Potential PDD diagnosis

[Anonymous]

Our 3 year old boy has been exhibiting some delays, particularly in social skills. We went for initial check-up with a developmental psychologist and he so far suspects he has PDD/NOS. We are completely stunned. This is a bright, smart boy, with a wide variety of interests and skills. How can he be PDD? Just because he doesn't make eye contact with a total stranger? Just because he wants to play by himself 50% of the time? We went over the DSV form and he only shows 1 or 2 things. This is a shock for us.
What can we do to help him?

[Anonymous]

Oh man, PP, I think it would serve you and you boy both to go back and ask some hard questions. Just to give you an example, our little guy was also diagnosed with PDD-NOS this spring. He is a sweet, bright, loving little boy who is as happy as the day is long. Like your little guy, ours does not easily make eye contact and ends up playing by himself a lot, though we can't tell if it is because he wants to or if it's because he can't figure out social interactions. BUT (and this is a big BUT): he is also testing at the 1st percentile or below in every major language/speech category, at the 2nd percentile below in every major OT category (with especially bad muscle tone and fine motor issues) and with delayed social skills that test at the 'severely delayed' level. So, there's a ton of doucmentation to support the diagnosis. What sorts of testing has the doctor performed for your child? How did he conclude that it is PDD-NOS, rather than a language delay or perhaps social anxiety? I don't mean to second-guess him, but I think you are right to have concerns.

[Anonymous]

I would find a more supportive doctor. A good developemental pediatrician or psych should give you a roadmap on what therapies (and recommend providers) will be helpful for your DC or at a bare minimum tell you how to contact your county Childfind to get services. Just giving a possible diagnosis is not helpful.

[Anonymous]

PDD-NOS is such an amorphous diagnosis. I would take your DS to KKI to see a developmental pediatrician.

[Anonymous]

PP again - just to add, sometimes it seems that for every specialist who will diagnose your child with an ASD, there is another who will rule it out - it can be very subjective. Since your boy is so young, it make take a little while to tease out
what is really going on. But a developmental pediatrician is a good place to start. He might also benefit from a social skills group.

[Anonymous]

Just so you know the PDD-NOS diagnosis is sometimes given to kids on the very high functioning end of the spectrum, kids who have above average intelligence so just b/c your son is bright does not mean he cannot have PDD-NOS. Also, b/c Aspergers can only be diagnosed when kids are older (i.e around 6 years old), a lot of dev. pediatricians will give the PDD-NOS diagnosis when the kid is younger than 6, but it is more of a PDD-NOS/Aspergers like diagnosis: meaning they think the kid actually has Aspergers but since the kid is too young to be able to say that, they give him the PDD-NOS diagnosis. Maybe that's the case with your toddler especially since you are saying his problem is mainly social skills.

[Anonymous]

Anonymous wrote:Just so you know the PDD-NOS diagnosis is sometimes given to kids on the very high functioning end of the spectrum, kids who have above average intelligence so just b/c your son is bright does not mean he cannot have PDD-NOS. Also, b/c Aspergers can only be diagnosed when kids are older (i.e around 6 years old), a lot of dev. pediatricians will give the PDD-NOS diagnosis when the kid is younger than 6, but it is more of a PDD-NOS/Aspergers like diagnosis: meaning they think the kid actually has Aspergers but since the kid is too young to be able to say that, they give him the PDD-NOS diagnosis. Maybe that's the case with your toddler especially since you are saying his problem is mainly social skills.

This is simply not true. My 4 yr old was diagnosed with Asperger's by a developmental pediatrician, Children's Hospital Autism Clinic and the school psych this year.

[Anonymous]

This is one of the reasons PDD-NOS is going away as a Dx. It can be slapped on almost any kid with a delay.

First, how is your child's language? Is it on target? Lots of kids with language issues are misdiagnosed with PDD-NOS.

[Anonymous]

PDD-NOS applies when some but not all of the criteria for an ASD are met, so it makes sense that he doesn't have all the criteria. Its really a catch-all and I think its good they are getting rid of it.

But . . . you took him to a developmental psychologist for a reason. He has some delays. So address those and have him evaluated by someone different in a year. Time should bring some clarity. And I agree that the fact that he's bright doesn't affect his diagnosis. My DS with an ADS is extremely bright.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Just so you know the PDD-NOS diagnosis is sometimes given to kids on the very high functioning end of the spectrum, kids who have above average intelligence so just b/c your son is bright does not mean he cannot have PDD-NOS. Also, b/c Aspergers can only be diagnosed when kids are older (i.e around 6 years old), a lot of dev. pediatricians will give the PDD-NOS diagnosis when the kid is younger than 6, but it is more of a PDD-NOS/Aspergers like diagnosis: meaning they think the kid actually has Aspergers but since the kid is too young to be able to say that, they give him the PDD-NOS diagnosis. Maybe that's the case with your toddler especially since you are saying his problem is mainly social skills.

This is simply not true. My 4 yr old was diagnosed with Asperger's by a developmental pediatrician, Children's Hospital Autism Clinic and the school psych this year.

It probably depends on the developmental pediatrician. My developmental pediatrician won't diagnose with Aspergers until the child is in kindergarten, at which point he feels that there is a better understanding of how the child is doing academically and how the child reacts to the demands placed on him by school. Before that, he gives the diagnosis of "PPD-NOS Aspergers like" (i.e. we think it is Aspergers but we are not 100% sure yet).

[Anonymous]

Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

[Anonymous]

8:30 again. OP, it really does not matter what the diagnosis is. Try to get him supports at school and/or have it set up as soon as he enters school. It can make a big difference. I credit early intervention with avoiding anxiety/frustration, social isolation and behavior problems that often causes more problems than the diagnosis itself. Good luck!

P.S. my son has obsessive interests and repetitive behaviors in addition to his social problems which gave him the AS DX. Sounds like your DS does not have those.

[Anonymous]

Anonymous wrote:Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

Is it really possible that a child with AS would present as totally NT one-on-one?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

Is it really possible that a child with AS would present as totally NT one-on-one?

Yes, although a child doesn't have to appear "totally" NT to make you think he is NT. Parents unconsciously compensate for their child's social deficits. Plus, the child doesn't need the same social skills at home where there is already a social connection and where the demands aren't great. My DS will make eye contact with me. He rarely makes eye contact with anyone outside our family. He also knows how to engage with us and we know how to engage with him. There's none of the mystery of how to initiate and conduct interaction.

[Anonymous]

It TOTALLY matters what the Dx is, because that will drive treatment in the real world, even though it's not supposed to.

If the PDD-NOS Dx seems wrong, go for an early developmental delay category.

Treat all the symptoms right away, but don't let your child be saddled with a label that might be wrong if your gut tells you it might not be right. It's very hard to get off the PDD-NOS label once it goes on. So do your homework.