Epidemiology of pervasive developmental disorders. J Pediatr Res

Department of Psychiatry, Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada.
Pediatric Research (Impact Factor: 2.84). 03/2009; 65(6):591-8. DOI: 10.1203/PDR.0b013e31819e7203
Source: PubMed

ABSTRACT This article reviews the results of 43 studies published since 1966 that provided estimates for the prevalence of pervasive developmental disorders (PDDs), including autistic disorder, Asperger disorder, PDD not otherwise specified, and childhood disintegrative disorder. The prevalence of autistic disorder has increased in recent surveys and current estimates of prevalence are around 20/10,000, whereas the prevalence for PDD not otherwise specified is around 30/10,000 in recent surveys. Prevalence of Asperger disorder is much lower than that for autistic disorder and childhood disintegrative disorder is a very rare disorder with a prevalence of about 2/100,000. Combined all together, recent studies that have examined the whole spectrum of PDDs have consistently provided estimates in the 60-70/10,000 range, making PDD one of the most frequent childhood neurodevelopmental disorders. The meaning of the increase in prevalence in recent decades is reviewed. There is evidence that the broadening of the concept, the expansion of diagnostic criteria, the development of services, and improved awareness of the condition have played a major role in explaining this increase, although it cannot be ruled out that other factors might have also contributed to that trend.

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Available from: Eric Fombonne, Apr 01, 2015
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    • "Autism is now considered to be one of the most common and debilitating mental disorders that children can be diagnosed with. The worldwide prevalence of autism is 0.6% (World Health Organization, 2013) (Fombonne, 2009), however, the prevalence in The Netherlands is describes the 3 core symptoms that should be present for AD ((1) deficits in social interaction, (2) communication and (3) stereotype repetitive behavior before the age of three) while for PDD- NOS no pre-defined symptoms are clearly specified. There are no clear guidelines for which, or how many, of the core domain symptoms should be present when diagnosing PDD-NOS. "
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    ABSTRACT: The objective of this study was to identify differences between and determine predictors for Autistic Disorder (AD) and Pervasive developmental disorder not otherwise specified (PDD-NOS). The motivation behind this is that the criteria for PDD-NOS stated in the Diagnostic and Statistical Manual of Mental Disorders - fourth edition (DSM-4) are ambiguous and need clarification in order to formulate more precise and validated criteria. Differences and predictors were derived from the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), a questionnaire which is conducted as part of Routine Outcome Monitoring in mental health institutions. Participants originated from a pool of individuals who were assessed at the child- and adolescent psychiatric department of the University Medical Centre Utrecht (The Netherlands). Seventy-two children and adolescents with AD (mean age 9.5 years, SD= 4.2) and 75 with PDD-NOS (mean age 9.6 years, SD= 4.2) were included and analyzed with on 15 items of the HoNOSCA. Independent sample T-test showed that the AD subgroup displayed significantly more problems on the items ‘overactivity, attention or concentration’, ‘scholastic or language skills’ and ‘self-care and independence’ whereas the PDD-NOS subgroup displayed significantly more problems regarding ‘emotional and related symptoms’. Binary logistic regression revealed that more problems on ‘overactivity, attention or concentration’, ‘self-care and independence’ and ‘disruptive, antisocial or aggressive behavior’ are predictive for AD rather than PDD-NOS with respectively OR of 2.06 (95%C.I. 1.34-3.18), 1.75 (95%C.I. 1.30-2.36) and 1.32 (95%C.I. 1.00-1.75). More ‘emotional and related symptoms’ predicted PDD-NOS rather than AD with an OR 1.79 (95%C.I. 1.28-2.49). The HoNOSCA could serve as a rapid and cost-effective instrument to help identify cases of AD and PDD-NOS. Emotional and related symptoms may be useful to formulate new and more precise criteria for PDD-NOS.
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    • "Still, many parents continue to believe that the vaccine causes autism or that there is an ongoing epidemic of autism (Waterhouse 2008). A variety of intrauterine and extra-uterine environmental causes, prenatal , peri-natal and post natal risks, even tropical storms and hurricanes during sensitive gestational periods, toxic metals or chemicals have been implicated for the increasing numbersalthough none of them have been validated to date (Fombonne 2009). In recent times, acculturation, ethnic bias and related social factors have also being linked for the rising rates of this disorder (Nassar et al. 2009; DeSoto 2009). "
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    ABSTRACT: There is a growing trend in favor of diagnosing many children as cases of autism. This study seeks to address the key problems and issues related to diagnosis of children as autism in our country. One-hundred fifty four cases of children below 8 years diagnosed as autism at some point in their lifetime underwent a detailed individualized re-evaluation covering manifold processes and techniques. Data units of information attempted to recapture the subjective experience of diagnostic decision making by using schemas that enables one ‘to think about it, mull it over and evaluate it’. Results analyzed in terms of derived quantitative and qualitative metrics highlight more than 60 sources of diagnostic errors. Thus, out of the studied sample only 30 children (19.48 %) eventually qualified for final diagnosis of autism against the set official criteria. The findings are delineated with explanations and examples for prospective diagnosticians to be wary before labeling children as autism or on its spectrum.
    Psychological Studies 03/2015; 60(1):91-100. DOI:10.1007/s12646-015-0302-1
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    • "Epidemiological data have shown a significantly higher prevalence of ASD in males and recent evidence suggests that the observed gender ratio may be influenced by sex differences in symptomatology of ASD (Fombonne 2009). However, there is a great deal of literature concerning the varying profile of autism as expressed by gender differences and the vast majority of studies have been conducted with predominantly male samples (Bell et al. 2005). "
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    ABSTRACT: Epidemiological studies have highlighted a strong male bias in autism spectrum disorder (ASD), however few studies have examined gender differences in autism symptoms, and available findings are inconsistent. The aim of the present study is to investigate the longitudinal gender differences in developmental profiles of 30 female and 30 male age-matched preschool children with ASD. All the children underwent a comprehensive evaluation at T0 and at T1. Our results have shown no significant interaction between time and gender for predicting autism symptoms, developmental quotient, parental stress, children's adaptive skills and behavior problems. Shedding light on the developmental trajectories in ASD could help clinicians to recognize children with ASD at an earlier age and contribute to the development of appropriate treatments.
    Journal of Autism and Developmental Disorders 01/2015; 45(7). DOI:10.1007/s10803-015-2366-0 · 3.34 Impact Factor
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