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Friday, May 8, 2009
Northwest Hall (Chicago Hilton)
10:00 AM
Background: Although research supports the distinction between ASDs and child onset schizophrenia and other psychotic disorders (Konstantareas & Hewitt, 2001), the differential diagnosis of these disorders, in clinical practice, is often less obvious. Symptom overlap exists in the social domain, including limited affective expression,, narrow interests (White, Anjum, & Schulz, 2006), and lack of interest in friendships (Rappoport, 2001). In one study, over 88% of participants with Psychosis-NOS had a history of atypical social development (Nicoloson et al., 2001). Additionally, children in both groups demonstrate cognitive impairments, such as deficits in executive functioning, working memory, and attention (Lencz et al., 2006; Tsatsanis, 2005). As an increasing number of individuals with adequate language and cognitive function are identified with ASDs, the ability to distinguish psychosis from ASD symptommatology, and an understanding of how the two disorders may co-occur, is even more important.
Objectives: The current project expands on the existing findings from the research literature and qualitatively describes three cases which involved the differential diagnosis of ASD and psychosis (Autistic Disorder, Psychotic Disorder, NOS, and co-morbid ASD and Delusional Disorder). The authors will discuss themes illustrated by each case in relation to the existing literautre in order to inform the audience, as well as stimulate a discussion, about themes that emerge.
Methods: Each case received a comprehensive evaluation in a developmental disorders clinic which included assessment of cognition, adaptive functioning, developmental history (The Autism Diagnostic Interview- Revised) and child social-communication presentation (The Autism Diagnostic Observation Schedule). Social profiles are examined to highlight diagnostic differences between these disorders. In the context of case studies, particular attention is given to areas where symptoms appear to overlap including unusual social behaviors, such as suspicion and hostile attributions about the behavior of others; atypical language, such as use of stereotyped speech and reports of hallucinations; and circumscribed interests, which may be so all-consuming that they appear like delusions.
Results: Case studies will illustrate the ways in which differences between ASD and psychosis are evaluated, and clinical recommendations will be offered.
Conclusions: The differential diagnosis and comorbidity of autism and schizophrenia spectrum disorders present a number of challenges for clinicians. However, careful evaluation of the quality of symptom presentation, alongside the presence/absence of hallmark behaviors, can inform clinical decision-making and treatment decisions.
Objectives: The current project expands on the existing findings from the research literature and qualitatively describes three cases which involved the differential diagnosis of ASD and psychosis (Autistic Disorder, Psychotic Disorder, NOS, and co-morbid ASD and Delusional Disorder). The authors will discuss themes illustrated by each case in relation to the existing literautre in order to inform the audience, as well as stimulate a discussion, about themes that emerge.
Methods: Each case received a comprehensive evaluation in a developmental disorders clinic which included assessment of cognition, adaptive functioning, developmental history (The Autism Diagnostic Interview- Revised) and child social-communication presentation (The Autism Diagnostic Observation Schedule). Social profiles are examined to highlight diagnostic differences between these disorders. In the context of case studies, particular attention is given to areas where symptoms appear to overlap including unusual social behaviors, such as suspicion and hostile attributions about the behavior of others; atypical language, such as use of stereotyped speech and reports of hallucinations; and circumscribed interests, which may be so all-consuming that they appear like delusions.
Results: Case studies will illustrate the ways in which differences between ASD and psychosis are evaluated, and clinical recommendations will be offered.
Conclusions: The differential diagnosis and comorbidity of autism and schizophrenia spectrum disorders present a number of challenges for clinicians. However, careful evaluation of the quality of symptom presentation, alongside the presence/absence of hallmark behaviors, can inform clinical decision-making and treatment decisions.