※ [本文轉錄自 tmlu 信箱]
作者: tm@bbs.sob.com.tw
標題: ◇ [參考]Autism FAQ (5):Similar Conditions
時間: Mon Oct 14 21:53:09 2002
作者: Jf (寫給往事的一封匿名信) 看板: NTUStar_rain
標題: [參考]Autism FAQ (5):Similar Conditions
時間: Thu Sep 27 19:41:55 2001
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Autism FAQ - Similar Conditions
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There are a number of diseases which cause children to display some of
the symptoms of autism. Also, on occasion, brain injury has caused
people to display some of the symptoms of autism. Some diseases:
Deafness
Some children who exhibit symptoms similar to autism have been
discovered to be deaf. A child should always have his hearing
checked before being identified as autistic.
Galactosemia
Inborn error in carbohydrate metabolism. [Inability to
metabolize galactose?]
Heller's Disease
Normal development to age 3 or 4, then abrupt onset of
fretfulness, negativism and anxiety. Regression of mental
development and gradual loss of speech.
LKS "Landau-Kleffner Syndrome"
Also Acquired Childhood Epileptic Aphasia. Very rare disorder.
Typical profile: normal development and age appropriate
language first 3-7 years; Loss of receptive language while
retaining some expressive language; "Telegraphic" speech--few
verbs; Suspicion of deafness; Child frustrated, puzzled by
change in himself; Autistic-like behaviors; normal or above
normal non-verbal IQ score; abnormal EEG, with or without
seizures. Some practitioners suspect that some cases of
Childhood Disintegrative Disorder or "late outset" autism may
be Landau-Kleffner Syndrome.
PKU "Phenylketonuria"
A genetic disorder of the metabolism which will result in
brain-damage during the first years of life unless special
dietary measures are taken. Inadequate production of the enzyme
which converts the amino acid phenylalanine into another amino
acid, tyrosine. The extra phenylalanine accumulates in body
fluids and converts to several chemicals that damage the brain.
Symptoms include mental retardation as well as some of the
symptoms of autism. PKU has been eliminated by screening all
children immediately after birth so proper dietary measures can
be taken.
Rett's Syndrome
a neurological disorder that occurs only in girls. Unlike
autism, girls initially show normal development, then revert.
The initial symptoms include some that are associated with
autism. From DSM IV:
DIAGNOSTIC CRITERIA FOR 299.80 RETT'S DISORDER (females only)
A. All of the following:
(1) apparently normal prenatal and postnatal development (2)
apparently normal psychomotor develop (3) normal head circumference
at birth
B. Onset of all of the following after a period of normal
development:
(1) deceleration of head growth between ages 5 and 48 months (2)
loss of previously acquired purposeful hand skills between ages 5
and 30 months with subsequent development of stereotyped hand
movements (e.g. hand wringing or hand washing) (3) loss of social
engagment early in the course (although social interaction often
develops later) (4) appearance of poorly coordinated gait or trunk
movements (5) severely impaired expressive and receptive language
development with severe pyschomotor retardation.
Childhood Disintegrative Disorder
Much rarer than autism. I've seen references which treat this
as a synonym for Heller's Disease (see above). From DSM IV:
DIAGNOSTIC CRITERIA FOR 299.10 CHILDHOOD DISINTEGRATIVE DISORDER
A. Apparently normal development for at least the first 2 years
after birth as manifested by the presence of age appropriate verbal
and nonverbal communication, social relationships, play and adaptive
behavior.
B. Clinically significant loss of previously acquired skills
(before age 10 years in at least two of the following areas:
(1) expressive or receptive language (2) social skills or adaptive
behavior (3) bowel or bladder control (4) play (5) motor skills
C. Abnormalities of functioning in at least two of the following
areas:
(1) qualitative impairment in social interaction (e.g., impairment
in nonverbal behaviors, failure to develop peer relationships, lack
of social or emotional reciprocity)
2) qualitative impairments in communication (e.g., delay or lack of
the development of spoken language, inability to initiate or sustain
a conversation, stereotyped and repetitive use of language, lack of
verbal make-believe play)
(3) Restricted repetitive & stereotyped patterns of behavior,
interests and activities, including motor stereotypes and
mannerisms.
D. The disturbance is not better accounted for by another specific
Pervasive Developmental Disorder or by Schizophrenia.
Tourette's Syndrome
a condition thought to be genetic that causes uncontrollable
motor and/or vocal tics. A major longterm study is being
conducted by David Cummings, who published a thick book on the
genetic links between various neurological disorders. (Not easy
reading.)
Obsessive-compulsive disorder
Obsessions are thoughts or images that are involuntary,
intrusive, and anxiety-provoking. Compulsions are impulses to
perform a variety of stereotyped behaviors or rituals. OCD is a
neurological disorder, cause uncertain. However, it is often
confused with obsessions and compulsions caused by mental
illness or simple neurosis, in much the way that the term
"Autism" has been used to refer to any person who is severely
withdrawn. For a clearer picture of OCD, read The Boy Who
Wouldn't Stop Washing (Judith Rapaport). Clinical OCD has
easily categorized symptomology that tend to occur at certain
stages of life; counting and sorting and "evening out" usually
start during childhood, "grooming" compulsions usually start at
puberty, and "ruminating" (obsessions) usually begin during
adulthood.
Cocktail party speech syndrome
a syndrome comprising the following characteristics: (1) A
perseveration of response, either echoing the examiner, or
repetition of an earlier statement made by the child. (2) An
excessive use of social phrases in conversation. (3) An
over-familiarity in manner, unusual for one's age. (4) A habit
of introducing personal experience into the conversation in
irrelevant and inappropriate contexts. (5) Fluent and normally
well articulated speech.
Asperger's Syndrome
Similar to Autism except that language development is normal.
In some people's minds, the same thing as high-functioning
Autism. From DSM IV (p77):
DIAGNOSTIC CRITERIA FOR 299.80 ASPERGER'S DISORDER
A. Qualitative impairment in social interaction, as manifested by
at least two of the following:
(1) marked impairments in the use of multiple nonverbal behaviors
such as eye-to-eye gaze, facial expression, body postures, and
gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to
developmental level
(3) a lack of spontaneous seeking to share enjoyment, interests, or
achievements with other people (e.g. by a lack of showing,
bringing, or pointing out objects of interest to other people)
(4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behavior,
interests, and activities, as manifested by at least one of the
following:
(1) encompassing preoccupation with one or more stereotyped and
restricted patterns of interest that is abnormal either in
intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional
routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g., hand or
finger flapping or twisting, or complex whole-body movements)
(4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairments in
social, occupational, or other important areas of functioning
D. There is no clinically significant general delay in language
(e.g., single words used by age 2 years, communicative phrases used
by age 3 years)
E. There is no clinically significant delay in cognitive
development or in the development of age-appropriate self-help
skills, adaptive behavior (other than social interaction), and
curiosity about the environment in childhood
F. Criteria are not met for another specific Pervasive
Developmental Disorder of Schizophrenia
Nonverbal learning disabilities
Semantic-pragmatic speech disorder (Semantic Pragmatic Disorder or
SPD)
A communication problem with mild autistic symptoms and
problems generalizing.
Schizophrenia
a mental illness which can result in behavior similar to
autism. Unlike autism, schizophrenia usually starts in
adolescence or early adulthood, and involves delusions or
hallucinations. Note that "Childhood Schizophrenia" used to
refer to what we now label "Autism" and that the former term is
still used in some circles.
PDD or PDD/NOS or PDD-NOS "Pervasive Development Disorder/Not
Otherwise Specified"
PDD therefore becomes a term for individuals who do not fully
meet the medical criteria for autism, but it is a very loose
term. From DSM IV:
299.80 PERVASIVE DEVELOPMETAL DISORDER
NOT OTHER SPECIFIED (including Atypical Autism)
This category should be used when there is a severe and pervasive
impairment the development of reciprocal social interaction,
verbal and nonverbal communication skills, or when the stereotyped
behavior, interest and activities are present, but the criteria are
not met by a specific Pervasive Developmental Disorder,
Schizophrenia, Schizotypal Personality Disorder or Avoidant
Personality Disorder. For example, this category includes "atypical
autism" - presentations that do not meet the criteria for Autistic
Disorder because of late age at onset, atypical symptomatology, or
subthreshold symptomology (note; fewer than 6 items), or all
three.
mucopolysaccharoidoises (Type I)
Has coincided with autism.
adenylosuccinate lyase deficiency
a disorder of nucleic acid metabolism. Has coincided with
autism.
Childhood aphasia
?
Receptive Developmental Dysphasia
?
Celiac's disease
Gluten intolerance (?)
Fragile-X Syndrome
The most common cause of inherited mental retardation, with an
incidence of about 1/1500 in males and 1/2500 in females. The
inheritance pattern of the disease is unlike other X-linked
disorders, because it shows significant numbers of apparently
unaffected male carriers and some clinically affected females.
The disease derives its name from the presence of a fragile
site on the X chromosome of affected individuals.
ADD "Attention Deficit Disorder"
A disorder consisting of having a short attention span. Dr. C.
Gillberg from Sweden has proposed (in addition to others) that
there may be a continuum from ADD to autism. He proposes that
some kids are in the middle of the continuum, with a
combination of ADD and autistic features. These kids often have
"soft" neurologic signs (incl. fine and/or gross motor
coordination problems) in addition to their ADD, and are
socially awkward.
ADHD "Attention Deficit Hyperactivity Disorder"
Another term for ADD when the person is also hyperactive.
Thought to be caused by a chemical imbalance in the brain,
which results in a biological deficiency in a childs ability to
concentrate. Diagnosis of ADHD is a grey area: there are 18
criteria involved in identifying ADHD including such traits as
inability to concentrate and aggressiveness. The question of
how many criteria a child must have before pharmaceutical
treatment is however still debated. A daily dose of a
controversial prescription drug called RITALIN, has been
reported to cause marked improvement in childrens behaviour.
CMV
?
Tuberous Sclerosis
?
Hyperlexia
a disorder consisting of precocious reading development,
disordered language acquisition and social and behavioral
deficits. It is a matter of discussion whether to consider it a
type of autism or asperger's syndrome.
Manic Depression
Autistic Children who have no apparent neurological basis for
their disorders may actually be suffering from an inherited,
early-onset form of manic-depression, according to results of
two studies conducted at Duke University Medical Center,
Durham, NC. The findings were reported in the May and August
1994 issues of "Developmental Medicine and Child Neurology."
Angelman Syndrome
resembles autism only superficially since Angelman kids are
profoundly retarded and (somtimes?) don't exhibit the lack of
empathy, eye contact, etc. typical of autism. It is caused by a
particular defect in chromosome 15 which can be diagnosed
accurately by chromosome testing. The other name for it is the
Happy Puppet because the children's limbs are usually held out
from the body stiffly and the children always have a smiling
countenance. Besides extreme retardation, other symptoms
include low muscle tone, recurring seizures, sleep disorders,
gastrointetinal problems, and slow development. Another
syndrome caused by a defect in chromosome 15 is Prader-Willi.
Smith-Magenis Syndrome
has a lot of autistic characiteristics. Caused by a particular
defect in the 17th chromosome.
Klinefelter Syndromes
Having an XXY chromosome. It is easily testable through genetic
testing and occurs in about 1 in 1000 births. Often includes
developmental and language impairment, and has been correlated
with some kinds of withdrawn behavior.
DAS "Developmental Apraxia of Speech"
Also known as "Developmental Verbal Dyspraxia". A
neurologically-based speech disorder observed in children
learning to speak. It affects the rate of speech development,
the number of sounds in a child's repertoire, and the child's
ability to combine sounds during the production of words.
Lactic Acidosis
tendency to accumulate of lacitic acid in the blood. It's
connection with autism is that it has been found to coincide
with autism more than chance would dictate.
Prosopagnosia
The inability to recognize faces, also known as face blindness.
Irlen Syndrome/Scotopic Sensitivity Syndrome (SSS)
Visual perceptual problem identified by Helen Irlen which
causes (among other things) black-on-white print to be
difficult to read, and which can be alleviated by filtering out
portions of the light spectrum with colored glasses. See Irlen
Lenses under treatment.
Turner's syndrome
A syndrome in females where they are missing one of their two X
chromosomes.
Carnitine Deficiency
A condition which can have symptoms similar to Reye's Syndrome.
It can be caused by genetic factors.
Others I've heard mentioned: Congenital Rubella Syndrome,
Hypomelanosis of Ito, mucopolysacchrides, fetal alcohol effect,
cocaine use during pregnancy, Anxiety disorders, Mucopolysaccharidoses
(MPS), Lesch-Nyhan Syndrome, Intermittent Explosive Disorder, static
encephalopathy, sleep disorder, abnormal fear structure, Cornelia de
Lange Syndrome, Wilsons Disease, Aphasia, Schizoid Personality
Disorder, Porphyria (?), Bi-Polar Affective Disorder, Defiant
Disorder, Spacial Planning Disorder, Neurofibromatosis, Candida
Albicans.
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