Autism Spectrum Disorders

Abstract

TL was 2.5 years old when he presented with a recent diagnosis of regressive pervasive developmental disorder-not otherwise specified (PDD-NOS; Table 1). PDD-NOS falls into the autistic spectrum of disorders (ASD) and is sometimes referred to as atypical autism. According to his parents, TL's symptoms began at age 22 months, shortly after receiving the measles, mumps, and rubella (MMR) vaccine. TL was previously meeting normal developmental milestones and had a vocabulary of 20 words. He was a happy and responsive baby who smiled regularly. Over the months since the vaccine, TL had developed aphasia, was irritable and intolerant of certain sensory stimuli, and had difficulty maintaining eye contact, interacting with others, or responding to his name. He developed foul-smelling bowel movements (BMs), itchy ears, dark circles under his eyes, and red blotchy skin. He refused all but soft-textured foods. Comprehensive neuropsychiatric and developmental evaluations were conducted (listed below). Based on the results, full-time special education with speech and occupational therapy was recommended. While pregnant with TL, his mother consumed tuna regularly and had two amalgams. They lived in a large east coast city, in an apartment building known to have lead paint. The building also required periodic insect exterminations, although never in the family's own unit. TL's delivery was by emergency cesarean section at 36 weeks because of placental abruption. His birth weight was 6 lbs, 10 oz, and his Apgar score was normal.