Michelle Heyman, Megan Ledoux Galligan, Giselle Berenice Salinas, Elizabeth Baker, Jan Blacher and Katherine Stavropoulos
Professionals working with community populations are often presented with complicated cases where it is difficult to determine which diagnosis or diagnoses are appropriate…
Abstract
Purpose
Professionals working with community populations are often presented with complicated cases where it is difficult to determine which diagnosis or diagnoses are appropriate. Differentiating among neurodevelopmental disorders such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder and intellectual disability can be a complex process, especially, as these disorders have some overlapping symptoms and often co-occur in young children. This series of case studies aims to present commonly overlapping symptoms in children who present to clinics with developmental concerns.
Design/methodology/approach
This paper presents three case studies that were completed at a free community ASD screening clinic in Southern California.
Findings
The case studies have common presenting behaviors and symptoms (e.g. social communication difficulties) that often co-occur across diagnoses; explanations for the final diagnoses are given in each case.
Research limitations/implications
Conclusions from these three cases cannot generalize to all children being seen in clinics for neurodevelopmental concerns.
Practical implications
This series of case studies highlights commonly overlapping symptoms in children who present for differential diagnosis with social and/or behavioral concerns. Implications for educational placement and intervention are discussed.
Social implications
These cases highlight the challenges involved in the differential and dual diagnostic process for young children with developmental concerns. Diagnostic considerations can affect later educational placement and opportunities for socialization.
Originality/value
This series of case studies provide practical information for clinicians about how to effectively differentiate between commonly occurring neurodevelopmental disorders, particularly given recent changes to the Diagnostic and Statistical Manual, 5th edition (DSM-5).
Details
Keywords
Ann Marie Martin, Katherine Stavropoulos and Jan Blacher
Historically, children with autism spectrum disorder (ASD) were sometimes diagnosed with schizophrenia or major psychosis. Although significant advancements in the process of…
Abstract
Purpose
Historically, children with autism spectrum disorder (ASD) were sometimes diagnosed with schizophrenia or major psychosis. Although significant advancements in the process of differential diagnosis have been made since 1950s, there still exists a problematic delay in diagnosis due to overlap of symptoms. Negative symptoms of schizophrenia can mimic the social difficulties and stereotyped behaviors characteristic of ASD, whereas positive symptoms of schizophrenia can be perceived as restricted and repetitive behaviors, complicating the diagnostic process. The purpose of this paper is to present two clinical cases that highlight the complexities in differential diagnosis of early psychosis, schizophrenia and ASD.
Design/methodology/approach
Two females, 14 and 16 years of age, were referred to a free screening clinic in Southern California to be assessed for possible ASD. Both females were referred because of the presentation of restricted and repetitive behaviors and social communication difficulties. Both females and their families were administered a battery of measures to ascertain the youths’ cognitive functioning, adaptive living skills and severity of autism-related behaviors.
Findings
The 14-year-old presented with early-stage (prodromal or at-risk mental state) psychosis; 16-year-old met criteria for schizophrenia. Both were referred to clinics specializing in treatment for psychosis and/or schizophrenia. Neither met criteria for ASD.
Originality/value
More published studies are needed on the overlap of symptoms between ASD and schizophrenia to help prevent diagnostic overshadowing of autistic symptoms and promote treatment during the early stages of psychosis. This is particularly important given the strong evidence that early treatment for psychosis improves social, cognitive and functional outcomes.