 130–136.

    Article  PubMed  Google Scholar 

  • Tanguay, P. E, (1984). Toward a new classification of serious psychopathology in children. Journal of the American Academy of Child Psychiatry, 23, 373–384.

    Article  PubMed  Google Scholar 

  • Tantam, D. (1991). Asperger syndrome in adulthood. In U. Frith (Ed.), Autism and Asperger syndrome (pp. 147–183). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Towbin, K. E., Dykens, E. M., Pearson, G. S., & Cohen, D. J. (1993). Conceptualizing “Borderline Syndrome of Childhood” and “Childhood Schizophrenia” as a developmental disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 775–782.

    Article  PubMed  Google Scholar 

  • Van Krevelen, D. A. (1971). Early infantile autism and autistic psychopathy. Journal of Autism and Childhood Schizophrenia, 1, 82–86.

    Article  PubMed  Google Scholar 

  • Voeller, K. K. S. (1986). Right hemisphere deficit syndrome in children. American Journal of Psychiatry, 143, 1004–1009.

    PubMed  Google Scholar 

  • Volkmar, F. R., Klin, A., Schultz, R., Bronen, R., Marans, W. D., Sparrow, S., & Cohen, D. J. (1996). Asperger’s syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 118–123.

    Article  PubMed  Google Scholar 

  • Watkins, J. M., Asarnow, R. F., & Tanguay, P. E. (1988). Symptom development in childhood onset schizophrenia. Journal of Child Psychology and Psychiatry, 29, 865–878.

    Article  PubMed  Google Scholar 

  • Weintraub, S., & Mesulam, M.-M. (1983). Developmental learning disabilities of the right hemisphere. Archives of Neurology, 40, 463–468.

    Article  PubMed  Google Scholar 

  • Wing, L. (1981a). Asperger’s syndrome: A clinical account. Psychological Medicine, 11, 115–129.

    Article  Google Scholar 

  • Wing, L. (1981 b). The severe social and communication disorders of early childhood: Diagnosis and classification. Paper read at the League School International Symposium, New York.

    Google Scholar 

  • Wing, L. (1984). Schizoid personality in childhood [Letter to the editor]. British Journal of Psychiatry, 145, 444.

    Google Scholar 

  • Wing, L. (1991). The relationship between Asperger’s syndrome and Kanner’s autism. In U. Frith (Ed.), Autism and Asperger syndrome (pp. 93–121). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Wing, L., & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification. Journal olAutism and Developmental Disorders, 9, 11–29.

    Article  Google Scholar 

  • Wolff, S. (1964). Schizoid personality in childhood. Paper read at the Sixth International Psychotherapy Congress, London.

    Google Scholar 

  • Wolff, S., & Chick, J. (1980). Schizoid personality in childhood: A controlled follow-up study. Psychological Medicine, 10, 85–100.

    Article  PubMed  Google Scholar 

  • World Health Organization (1992). International classification of diseases (10th ed.). Geneva: Author.

    Google Scholar 

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Pomeroy, J.C. (1998). Subtyping Pervasive Developmental Disorder. In: Schopler, E., Mesibov, G.B., Kunce, L.J. (eds) Asperger Syndrome or High-Functioning Autism?. Current Issues in Autism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5369-4_3

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