Pervasive developmental disorders: a 10-year review.
OBJECTIVE
To summarize recent advances about the nature, diagnosis, and treatment of pervasive developmental disorders.


METHODS
Review of Medline databases, books, and book chapters published between July 1989 and November 1999.


RESULTS
Clinical and genetic studies support expansion of the concept of autism to include a broader spectrum of social communication handicaps. The prevalence of autism is approximately 1 per 2,000; the prevalence of autism and Asperger's disorder together is 1 per 1,000. The Checklist for Autism in Toddlers is a useful screening instrument for 18-month-old children; the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule are instruments of choice for research. Although twin and family studies clearly support genetic factors as important in autism, linkage analysis studies indicate that many genes may be involved. There is no one treatment of choice. Social-pragmatic approaches, augmented by individualized strategies and social coaching, may be best for teaching social communication skills. Pharmacological interventions have a limited role in improving social communication, but selective serotonin reuptake inhibitors and atypical neuroleptic medications may help ameliorate aggression, hyperactivity, and other secondary problems.


CONCLUSIONS
Private and government agencies must continue to support basic and applied research.
Tanguay
P E
PE
Department of Psychiatry, University of Louisville School of Medicine, KY 40202, USA. ptanky@aol.com
D001321:Autistic Disorder / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D001521:Behavior Therapy; D001921:Brain / Q000473:pathology; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D016021:Epidemiologic Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D009974:Orthomolecular Therapy; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012917:Social Adjustment
D011619:Psychotropic Drugs