The objective of this study was to document the neurodevelopmental profile of children with autism and pervasive developmental disorder (PDD) using a pediatric neurodevelopmental assessment. One hundred fifty-two patients (139 male, 13 female; age 18 months to 13 years) were diagnosed with autism or PDD at our center between 3/1/93 and 12/20/95. All children underwent a pediatric neurodevelopmental assessment, and developmental quotients (DQs) were obtained in language and visual problem solving.

All 152 children exhibited a significant discrepancy between language and visual problem solving with a disproportionate delay in language relative to visual problem solving development. The mean discrepancy for the group was 39 DQ points. Ninety-five (62%) of the children were also found to have mental retardation. However, even within this setting of overall cognitive delay, each patient exhibited a disproportionate delay in language development. There was a trend for children with higher overall DQs to exhibit larger discrepancies than those with lower overall DQs.

The most consistent neurologic, behavioral, or developmental feature found in every subject with PDD was this discrepancy between language and visual problem solving development. No patient with PDD evidenced an equivalent or“pervasive” delay across the neurodevelopmental domains under study. It is likely that this discrepancy in neurodevelopment contributes to the atypical behaviors seen in children with PDD. Pediatricians can employ such a pediatric neurodevelopmental assessment to identify children at risk for PDD. Early recognition of such a discrepant profile, and conversely, expectation of such a discrepant profile in children with atypical behavior may lead to improved outcome for these children as early intervention strategies can be designed to address the visual problem solving-language discrepancies.