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Autism and the Pervasive Developmental Disorders: Part 2

Differential Diagnosis

The differential diagnosis of autism includes many other conditions and will depend on the age of the child at the time of evaluation, the child's developmental level, and the type of symptom that is most prominent.

For a child found to fall within the spectrum of autism, the category most applicable along that spectrum is an additional differential diagnostic issue. The lines of division are not clear, although DSM-IV provides some help. In general, the term pervasive developmental disorder (PDD) is more likely to be used when cognitive, communicative, and social skills are high relative to other children who are autistic. Some studies have shown that the clinical criterion most useful in separating the two categories is the degree of socialization and relatedness shown by the child. Children who display an active social interest, a degree of empathy, and a better ability to sustain interactions tend to be placed in the PDD category. If they have particularly strong language skills along with the milder socialization difficulties, Asperger disorder is likely to be diagnosed.

For the child who has significant developmental delays in all areas, the primary differential diagnosis will be mental retardation without autism. Many children who are severely mentally retarded exhibit some of the behaviors seen in autism, such as stereotyped behaviors and perseveration, emotional lability, and self-injurious behavior.

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				Committee on Children With Disabilities Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children Pediatrics, May 1, 2001; 107(5): 85e - 85. [Abstract] [Full Text]