My Child Has PDD-NOS: What Should I Know?
by Lisa DiFalco
Was your child diagnosed with PDD-NOS recently? Sources indicate that approximately 2.6 million people classified with ASD are more specifically Asperger’s and PDD-NOS. Parents given a PDD-DOS diagnosis may find it difficult to find the information they need with changing classifications and health professionals unaware of how the diagnosis should be applied. Parents should know that no two children with PDD-NOS will develop in exactly the same way.
There have been changes in the classification of PDD-NOS in the last few years. The 2013 publication of the DSM-5 diagnostic manual included PDD-NOS, previously a separate subgroup of autism, within an ASD diagnosis. Both PDD-NOS and Asperger’s syndrome diagnoses can no longer be found in the Fifth edition of the DSM-5. PDD-NOS, or Pervasive Developmental Disorder-Not Otherwise Specified, was often applied to those with ASD. Children and adults that had the diagnosis had met some of the criteria of another ASD. A child with PDD-NOS could exhibit some of the behaviors for Asperger syndrome or autistic disorder and fall somewhere along the autism spectrum. A PDD-NOS diagnosis only became possible in the last 15 years or so as it was only then recognized. Health professionals and educators may be unaware of the term or how it currently applies. Developmental health professionals, affected individuals and their families should be aware of the defining characteristics of PDD-NOS, how PDD-NOS may be recognized and treatment options. Learn more about how PDD-NOS is currently applied and what the diagnosis means for an affected child or adult.
Current PDD-NOS Definition
Parents should know that PDD-NOS can still allow for a broad range of intellectual ability. The most significant features within PDD-NOS are challenges in language and social development. The criteria for a diagnosis of PDD-NOS is limited to a single paragraph. The DSM-IV definition is:
“This category should be used when there is severe and pervasive impairment in the development of reciprocal social interaction associated with impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behavior, interests, and activities, but the criteria are not met for a specific Pervasive Development Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes “atypical autism”- presentations that do not meet the criteria for Autistic Disorder because of late age at onset, atypical symptomatology, or subthreshold symptomatology, or all of these.”
The definition, as presented, is somewhat vague and appears to be catchall for individuals that do not meet all of the criteria for other specified conditions, including Autistic Disorder and Schizophrenia. New studies help with placing individuals with PDD-NOS into more specific subgroups. These subgroups are:
- Subgroup 1: Individuals whose symptoms are shared with those with Asperger’s but express differences in possessing a language development delay and mild cognitive impairment. Approximately 25 percent fall into this high-functioning group.
- Subgroup 2: Symptoms expressed are closer to those with autistic disorder but do not meet all criteria. About 25 percent of individuals fall within this group.
- Subgroup 3: These individuals meet all autistic disorder diagnostic criteria. However, repetitive and stereotypical behaviors are mild. Approximately half of all individual with PDD-NOS would fit within this subgroup.
Individuals with PDD-NOS can appear to have symptoms closer to those with Asperger syndrome or classic autistic disorder or differ in the level of expression. Treatment needs to be suited to the symptoms and needs of the affected child or adult.
When to Seek a Diagnosis
Diagnosis begins with observable signs. Parents can notice delays in the ability of a child to communicate and socialize as expected as early as during their infancy. Such notable developmental delays can be expressed by:
- Repetitive behavior patterns or body movements;
- Difficulty with changes to surroundings or routine;
- Problems relating to others; and
- Issues in understanding and use of language.
Autism Speaks® offers additional resources to detecting PDD-NOS or autistic behavior and treatment options for a child. Parents can turn to their:
- Video Glossary to understand subtle differences in behavior;
- M-CHAT (Modified Checklist for Autism in Toddlers) to decide if professional evaluation is necessary; and
- Autism Response Team for more assistance with resources, information and opportunities.
Many parents welcome a specific diagnosis as they can begin intervention services that can help a child with their developmental needs. Such parents have often felt alone wondering if their child would simply catch up on their own and want to know what they can do to help their atypically developing child.
What are the Best Treatment Options for PDD-NOS?
As noted in another Relias Academy blog discussing the need for early intervention, PDD-NOS is like other autism spectrum disorders and children benefit most from early diagnosis and intervention. With effective treatment, individuals with PDD-NOS can have more success in important aspects of their life such as:
- Integrating into mainstream classrooms;
- Achieving high levels of independence; and
- Enjoying a quality-life as an adult.
Behavioral therapy is recommended for individuals diagnosed later in life as well.
Intervention and treatments are highly individualized. PDD-NOS, as noted above, can express similarly to Asperger’s, Autism disorder or even to Schizophrenia, based on provided definitions. Affected children and adults will possess their own unique strengths and some stereotypical behaviors may be unusually mild. An assessment from a qualified developmental specialist should consider current symptoms, behavioral history, neuropsychological functioning, social competence and communication patterns in their evaluation. Children diagnosed with PDD-NOS are eligible for an Early Intervention Program (EIP) in early childhood and continue with an Individual Education Program (IEP) as they enter school. The development of additional resources for adults with PDD-NOS would be helpful when children “age-out” of services as they reach adulthood in many states. Parents, caregivers, behavioral therapists, teachers and other health professionals would do well to learn more about PDD-NOS to better assist affected children and adults under their care.