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a 23 yr old - kiranraja
#1
A 23-year-old man living in a group home for the developmentally challenged has an IQ of 73. He does not read
or write, and communicates with one or two word utterances. He will not interact with other group home members,
and since birth he has "pulled back" and becomes agitated when others get physically close to him. In his room,
everything is in a given place; if any of his belongings are moved, he becomes quite disturbed. Which of the
following is the most likely diagnosis?


A. Asperger's disorder

B. Autistic disorder

C. Childhood disintegrative disorder

D. Obsessive compulsive disorder

E. Schizophrenia, catatonic
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#2
B
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#3
BBB
Language function preserved in Asperger
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#4
The correct answer is B. The man is displaying the classic signs of autism, which include withdrawal from
interaction with others, failure to use speech for communication, and the obsessive need for sameness.

Even though patients with Asperger's disorder (choice A) display a social interaction deficit, there is no
language delay. Also, stereotyped patterns of behavior (e.g., hand twisting) occur in this disorder.

Children with childhood disintegrative disorder (choice C) develop normally for the first two years of life, and
then demonstrate deterioration, but this patient has demonstrated pathology from birth.

Obsessive compulsive disorder (choice D) does not include withdrawal from physical contact, language
impairment, or presence from birth.

Schizophrenic disorder, catatonic type (choice E), has its onset in late adolescence, and is characterized by
difficulties in movement, and either immobility or excitement. The patients also are negativistic and demonstrate
bizarre posturing.
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