Skip to main content

Atypical Autism

  • 2312 Accesses

Short Description or Definition

Atypical autism is often described as a subthreshold diagnosis, presenting with some symptoms of autism but insufficient to meet criteria for a diagnosis of childhood autism (or autistic disorder). Alternatively, atypical autism can be diagnosed when there is a late onset of symptomatology. Atypical autism (as defined by ICD-10) is seen as being equivalent to the DSM-IV-TR diagnostic category of pervasive developmental disorder not otherwise specified (PDD NOS). DSM-5 does not have a separate diagnostic category for PDD NOS.

Like PDD NOS, atypical autism is poorly defined, resulting in a research literature that can be difficult to interpret and conclusions difficult to reach. Atypical autism, as defined by the ICD, lacks operationalized diagnostic criteria, resulting in inconsistencies and variability in the way in which the diagnosis is applied. Although it now appears to be more common than autistic disorder, in general it remains poorly understood....

This is a preview of subscription content, access via your institution.

References

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

    Google Scholar 

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

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders – Text revision (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: American Psychiatric Association.

    CrossRef  Google Scholar 

  • Baghdadli, A., Picot, M.-C., Michelon, C., Bodet, J., Pernon, E., Burstezjn, C., et al. (2007). What happens to children with PDD when they grow up? Prospective follow-up of 219 children from preschool age to mid-childhood. Acta Psychiatrica Scandinavica, 115, 403–412.

    CrossRef  PubMed  Google Scholar 

  • Baird, G., Charman, T., Baron-Cohen, S., Cox, A., Swettenham, J., Wheelwright, S., et al. (2000). A screening instrument for autism at 18 months of age: A 6-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 39(6), 694–702.

    CrossRef  PubMed  Google Scholar 

  • Barton, M., Robins, D., Jashar, D., Brennan, L., & Fein, D. (2013). Sensitivity and specificity of proposed DSM-5 criteria for autism spectrum disorder in toddlers. Journal of Autism and Developmental Disorders, 45(5), 1184–1195.

    CrossRef  Google Scholar 

  • Bishop, D. V. M. (1998). Development of the Children’s communication checklist (CCC): A method for assessing qualitative aspects of communicative impairment in children. Journal of Child Psychology and Psychiatry, 39(6), 879–891.

    CrossRef  PubMed  Google Scholar 

  • Chakrabarti, S., & Fombonne, E. (2005). Pervasive developmental disorders in preschool children: Confirmation of high prevalence. The American Journal of Psychiatry, 162(6), 1133–1141.

    CrossRef  PubMed  Google Scholar 

  • Chawarska, K., Klin, A., Paul, R., & Volkmar, F. (2007). Autism spectrum disorder in the second year: Stability and change in syndrome expression. Journal of Child Psychology and Psychiatry, 48(2), 128–138.

    CrossRef  PubMed  Google Scholar 

  • Dawson, J. E., Matson, J. L., & Cherry, K. E. (1998). An analysis of maladaptive behaviors in persons with autism, PDD-NOS, and mental retardation. Research in Developmental Disabilities, 19(5), 439–448.

    CrossRef  PubMed  Google Scholar 

  • de Bruin, E. I., Verheij, F., & Ferdinand, R. F. (2006). WISC-R subtest but no overall VIQ-PIQ difference in Dutch children with PDD-NOS. Journal of Abnormal Child Psychology, 34(2), 263–271.

    CrossRef  PubMed  Google Scholar 

  • de Bruin, E. I., Ferdinand, R. F., Meester, S., de Nijs, P. F. A., & Verheij, F. (2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 37(5), 877–886.

    CrossRef  PubMed  Google Scholar 

  • Donno, R., Parker, G., Gilmour, J., & Skuse, D. H. (2010). Social communication deficits in disruptive primary-school children. British Journal of Psychiatry, 196, 282–289.

    CrossRef  PubMed  Google Scholar 

  • Drew, A., Baird, G., Baron-Cohen, S., Cox, A., Slonims, V., Wheelwright, S., et al. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism. Preliminary findings and methodological challenges. European Child & Adolescent Psychiatry, 11(6), 266–272.

    CrossRef  Google Scholar 

  • Ellefsen, A., Kampmann, H., Billstedt, E., Gillberg, I. C., & Gillberg, C. (2007). Autism in the Faroe Islands: An epidemiological study. Journal of Autism and Developmental Disorders, 37(3), 437–444.

    CrossRef  PubMed  Google Scholar 

  • Fernell, E., & Gillberg, C. (2010). Autism spectrum disorder diagnoses in Stockholm preschoolers. Research in Developmental Disabilities, 31(3), 680–685.

    CrossRef  PubMed  Google Scholar 

  • Fodstad, J. C., Matson, J. L., Hess, J., & Neal, D. (2009). Social and communication behaviours in infants and toddlers with autism and pervasive developmental disorder-not otherwise specified. Developmental Neurorehabilitation, 12(3), 152–157.

    CrossRef  PubMed  Google Scholar 

  • Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65(6), 591–598.

    CrossRef  PubMed  Google Scholar 

  • Gillberg, C., & Coleman, M. (1996). Autism and medical disorders: A review of the literature. Developmental Medicine & Child Neurology, 38(3), 191–202.

    CrossRef  Google Scholar 

  • Gillberg, C., & Steffenburg, S. (1987). Outcome and prognostic factors in infantile autism and similar conditions: A population-based study of 46 cases followed through puberty. Journal of Autism and Developmental Disorders, 17(2), 273–287.

    CrossRef  PubMed  Google Scholar 

  • Hara, H. (2007). Autism and epilepsy: A retrospective follow-up study. Brain & Development, 29(8), 486–490.

    CrossRef  Google Scholar 

  • Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114(1), 23–41.

    CrossRef  PubMed  Google Scholar 

  • Huerta, M., Bishop, S. L., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 criteria for autism Spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. American Journal of Psychiatry, 169(10), 1056–1064.

    CrossRef  PubMed  Google Scholar 

  • Jensen, V. K., Larrieu, J. A., & Mack, K. K. (1997). Differential diagnosis between attention-deficit/hyperactivity disorder and pervasive developmental disorder – Not otherwise specified. Clinical Pediatrics, 36(10), 555–561.

    CrossRef  PubMed  Google Scholar 

  • Juul-Dam, N., Townsend, J., & Courchesne, E. (2001). Prenatal, perinatal, and neonatal factors in autism, pervasive developmental disorder-not otherwise specified, and the general population. Pediatrics, 107(4), E63.

    CrossRef  PubMed  Google Scholar 

  • Kanai, C., Koyama, T., Kato, S., Miyamoto, Y., Osada, H., & Kurita, H. (2004). Comparison of high-functioning atypical autism and childhood autism by Childhood Autism Rating Scale-Tokyo version. Psychiatry & Clinical Neurosciences, 58(2), 217–221.

    CrossRef  Google Scholar 

  • Kasari, C., Freeman, S. F. N., & Paparella, T. (2001). Early intervention in autism: Joint attention and symbolic play. International Review of Research in Mental Retardation, 23(23), 207–237.

    Google Scholar 

  • Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620.

    CrossRef  PubMed  Google Scholar 

  • Kim, Y. S., Leventhal, B. L., Koh, Y.-J., Fombonne, E., Laska, E., Lim, E.-C., Cheon, K.-A., Kim, Y.-K., Lee, H. K., Song, D.-H., & Grinker, R. R. (2011). Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry, 168, 904–912.

    CrossRef  PubMed  Google Scholar 

  • Kim, Y. S., Fombonne, E., Koh, Y.-J., Kim, S.-J., Cheon, K.-A., Leventhal, B. A. (2014). Comparison of DSM-IV pervasive developmental disorder and DSM-5 autism spectrum disorder prevalence in an epidemiologic sample. Journal of the American Academy of Child & Adolescent Psychiatry, 53(5), 500–508.

    Google Scholar 

  • King, B. H. (2000). Pharmacological treatment of mood disturbances, aggression, and self- injury in persons with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 30(5), 439–445.

    CrossRef  PubMed  Google Scholar 

  • Kleinman, J. M., Robins, D. L., Ventola, P. E., Pandey, J., Boorstein, H. C., Esser, E. L., et al. (2008). The modified checklist for autism in toddlers: A follow-up study investigating the early detection of autism spectrum disorders. Journal of Autism & Developmental Disorders, 38(5), 827–839.

    CrossRef  Google Scholar 

  • Kobayashi, R., Murata, T., & Yoshinaga, K. (1992). A follow-up study of 201 children with autism in Kyushu and Yamaguchi areas, Japan. Journal of Autism and Developmental Disorders, 22(3), 395–411.

    CrossRef  PubMed  Google Scholar 

  • Kurita, H. (1997). A comparative study of Asperger syndrome with high-functioning atypical autism. Psychiatry & Clinical Neurosciences, 51(2), 67–70.

    CrossRef  Google Scholar 

  • Kurita, H., Miyake, Y., & Katsuno, K. (1989). Reliability and validity of the childhood autism rating scale-Tokyo version (CARS-TV). Journal of Autism and Developmental Disorders, 19(3), 389–396.

    CrossRef  PubMed  Google Scholar 

  • Lingam, R., Simmons, A., Andrews, N., Miller, E., Stowe, J., & Taylor, B. (2003). Prevalence of autism and parentally reported triggers in a north east London population. Archives of Disease in Childhood, 88(8), 666–670.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Luteijn, E. F., Serra, M., Jackson, S., Steenhuis, M. P., Althaus, M., Volkmar, F., et al. (2000). How unspecified are disorders of children with a pervasive developmental disorder not otherwise specified? A study of social problems in children with PDD-NOS and ADHD. European Child & Adolescent Psychiatry, 9(3), 168–179.

    CrossRef  Google Scholar 

  • Mahoney, W. J., Szatmari, P., MacLean, J. E., Bryson, S. E., Bartolucci, G., Walter, S. D., et al. (1998). Reliability and accuracy of differentiating pervasive developmental disorder subtypes. Journal of the American Academy of Child & Adolescent Psychiatry, 37(3), 278–285.

    CrossRef  Google Scholar 

  • Mandy, W., Charman, T., Gilmour, J., & Skuse, D. (2011). Toward specifying pervasive developmental disorder – not otherwise specified. Autism Research, 4, 1–11.

    CrossRef  Google Scholar 

  • Mayes, L., Volkmar, F., Hooks, M., & Cicchetti, D. (1993). Differentiating pervasive developmental disorder not other specified from autism and language disorders. Journal of Autism and Developmental Disorders, 23(1), 79–90.

    CrossRef  PubMed  Google Scholar 

  • Mayes, S. D., Black, A., & Tierney, C. D. (2013). DSM-5 under-identifies PDD-NOS: Diagnostic agreement between the DSM-5, DSM-IV, and checklist for autism Spectrum disorder. Research in Autism Spectrum Disorders, 7(2), 298–306.

    CrossRef  Google Scholar 

  • McConachie, H., & Diggle, T. (2005). Parent implemented early intervention for young children with autism spectrum disorder: A systematic review. Journal of Evaluation in Clinical Practice, 13, 129–129.

    Google Scholar 

  • McPartland, J. C., Reichow, B., & Volkmar, F. R. (2012). Sensitivity and specificity of proposed DSM-5 diagnostic criteria for autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 368–383.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Moulton, E., Barton, M., Robins, D. L., Abrams, D. N., & Fein, D. (2016). Early characteristics of children with ASD who demonstrate optimal progress between age two and four. Journal of Autism and Developmental Disorders, 46(6), 2160–2173.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Mouridsen, S. E., Rich, B., & Isager, T. (2008). Psychiatric disorders in adults diagnosed as children with atypical autism. A case control study. Journal of Neural Transmission, 115(1), 135–138.

    CrossRef  PubMed  Google Scholar 

  • Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20(1), 115–128.

    CrossRef  PubMed  Google Scholar 

  • Nordin, V., & Gillberg, C. (1998). The long-term course of autistic disorders: Update on follow-up studies. Acta Psychiatrica Scandinavica, 97(2), 99–108.

    CrossRef  PubMed  Google Scholar 

  • Oslejskova, H., Kontrova, I., Foralova, R., Dusek, L., & Nemethova, D. (2007). The course of diagnosis in autistic patients: The delay between recognition of the first symptoms by parents and correct diagnosis. Neuroendocrinology Letters, 28(6), 895–900.

    PubMed  Google Scholar 

  • Ozonoff, S. (2012). Editorial perspective: Autism spectrum disorders in DSM-5 – An historical perspective and the need for change. Journal of Child Psychology and Psychiatry, 53(10), 1092–1094.

    CrossRef  PubMed  Google Scholar 

  • Pearson, D. A., Loveland, K. A., Lachar, D., Lane, D. M., Reddoch, S. L., Mansour, R., et al. (2006). A comparison of behavioral and emotional functioning in children and adolescents with autistic disorder and PDD-NOS. Child Neuropsychology, 12(4–5), 321–333.

    CrossRef  PubMed  Google Scholar 

  • Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. (2005a). Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry, 62, 1266–1274.

    CrossRef  Google Scholar 

  • Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. (2005b). Risperidone treatment of autistic disorder: Longer-term benefits and blinded discontinuation after 6 months. The American Journal of Psychiatry, 162(7), 1361–1369.

    CrossRef  Google Scholar 

  • Research Units on Pediatric Psychopharmacology Autism Network. (2009). Medication and parent training in children with pervasive developmental disorders and serious behavior problems: Results from a randomized clinical trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48(12), 1143–1154.

    CrossRef  Google Scholar 

  • Roeyers, H., Keymeulen, H., & Buysse, A. (1998). Differentiating attention- deficit/hyperactivity disorder from pervasive developmental disorder not otherwise specified. Journal of Learning Disabilities, 31(6), 565–571.

    CrossRef  PubMed  Google Scholar 

  • Rogers, S. J., & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37(1), 8–38.

    CrossRef  Google Scholar 

  • Rondeau, E., Klein, L. S., Masse, A., Bodeau, N., Cohen, D., & Guile, J. M. (2010). Is pervasive developmental disorder not otherwise specified less stable than autistic disorder? A meta-analysis. Journal of Autism & Developmental Disorders, 41(9), 1267–1276.

    CrossRef  Google Scholar 

  • Rutter, M., Bailey, A., Bolton, P., & Le Couteur, A. (1994). Autism and known medical conditions: Myth and substance. Journal of Child Psychology & Psychiatry & Allied Disciplines, 35(2), 311–322.

    CrossRef  Google Scholar 

  • Scheirs, J. G. M., & Timmers, E. A. (2009). Differentiating among children with PDD-NOS, ADHD, and those with a combined diagnosis on the basis of WISC-III profiles. Journal of Autism and Developmental Disorders, 39(4), 549–556.

    CrossRef  PubMed  Google Scholar 

  • Sigman, M., & Ruskin, E. (1999). Continuity and change in the social competence of children with autism, down syndrome, and developmental delays. Monographs of the Society for Research in Child Development, 64(1), v-114.

    CrossRef  Google Scholar 

  • Skuse, D. H. (2012). DSM-5’s conceptualization of autistic disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 344–346.

    CrossRef  PubMed  Google Scholar 

  • Stone, W. L., Lee, E. B., Ashford, L., Brissie, J., Hepburn, S. L., Coonrod, E. E., et al. (1999). Can autism be diagnosed accurately in children under 3 years? Journal of Child Psychology and Psychiatry, 40(2), 219–226.

    CrossRef  PubMed  Google Scholar 

  • Sutera, S., Pandey, J., Esser, E. L., Rosenthal, M. A., Wilson, L. B., Barton, M., et al. (2007). Predictors of optimal outcome in toddlers diagnosed with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 98–107.

    CrossRef  PubMed  Google Scholar 

  • Tonge, B., Brereton, A. V., Kiomall, M., Mackinnon, A., King, N. M., & Rinehart, N. (2006). Effects on parental mental health of an education and skills training program for parents of young children with autism: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 45(5), 561–569.

    CrossRef  PubMed  Google Scholar 

  • Towbin, K. E. (2005). Pervasive developmental disorder not otherwise specified. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (Vol. 1, 3rd ed., pp. 165–200). Hoboken: Wiley.

    Google Scholar 

  • Turner, L. M., Stone, W. L., Pozdol, S. L., & Coonrod, E. E. (2006). Follow-up of children with autism spectrum disorders from age 2 to age 9. Autism, 10(3), 243–265.

    CrossRef  PubMed  Google Scholar 

  • van Daalen, E., Kemner, C., Dietz, C., Swinkels, S. H. N., Buitelaar, J. K., & van Engeland, H. (2009). Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age. European Child & Adolescent Psychiatry, 18(11), 663–674.

    CrossRef  Google Scholar 

  • Volkmar, F. R. (1998). Categorical approaches to the diagnosis of autism: An overview of DSM-IV and ICD-10. Autism: The International Journal of Research and Practice, 2(1), 45–60.

    CrossRef  Google Scholar 

  • Volkmar, F. R., Shaffer, D., & First, M. (2000). PDDNOS in DSM-IV. Journal of Autism and Developmental Disorders, 30(1), 74–75.

    PubMed  Google Scholar 

  • Walker, D. R., Thompson, A., Zwaigenbaum, L., Goldberg, J., Bryson, S. E., Mahoney, W. J., et al. (2004). Specifying PDD-NOS: A comparison of PDD-NOS, Asperger syndrome, and autism. Journal of the American Academy of Child & Adolescent Psychiatry, 43(2), 172–180.

    CrossRef  Google Scholar 

  • Whittingham, K., Sofronoff, K., Sheffield, J., & Sanders, M. R. (2009). Stepping stones triple P: An RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder. Journal of Abnormal Child Psychology, 37(37), 469–480.

    CrossRef  PubMed  Google Scholar 

  • Williams, E., Thomas, K., Sidebotham, H., & Emond, A. (2008). Prevalence and characteristics of autistic spectrum disorders in the ALSPAC cohort. Developmental Medicine & Child Neurology, 50(9), 672–677.

    CrossRef  Google Scholar 

  • World Health Organisation. (1978). International classification of diseases: Mental disorders: Glossary and guide to their classification (9th ed.). Geneva: World Health Organisation.

    Google Scholar 

  • World Health Organisation. (1992). The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organisation.

    Google Scholar 

  • World Health Organisation, GCP Network (2017). ICD-11 draft guidelines. Available at https://gcp.network/en/private/icd-11-guidelines/grouping. Accessed 22 Dec 2017.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kylie M. Gray .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2018 Springer Science+Business Media LLC

About this entry

Verify currency and authenticity via CrossMark

Cite this entry

Gray, K.M. (2018). Atypical Autism. In: Volkmar, F. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6435-8_1635-3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-6435-8_1635-3

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6435-8

  • Online ISBN: 978-1-4614-6435-8

  • eBook Packages: Springer Reference Behavioral Science and PsychologyReference Module Humanities and Social Sciences