Ques. about Mild Mental Retard. VS PDD
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Ques. about Mild Mental Retard. VS PDD
| Sat, 02-25-2006 - 5:08pm |
Hi Everyone,
Does anyone know how specialists evaluating a child suspected of having PDD can differentiate a diagnosis of PDD-NOS as opposed to the child being Mildly Mentally Retarded or a "Slow Learner"? I ask this because my 9 year old DD (who has an IQ of 70, a Vineland of 66 but reads and comprehends on a 7-8 year old level) is just now probably going to be given a diagnosis of PDD-NOS. In the past, she has been diagnosed as Developmentally Delayed and I am wondering why the doctors are just now seeing her as PDD-NOS and not just Mildly MR or even a slow learner type.
Any ideas how they know which one the child really has?
TIA!
Robin

Well, one mom put the difference to me in a very clear way. (Her son was severe autistic). Picture development as a train. Typical kids chug along at a decent speed, pretty much steady. A child with MR or mental delays also kind of chugs along evenly but at a slower pace. A child with autism is like it isn't just a train, but there is also a person walking along beside, a bike, the train and a plane over head going much faster. In other words thier development can be all over teh place with some things really behind, some way ahead and some chugging along in the middle. Often on testing there is alot of what is called "scatter" amung thier tests.
Aside from that there are typically 3 areas that affect a child with ASD. Language, play and social skills. And they will be atypical rather than just delayed in a regular way.
Language - they may use echolalia, or they may have a hard time putting words together, they may put together sentences they themselves don't understand or conversely suddenly react and understand something that you didn't think they did.
Social skills - again atypical. Most kids with MR are more social and can understand social cues better than a child with ASD might. At least to thier developmental level. So if a child who is 10yo is delayed across the board to say 5yo, then thier social skills will be typical of about a 5yo where a child with PDD is likely even more delayed socially than that or they may not be particularly interesting in others. Even if they are interested and socially outgoing, they have a hard time connecting with others.
Play - play particularly imaginative or pretend play are delayed or not really existant. Some do have pretend play but there is a rote-ness to it that maybe they learned from a tv show or similar. Or it may be more creative but they cannot successfully pretend with other children. If other children are involved the PDD child may insist on being the one in charge and uses the other children as almost pawns in thier play scheme insisting that it be thier way rather than interactive.
My DH likes to talk about the CBS of autism being 3 main things to look for. (He is an autism specialist who does lots of trainings in a large district). The CBS are communication, behavior and social skills. He says the communication is beyond just regular delays, it is delays in being able to communicate effectively on many levels both verbally and non-verbally. And behavior can mean many things from difficult behaviors like meltdowns to repeptitive behaviors like stimming.
Also, DH has told me he often thinks diagnostics for autism should be intervention based. He truly believes a person can be downs syndrome and autistic, LD and autistic, ED and autistic, delayed and autistic, etc. What makes the difference he finds wiht autitistics is if they respond to typical techniques for autistics. If the child NEEDS things like ABA, social stories, or visual schedules, etc to learn and function then they very well may be autistic. If they are very concrete learners who need things set up in those concrete fashion, etc. I don't know that I am explaining it well though.
HTH
Renee
Renee, that was really helpful to me. I do not have the same question about MR vs. PDD-NOS, at least not at this point, but I am always looking for new ways to understand his development and explain it to other people.
My son's diagnosis is PDD-NOS. Since he's still a little guy,I have no idea about IQ etc. since that hasn't been tested but your analogy of the train, bike, plane makes a lot of sense. That's exactly how Eric is. He seems like a plane zooming ahead for "academic" things like reading, counting etc. In gross motor and overall health he is like the train, just chugging. In social he is like a bike rider and in adaptive like someone walking.
Thank you for such an interesting and clear explanation of the CBS theory of autism too.
Katherine