I don't see difference between CD and ASD

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FranzOren
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11 Mar 2021, 4:49 pm

I seem not to see the difference between communication disorders and Autism Spectrum Disorder.

The symptoms of CD is the same as Autism but the only one difference is that there was lack of evidence of restricted interests and repetitive behavior from early childhood to adulthood.




Diagnostic criteria for Social (pragmatic) communication disorder:

A. Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following:


1. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context.

2. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding use of overly formal language.

3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.

4. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).

B. The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination.

C. The onset of symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).


Diagnostic criteria for Autism:

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):

1)Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.


2) Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Specify current severity:

1) Severity is based on social communication impairments and restricted, repetitive patterns of behavior.

3) Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).

3) Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).

4) Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

5) Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Specify current severity:

A) Severity is based on social communication impairments and restricted, repetitive patterns of behavior.

B) Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.


I tend to think communication disorders as PDD-NOS

I tend to think Stereotypic Movement Disorder, communication disorders and ASD as Pervasive Developmental Disorders.


Term for Pervasive Developmental Disorder:

The diagnostic category of pervasive developmental disorders (PDD) refers to a group of disorders characterized by delays in the development of socialization and communication skills.



Types of Pervasive Developmental Disorders:

PDD-NOS, Asperger's Syndrome, Childhood Disintegrative Disorder, Rett's Syndrome and Autistic Disorder



Symptoms of Autistic Disorder:

Symptoms may include impaired social communications or interactions, bizarre behavior, and lack of social or emotional reciprocity. Sleep problems, aggressiveness, and self-injurious behavior are also possible frequent occurrences. It can include low IQ.



Symptoms of Childhood disintegrative disorder:

1) receptive language skills (language understanding)

2) expressive language skills (spoken language)

3) social skills or adaptive behaviors

4) play with peers

5) motor skills

6) bowel or bladder control, if previously established.

7) Impaired nonverbalbehaviors, failure to develop peer relations with no social and emotional reciprocity

8 ) In ability to start and maintain conversations with other people etc.)

9) Restricted, repetitive and stereotyped behavior, such as bobbing the head up and down, or other repeated movements. These changes must not be caused by a general medical condition or another diagnosed mental disorder.



Symptoms of Rett syndrome:

Muscular: flaccid muscles, inability to combine muscle movements, muscle weakness, problems with coordination, stiff muscles, or rhythmic muscle contractions

Respiratory: abnormal breathing patterns, episodes of no breathing, rapid breathing, or shallow breathing

Developmental: delayed development or failure to thrive

Behavioral: irritability or repetitive movements

Cognitive: inability to speak or understand language or slowness in activity

Also common: seizures, constipation, drooling, scoliosis, teeth grinding, or tremor



Symptoms of Asperger Syndrome:

1) Difficulty in social interaction, often due to issues with nonverbal communication

2) Specific subjects of interest, often manifesting as a borderline obsession with a few areas and/or hobbies

3) IQ can vary, but is generally higher than average

4) Surpressed and/or difficulty expressing emotions



It is common for individuals with PDD-NOS to have more intact social skills and a lower level of intellectual deficit than individuals with other PDDs.[3] Characteristics of many individuals with PDD-NOS are:

1) Communication difficulties (e.g., using and understanding language)[7]
2) Difficulty with social behavior
3) Difficulty with changes in routines or environments
4) Uneven skill development (strengths in some areas and delays in others)
5) Unusual play with toys and other objects
6) Repetitive body movements or behavior patterns
7) Preoccupation with fantasy, such as imaginary friends in childhood

But I think PDD-NOS as ASD without repetitive body movements or pattern behaviors.



If we add communication disorders and Stereotypic Movement Disorder together, it would look like Autism.


Symptoms of this disorder may include any of the following movements:

1) Biting self
2) Hand shaking or waving
3) Head banging
4) Hitting own body
5) Mouthing of objects
6) Nail biting
7) Rocking



ImeldaJace
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12 Mar 2021, 3:21 pm

FranzOren wrote:
I seem not to see the difference between communication disorders and Autism Spectrum Disorder.

The symptoms of CD is the same as Autism but the only one difference is that there was lack of evidence of restricted interests and repetitive behavior from early childhood to adulthood.


From what I understand, what you say here is actually the difference between Autism Spectrum Disorder and Social Pragmatic Communication Disorder: ASD includes some sort of restrictive pattern of behavior or interest while social pragmatic communication disorder does not.

It’s important to understand the way autism was diagnosed/classified in the recent past and how it is classified currently. (It’s important to note that what I’m going to say here mostly applies to the United States which uses the Diagnostic and statistical manual of mental disorders (DSM) while much of the rest of the world uses the International classification of diseases (ICD).) The previous version of the DSM, the DSM-IV-TR, included the diagnoses Autistic Disorder, Aspergers Disorder, Childhood Disintegrative Disorder, and Rett Syndrome. These diagnoses were all under the broad category of Pervasive Development Disorders. If a person had a condition that fell under the Pervasive Development Disorders but for some reason or another didn’t meet the exact diagnostic criteria for any of the specific diagnoses, they would be given the label Pervasive Development Disorder Not Otherwise Specified or PDD-NOS, which is often shortened to just PDD.

This system was all changed in 2013 with the introduction of the current addition of the DSM, the DSM V. The broad category of Pervasive Development Disorder was removed and the individual diagnoses under it were combined into one new diagnostic label Autism Spectrum Disorder. One reason that many people had been given a diagnosis of PDD-NOS in the past was because they didn’t have any symptoms that fell under the category of restrictive patterns of behavior or interest which was characteristic of the specific disorders. So with the DSM V, a new disorder was added: Social Pragmatic Communication Disorder. So some people who previously were diagnosed with PDD-NOS are now diagnosed with Social pragmatic communication disorder and others are now diagnosed with ASD. Off the top of my head I've known in person 3 people who were diagnosed with PDD-NOS but it was for different reasons. For example one person was diagnosed with PDD-NOS instead of Asperger Disorder because of how significant her motor delay was, but she wasn't diagnosed with autistic disorder because she didn't have a language delay. While another person was diagnosed with PDD-NOS because she doesn't have restrictive patterns of behavior or interest. The first person I mentioned now has a diagnosis of ASD while the second person I mentioned has a diagnosis of Social pragmatic Communication disorder.

So the diagnoses of Autistic Disorder, Childhood Disintegrative Disorder, Asperger's Disorder, and PDD-NOS are technically no longer exist here in the United States. The reason you still hear them used is that many of us were originally diagnosed before the DSM V came out and still use our original diagnosis. For instance, I was evaluated and originally diagnosed in 2012. So my official evaluation lists Asperger Disorder. But if my doctor is filling out paperwork for me now she writes Autism Spectrum Disorder. When talking about myself I use both Aspergers and autism, though mostly I just say autism. Rhett Syndrome is still a separate diagnosis because it's actually a specific genetic disorder that has some similar features to autism symptoms. Someone could be diagnosed with Rhett's and ASD with the specifier "associated with a known medical or genetic condition or environmental factor."

Also, ASD and Social Pragmatic Communication disorder are both in the Neurodevelopmental Disorders chapter in the DSM V, along with other types of communication disorders, Intellectual Disability, and ADHD etc. Social Pragmatic Communication Disorder is just one type of communication disorder. An example of another communication disorder is Child Onset Fluency Disorder (stuttering).

Social Pragmatic Communication Disorder and Stereotypical Movement Disorder I guess technically could add up to ASD, but it couldn't be diagnosed like that. That's because the diagnostic criteria for Social Pragmatic Communication Disorder specifically excludes repetitive behaviors and it states that if those types of behaviors are present then the diagnosis would be ASD. The diagnostic criteria for Stereotypical Movement Disorder generally excludes the presence of social communication difficulties that are the distinguishing feature of ASD. It is possible to be diagnosed with both ASD and Stereotypical Movement Disorder but the DSM states that that should only be done when the behaviors are self injurious or are severe enough that they need to be the focus of treatment.

I hope this helps clear things up a little.


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FranzOren
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13 May 2022, 1:11 am

It's not helpful, because females with ASD present their behaviors differently than males with ASD, and what may look like SCD is actually ASD, but repetitive behaviors seem normal to others, or you has repetitive behaviors during developmental stages, but no longer have those anymore, and/ or, you have repetitive behaviors, but it's not manifested.



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14 May 2022, 7:48 pm

CD does not have sensory issues in the diagnostic criteria. There are also very big differences that you will not find listed in the diagnostic criterias. Sensory sensitivities have been added to the Autism diagnosis as far as I know.


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14 May 2022, 8:00 pm

it might be helpful to look at genes. It's likely there is a cluster of genes that express conditions ranging from ASD to CD, OCD and SPCD and ADHD.



FranzOren
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14 May 2022, 8:18 pm

That makes sense. But if those neurodevelopental disorders happened without genetic mutation? That can happen as well.



cyberdad
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14 May 2022, 8:25 pm

FranzOren wrote:
That makes sense. But if those neurodevelopental disorders happened without genetic mutation? That can happen as well.


I've attended an autism conference where speakers have said that NTs carry the genes but where they are not "switched on".



FranzOren
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14 May 2022, 8:30 pm

This is interesting, and if it is switches on, then symptoms of ASD seeps out. I hope that I am correct.



kraftiekortie
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14 May 2022, 8:36 pm

Autism is not purely “genetic.” Though there is a genetic element to it.

Plenty of autistic parents have NT children; plenty of NT parents have one autistic child, with the others NT.

I believe you could inherit a predisposition towards autism—but never actually develop autism.

I didn’t deny myself kids because I feared that my children would be autistic because of me.



cyberdad
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14 May 2022, 8:38 pm

kraftiekortie wrote:
Autism is not purely “genetic.” Though there is a genetic element to it.

Plenty of autistic parents have NT children; plenty of NT parents have one autistic child, with the others NT.

I believe you could inherit a predisposition towards autism—but never actually develop autism.

I didn’t deny myself kids because I feared that my children would be autistic because of me.


How the genes are "acquired" is not well understood. I know there was a Canadian research team who were focussing on Somalian migrants where the rate of autism in Canada was higher than any known population. Yet in Somalia autism in these families going back multiple generations was completely unknown?



cyberdad
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14 May 2022, 8:40 pm

FranzOren wrote:
This is interesting, and if it is switches on, then symptoms of ASD seeps out. I hope that I am correct.


That seems to be the prevailing thought, it explains why identical twins - one twin expresses autism/ADHD etc...and the other doesn't. Some pre-natal trauma experienced by one twin and not the other might switch the gene/s on.



FranzOren
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15 May 2022, 12:21 am

Are you describing High-functioning CDD? This should be studied more.



cyberdad
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15 May 2022, 5:11 am

FranzOren wrote:
Are you describing High-functioning CDD? This should be studied more.


ASD



FranzOren
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15 May 2022, 6:29 am

I was being a bit outdated, but yes, ASD. I am sorry! I will be up to date from now on.