Question: PDD-NOS vs. other ASD's

iVillage Member
Registered: 03-27-2003
Question: PDD-NOS vs. other ASD's
3
Sun, 08-22-2010 - 10:39pm

One of the presenters at my conference made a comment that got me thinking.

                                

iVillage Member
Registered: 03-26-2003
Mon, 08-23-2010 - 12:42am

Oh I totally get your frustration with this but I have a different take in a small way. I don't think any kid fits neatly into a box. Spectrum kids in particular dont fit into boxes, kwim? So why do we have to be so caught up on figuring out exactly which ASD box they fit into?

My problem is that the more communicative aka "high functioning" end of the spectrum we try to delineate way too much. (IMHO I am hopeful they change the whole darn thing to ASD-autism spectrum disorder and be done with it). They are never going to be able to classify all children perfectly which is why PDD-NOS was created in the first place but PDD-NOS has become such a flippin catch all it means very little in understanding what a child's needs are or where they are at. It can be a child who is non-verbal or one who's only spectrum system is sensory issues.

Honest, I think we need to have just 2 classifications. 1 for children who are more impacted, non-verbal and likely will need life long support and one classification for the more verbal/communicative, less impacted end of the spectrum.

BTW I specifically don't use terms like low or high functioning, or mild/moderate/severe on purpose. I have met plenty of impacted/non-verbal autistics that I would not call "Low functioning". It seems a diservice and insult. Conversely I have met plenty of Aspies or HFA folks who are not mild by any stretch of the immagination.

However, that said as a teacher, the strategies and supports needed for those 2 groups are enormously different and it is like 2 different diagnosis all together. While there are some similarities (sensory over load, uneven skills, etc) teaching a child to communicate using a device, or teaching a 3rd grader how to wash his hands and proper toileting is not the same as teaching a child pragmatic language, organizational skills or social etiquette.

So I went off on a tangeant.

Basically, I have heard about everything when it comes to AS, PDD-NOS, HFA, etc etc etc. We can get stuck on the semantics of the diagnosis and yes, according to the DSM that guy is wrong and that is just his oppinion. The problem is that each doctor tends to go by their own oppinion.

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iVillage Member
Registered: 03-26-2003
Mon, 08-23-2010 - 12:51am

Oh, on this, Mike recently went to a new doctor who decided to change his diagnosis. He thought Mike was too autistic to be Aspergers. I was talking up the progress mike has made etc (because he was there and stressing out) so the doc was thinking, well he is too autistic to be AS but he has made all this progress so maybe PDD-NOS. He eventually ended up at autistic disorder for Mike. Mostly because I kind of balked at the PDD-NOS dx since I knew I would get that reaction like you said (it isn't really autism) where this guy was thinking of making that change because he felt mike was too severe for an AS dx.

I kept trying to tell the guy I didn't care as long as he had something on paper that got the insurance to pay, lol. Mike is mike is mike regardless. But I really didn't want to deal with the ambiguity of PDD.

On that as well, Cait was very langauge delayed but her DX was changed from PDD-NOS to aspergers around 7 when her language basically caught up. just depends on the doc.

I thinkk the education system has it right on this one. It is just autism and either a kid fits under that criteria or they don't but it really doesn't matter which brand of autism they have.

I

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iVillage Member
Registered: 02-28-2008
Mon, 08-23-2010 - 1:12pm

I agree with Renee. The current hodge-podge of autism classifications is too confusing and misleading. There is a reason why people are moving to calling it the autism spectrum and I think the move to change the DSM is a good one.

I've listed Miles as PDD-NOS because that's what the neuropsychologist said, but really he's just a very high functioning, slightly autistic kid. In many ways, he's higher functioning than Graham is as he has some social awareness and skill even if it's lower than his peers. Graham is quite oblivious in comparison. Miles also doesn't share the same intense occupation with topics that Graham has.

BTW, Tony Attwood, a noted expert in AS, disagrees with the 'no language delay' component of the DSM AS dx and thinks that many more kids should be dx as AS than PDD-NOS. The experts don't even agree.

The actual label matters less than whether or not your kids needs are being met.

So call Tom what ever label your comfortable with and let the experts argue among themselves. Just my own opinion.

Andrea, mom to

Graham
Miles
Anson

Andrea, mom to

Graham
Miles
Anson