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Austism and PDD | Dr. William Winter is a child and adolescent psychiatrist.
Will Winter, MD, FAAP
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Parents are concerned about one of their children.They are aware that the 3 year old is not talking. He does not listen to his parents and is hard to manage. He may play but doesn't play in an interactive or sharing way with his siblings. The parents are concerned because this child is so different from the other children in these respects. In fact, even the 18 month old is talking, and quite a bit at that.

During the initial evaluation, the parents reflect on the fact that this child never really had good eye contact or interactive non-verbal communication going all the way back to infancy. All of his siblings were well related going back to 6 months of age or younger- but not this one.

When this child gets excited he flaps his hands.

Discussion
From the above description, it seems that this child may meet criteria for autism.

When someone meets criteria for autism, we see impairment in the following areas:
Nonverbal social interaction
Communication
Restricted repetitive and stereotyped patterns of behavior, interests and activities

Delays are found, prior to age 3, in at least one of the following areas:
Social interaction
Language as used in social communication
Play

An autistic presentation is associated with tremendous impairment because relationships will be limited. Social communication in all respects- verbal and non-verbal- are extremely limited. As a result, a child with autism will have problems learning and functioning on a day-to-day basis. As a child with autism becomes older, the time and energy devoted to taking care of him may become overwhelming for a family and additional help will likely be necessary. Medication may be useful in the treatment of autism as well.

There are different types of presentations and levels of severity of autism. It is considered to be a part of the PDD spectrum (Pervasive Developmental Disorder). Some people with PDD may not meet criteria for autism because their level of functioning is higher or their impairments are fewer. Nonetheless, they still may benefit from treatment for whatever impairments they do have.