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231: AUTISM SPECTRUM DISORDER

Kay Tasso, PhD, PT, PCS

CONDITION/DISORDER SYNONYMS

  • Autism

  • Early infantile autism

  • Childhood autism

  • Kanner’s autism

  • Pervasive developmental disorder, not otherwise specified (PDD-NOS)

ICD-9-CM CODES1

  • 299 Pervasive developmental disorders

  • 299.0 Autistic disorder

  • 299.00 Autistic disorder current or active state

  • 299.01 Autistic disorder residual state

  • 299.9 Unspecified pervasive developmental disorder

  • 299.90 Unspecified pervasive developmental disorder current or active state

  • 299.91 Unspecified pervasive developmental disorder residual state

ICD-10-CM CODES2

  • F84.0 Autistic disorder

  • F84.9 Pervasive developmental disorder unspecified

  • F84.5 Asperger syndrome

  • F84.8 Other pervasive developmental disorders

  • F84.9 Pervasive developmental disorder, unspecified

PREFERRED PRACTICE PATTERN

  • 5B: Impaired Neuromotor Development3

TABLE 231-1Differential Diagnostic Features of Autism and Nonautistic Pervasive Developmental Disorders
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TABLE 231-1 Differential Diagnostic Features of Autism and Nonautistic Pervasive Developmental Disorders
Feature Autistic Disorder Asperger’s Syndrome Rett Syndrome Pervasive Developmental Disorder NOSa
Age at recognition (months) 0–36 Usually >36 5–30 Variable
Sex ratio M > F M > F F >> M M > F
Loss of skills after initial mastery Variable Usually not Marked Usually not
Social skills Very poor Poor Vary with stage Variable
Communication skills Usually poor Fair Very poor Fair to good
Circumscribed interests Variable (mechanical) Marked (facts) NA Variable
Eye contact Very poor Variable Varies with stage Variable
Family history of similar problems Sometimes Frequent Not usually Unknown
Seizure disorder Common Uncommon Frequent Uncommon
Head growth decelerates No No Yes No
IQ range Severe MR to normal Mild MR to normal Severe MR Severe MR to normal
Outcome Poor to good Fair to good Very poor Fair to good

F, female; IQ, intelligence quotient; M, male; MR, mental retardation; NA, not applicable; NOS, not otherwise specified.

aImpairments are not as severe as in autism.

Source: From DiPiro JL, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM (eds): Pharmacotherapy: A Pathophysiologic Approach. New York, McGraw-Hill Education, 2014. Data from American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision. Washington, DC, American Psychiatric Association, 2000; Johnson CP, Myers SM. Identification and evaluation of children with autism spectrum disorders. Pediatrics 2007;120:1183-1215; Filipek PA, Accardo PJ, Baranek GT. The screening and diagnosis of autistic spectrum disorders. J Autism Dev Disord 1999;29:439-484; Baird G, Cass H, Slonims V. Diagnosis of autism. BMJ 2003;327:488-493; Chawarska K, Volkmar FR. Autism in infancy and early childhood. In: Volkmar FR, Paul R, Klin A, Cohen DJ, eds. Handbook of Autism and Pervasive Developmental Disorders. 3rd ed. Hoboken, N.J.: John Wiley and Sons, Inc.; 2005:223-246.

PATIENT PRESENTATION

A 3-year-old male is referred to physical therapy for poor coordination. His mother reports he was born full term via vaginal delivery with no difficulty with pregnancy or delivery. As an infant, he seldom made eye contact and disliked being held. His mother states “I don’t think he likes me.” He ...

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