5.Overactive disorder with mental retardation
and stereotyped movements
7.Other Pervasive Developmental Disorder
The DSM-IV seems to be used more by psychiatrists and psychologist in the United States dealing with individuals with pervasive developmental disorders. Several Delaware state agencies use the DSM-IV including Adult Mental Health, Developmental Disabilities Services, and Child Mental Health. The Department of Education autism classification is based on the DSM-IV diagnostic system.
A diagnosis alone is not generally considered sufficient to determine the need or eligibility for public services. This is true in ASD and PDD especially because of the continuum concept of the severity of the disability. In addition to disorder diagnosis, agency services eligibility is dependent on criteria based functional impairments. Criteria and types of functional impairments vary based on the service agency’s area of focus and the target population. The Department of Education focus is related to educational and academic impairments for individuals within the school system, Vocational Rehabilitation and Social Security Disability focuses on work related impairment, Division of Developmental Disability Services focuses on adaptive behavior deficits. Eligibility for services is usually a dual criterion of specific diagnosis and defined functional impairment.
A serious problematic area is the diagnostic process. There are no known medical tests that aid in making the diagnosis. The diagnosis must be made on the basis of behavioral and social functioning and developmental history prior to 36 months of age. This is especially problematic in adults the target population of this Task Force. Recently, some evaluation instruments have been developed to assist in the diagnostic process. These instruments utilize behavioral observations, structured interviews and developmental history.
1.Diagnosis of disorders within ASD or PDD should be made using the DSM-IV diagnostic criteria.
2.Service agency eligibility should include both a diagnostic criteria and functional impairment criteria. A functional impairment criteria based on adaptive behavior would provide a fairly broad definition of functional impairment.
Service agencies that currently serve this population to some degree should continue to provide services while other services agencies should add service eligibility criteria around their service focus.
Diagnoses should be made with the aid of standardized instruments designed to identify individuals with PDD by qualified and licensed professionals.
Further discussion is needed regarding whether to address Rett’s Disorder because of its eventual course resulting in mental retardation.
The diagnosis of Rett’s Disorder should be confirmed with the use of the Rett’s DNA Test.