Peads Condition

1.
Autism Spectrum Disorder (ASD)
Mild Moderate Severe
Type of Autism
Asperger’s Syndrome Classic Autism Rett Syndrome

High Functioning Progressive Loss of Motor
Skills and Language
The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition
(DSM-5) provides standardized criteria to help diagnose ASD.
Diagnostic Criteria for Autism Spectrum Disorder

To meet diagnostic criteria for ASD according to DSM-5, a child must have persistent
deficits in each of three areas of social communication and interaction (see A.1.
through A.3. below) plus at least two of four types of restricted, repetitive
behaviors (see B.1. through B.4. below).
A. 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.
3. Deficits in developing, maintaining, and understanding 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.
B. 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):
1. Stereotyped or repetitive motor movements, use of objects, or speech

(e.g., simple motor stereotypes, lining up toys or flipping objects,
echolalia, idiosyncratic phrases).
2. 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).
3. 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).
4. 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:
Severity is based on social communication impairments and restricted,

repetitive patterns of behavior. For either criterion, severity is described in 3
levels: Level 3 – requires very substantial support, Level 2 – Requires
substantial support, and Level 1 – requires support. .1
C. 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).
D. Symptoms cause clinically significant impairment in social, occupational, or
other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability
(intellectual developmental disorder) or global developmental delay.
Intellectual disability and autism spectrum disorder frequently co-occur; to
make comorbid diagnoses of autism spectrum disorder and intellectual
disability, social communication should be below that expected for general
developmental level.
2. Down Syndrome
Though not all people with Down syndrome have the same features, some of the more
common features include:
 Flattened face
 Small head
 Short neck
 Protruding tongue
 Upward slanting eye lids (palpebral fissures)
 Unusually shaped or small ears
 Poor muscle tone (strength/endurance may also affected)
 Broad, short hands with a single crease in the palm
 Relatively short fingers and small hands and feet
 Excessive flexibility
 Tiny white spots on the colored part (iris) of the eye called Brushfield's spots
 Short height
Infants with Down syndrome may be average size, but typically they grow slowly and remain
shorter than other children the same age.
Intellectual disabilities
Most children with Down syndrome have mild to moderate cognitive impairment. Language
is delayed, and both short and long-term memory is affected
3. Attention-Deficit Hyperactivity Disorder
(ADHD)
Diagnostic Criteria for ADHD

1. Inattention: Six (or more) of the following symptoms have persisted for at
least 6 months to a degree that is inconsistent with developmental level and
that negatively impacts directly on social and academic/occupational activities:
 Often fails to give close attention to details or makes careless mistakes in
schoolwork, at work, or with other activities.
 Often has trouble holding attention on tasks or play activities.
 Often does not seem to listen when spoken to directly.
 Often does not follow through on instructions and fails to finish schoolwork,
chores, or duties in the workplace (e.g., loses focus, side-tracked).
 Often has trouble organizing tasks and activities.
 Often avoids, dislikes, or is reluctant to do tasks that require mental effort over
a long period of time (such as schoolwork or homework).
 Often loses things necessary for tasks and activities (e.g. school materials,
pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
 Is often easily distracted
 Is often forgetful in daily activities.

2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have
persisted for at least 6 months to a degree that is inconsistent with
developmental level and that negatively impacts directly on social and
academic/occupational activities:
 Often fidgets with or taps hands or feet, or squirms in seat.
 Often leaves seat in situations when remaining seated is expected.
 Often runs about or climbs in situations where it is not appropriate
(adolescents or adults may be limited to feeling restless).
 Often unable to play or take part in leisure activities quietly.
 Is often “on the go” acting as if “driven by a motor”.
 Often talks excessively.
 Often blurts out an answer before a question has been completed.
 Often has trouble waiting their turn.
 Often interrupts or intrudes on others (e.g., butts into conversations or
games)
In addition, the following conditions must be met:
 Several inattentive or hyperactive-impulsive symptoms were present before
age 12 years.
 Several symptoms are present in two or more settings, (such as at home,
school or work; with friends or relatives; in other activities).
 There is clear evidence that the symptoms interfere with, or reduce the quality
of, social, school, or work functioning.
 The symptoms are not better explained by another mental disorder (such as a
mood disorder, anxiety disorder, dissociative disorder, or a personality
disorder). The symptoms do not happen only during the course of
schizophrenia or another psychotic disorder.
Based on the types of symptoms, three kinds (presentations) of ADHD can occur:
 Combined Presentation: if enough symptoms of both criteria inattention and
hyperactivity-impulsivity were present for the past 6 months
 Predominantly Inattentive Presentation: if enough symptoms of inattention, but
not hyperactivity-impulsivity, were present for the past six months
 Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of
hyperactivity-impulsivity, but not inattention, were present for the past six
months.
Because symptoms can change over time, the presentation may change over
time as well.
4. Cerebral Palsy
a group of disorders that affect a person's ability to move and maintain balance and
posture. CP is the most common motor disability in childhood. Cerebral means
having to do with the brain. Palsy means weakness or problems with using the
muscles.
Symptom
 Stiff muscles and exaggerated reflexes (spasticity), the most common
movement disorder
 Variations in muscle tone, such as being either too stiff or too floppy
 Stiff muscles with normal reflexes (rigidity)
 Lack of balance and muscle coordination (ataxia)
Type of CP

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1.

Autism Spectrum Disorder (ASD)

Mild Moderate Severe

Asperger’s Syndrome Classic Autism Rett Syndrome

Diagnostic Criteria for Autism Spectrum Disorder

A. Persistent deficits in social communication and social interaction across

1. Deficits in social-emotional reciprocity, ranging, for example, from

2. Deficits in nonverbal communicative behaviors used for social

3. Deficits in developing, maintaining, and understanding relationships,

1. Stereotyped or repetitive motor movements, use of objects, or speech

2. Insistence on sameness, inflexible adherence to routines, or ritualized

3. Highly restricted, fixated interests that are abnormal in intensity or focus

4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory

Severity is based on social communication impairments and restricted,

 Upward slanting eye lids (palpebral fissures)

 Unusually shaped or small ears

 Poor muscle tone (strength/endurance may also affected)

 Broad, short hands with a single crease in the palm

 Relatively short fingers and small hands and feet

Diagnostic Criteria for ADHD

 Often fails to give close attention to details or makes careless mistakes in

schoolwork, at work, or with other activities.

 Often has trouble holding attention on tasks or play activities.

 Often does not seem to listen when spoken to directly.

chores, or duties in the workplace (e.g., loses focus, side-tracked).

 Often has trouble organizing tasks and activities.

a long period of time (such as schoolwork or homework).

pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

 Is often easily distracted

 Is often forgetful in daily activities.

 Often fidgets with or taps hands or feet, or squirms in seat.

 Often leaves seat in situations when remaining seated is expected.

 Often runs about or climbs in situations where it is not appropriate

(adolescents or adults may be limited to feeling restless).

 Often unable to play or take part in leisure activities quietly.

 Is often “on the go” acting as if “driven by a motor”.

 Often talks excessively.

 Often blurts out an answer before a question has been completed.

 Often has trouble waiting their turn.

 Often interrupts or intrudes on others (e.g., butts into conversations or

 Several inattentive or hyperactive-impulsive symptoms were present before

 Several symptoms are present in two or more settings, (such as at home,

school or work; with friends or relatives; in other activities).

of, social, school, or work functioning.

mood disorder, anxiety disorder, dissociative disorder, or a personality

disorder). The symptoms do not happen only during the course of

schizophrenia or another psychotic disorder.

 Combined Presentation: if enough symptoms of both criteria inattention and

hyperactivity-impulsivity were present for the past 6 months

 Predominantly Inattentive Presentation: if enough symptoms of inattention, but

not hyperactivity-impulsivity, were present for the past six months

 Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of

posture. CP is the most common motor disability in childhood. Cerebral means

 Stiff muscles and exaggerated reflexes (spasticity), the most common

 Stiff muscles with normal reflexes (rigidity)

 Lack of balance and muscle coordination (ataxia)

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