전반적 발달장애의 분류 및 진단상의 논쟁점

Current Controversies in Classification and Diagnosis of Pervasive Developmental Disorders

This study examined the controversial classification and diagnostic criteria of pervasive developmental disorders through literature review. The results are as follows: First, there is an argument that Asperger disorder is not the condition which is qualitatively different from autism rather than just a milder form of it. Thus, the validity of Asperger disorder as a distinct disorder is in question. In diagnosis of Asperger disorder the criterion of normal development of language before age 3 is the most controversial one. In addition, exclusion of high interest in social functioning, pedantic speech, and poor motor coordination and integration as diagnostic criteria remains controversial. Second, in diagnosis of childhood disintegrative disorder, the criterion of the age of onset is very important, but it is putative. Instead of age 2 which is officially stated in DSM-Ⅳ and ICD-10, age 3 is suggested by many research results. Third, there is general agreement that Rett disorder should be excluded from pervasive developmental disorders, because it differs from autistic disorder in many terms. Fourth, pervasive developmental disorder not otherwise specified(PDD-NOS) is not recognized as a distinct clinical entity, although it is thought to have milder symptoms. The differential diagnosis between high functioning and PDD-NOS is difficult. Implications for future research are discussed according to each controversy.