Walker Darlene R, Thompson Ann, Zwaigenbaum Lonnie, Goldberg Jeremy, Bryson Susan E, Mahoney William J, Strawbridge Christina P, Szatmari Peter
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
J Am Acad Child Adolesc Psychiatry. 2004 Feb;43(2):172-80. doi: 10.1097/00004583-200402000-00012.
To describe the clinical characteristics of children given a diagnosis of pervasive developmental disorder-not otherwise specified (PDD-NOS) by expert clinicians and to compare these to the clinical characteristics of children given a diagnosis of autism and Asperger syndrome (AS).
Two hundred sixteen children with autism, 33 with AS, and 21 with PDD-NOS were compared on measures of level of functioning (communication, daily living and social skills, IQ, and age of acquisition of language) and on various symptoms of autism (impaired communication and reciprocal social interaction and a preference for repetitive and stereotyped activities).
In terms of level of functioning measures, the PDD-NOS children had scores that were between those of the children with autism and those of the children with AS. In contrast, the PDD-NOS group had fewer autistic symptoms, especially repetitive stereotyped behaviors, than both the autism and AS groups (chi2 = 11.06, p =.004). Children with PDD-NOS could be placed into one of three subgroups: a high-functioning group (24%) who resembled AS but had transient language delay or mild cognitive impairment; a subgroup resembling autism (24%) but who had late age of onset or too severe cognitive delays or were too young to potentially meet the full diagnostic criteria for autism; and a group (52%) not fulfilling the criteria for autism because of fewer stereotyped and repetitive behaviors.
With some revision to current diagnostic criteria, a more homogenous atypical group with significant impairments in social-communication but fewer repetitive behaviors can be differentiated from the more nonspecific PDD-NOS group. This differentiation may lead to better reliability in diagnosis and to further progress in studies of etiology.
描述由专家临床医生诊断为未特定的广泛性发育障碍（PDD-NOS）的儿童的临床特征，并将其与诊断为自闭症和阿斯伯格综合征（AS）的儿童的临床特征进行比较。
对216名自闭症儿童、33名AS儿童和21名PDD-NOS儿童在功能水平（沟通、日常生活和社交技能、智商以及语言习得年龄）指标以及各种自闭症症状（沟通和相互社交互动受损以及对重复和刻板活动的偏好）方面进行比较。
在功能水平指标方面，PDD-NOS儿童的得分介于自闭症儿童和AS儿童之间。相比之下，PDD-NOS组的自闭症症状较少，尤其是重复刻板行为，比自闭症组和AS组都少（卡方=11.06，p=0.004）。PDD-NOS儿童可分为三个亚组之一：一个高功能组（24%），类似于AS，但有短暂的语言延迟或轻度认知障碍；一个类似于自闭症的亚组（24%），但发病年龄较晚或认知延迟过于严重或年龄太小以至于可能无法完全符合自闭症的诊断标准；以及一个因刻板和重复行为较少而不符合自闭症标准的组（52%）。
对当前诊断标准进行一些修订后，可以将一个在社交沟通方面有明显损害但重复行为较少的更同质的非典型组与更不具特异性的PDD-NOS组区分开来。这种区分可能会提高诊断的可靠性，并在病因学研究方面取得进一步进展。
