Hi all- I know that the 3 feastures of PDD-NOS are in:
Can someone provide me some examples of "Repetitive Stereotyped Behaviors" other than lining up toys, verbal stimming on particular workds or phrases, etc?
Ryan seemed to have a lot more of these behaviors a year ago and i think much of it is starting to dissapate. However, Im sure he is still presenting some behaviors that would fall into this category, but It hard to know whats typical and whats not.
For example, often when I read him a book, he wants me to read it to him more than once in a row. Would this be considered "repetitive, stereotyped"? I could see typical kids doing this too- he doesnt tantrum when I say "no more", he transitions to the next activity fairly well.
What are some other examples?
My son hand flaps. He will run across the room, stand on his toes, cross his eyes and flap his hands. Then he will do it again and again and sometimes we have to break the cycle or sometimes he will stop on his own. Here is a video I posted earlier of him singing a song and in it you can see him hand flapping and standing on his toes. Occassionally if you look closely you can see him cross his eyes. It is more subtle in the video because he is singing a song, but you can still see him doing it. This is repetitive behavior as I know it.
Sorry, here is the link.
http://s197.photobucket.com/albums/aa22/rubymarv/?action=vie w¤t=MPEG0035-2.flv
So this is what I dont quite understand: If a child has delays in communication and socialization, but not the repetitive behaviors category- why are they classified as pdd-nos or autisitic? The answer may be obvious, but am i missing something? Seems as though his "repetitive" behaviors Ryan has are pretty typical and ones i see all the time with typical kids. I dont think he meets the criteria in that area.
A child without repetive behaviours or perserverative interests would not be dx'd with autisitc disorder. But could be dx'd with PDD-NOS.
PDD-Nos is dx'd by some of what it is and some of what it's not. Since PDD-nos doesn't meet the criterion it is not autistic disorder or asperger's, or rett's or CDD. But it is one of the PDD's.
There is also very little study about what PDD-nos is eventhough it is dx'd 2x's as often as autistic disorder. Some researcher's believe SOME kids who get caught in the pdd-nos pool meet the criteria for Pathological Demand Avoidance Syndrome or Multiple Complex Developmental Disorder. Additions they would like to see added to the PDD list.
PDD-NOS is applicable if:
1. If the child has a less severe form of behaviour decribed in the criterion.
2. If no criteria is met for atypical interests, activities (Part C Table 1) but there are concerns with social (part A) and communication (part B). Some clinicians dx on as little as 2 criterions one from part A and one part B. Unfortunately, other dev. language disorders also would meet 2 criterion that are not PDD.
3. If the child is very young it can be used provisionally if they're unclear of symptoms.
If you have a child that is borderline or mild I would suggest an evaluation by someone who has ALOT of knowledge of ASD's. To get an accurate dx. Some clinicians will not recognize mild ASD and you don't want an ASD dx if it's in fact something else like a processing issue.
When my son was 2 - 3, and he was upset, he would go into the kitchen and open/shut a drawer or cabinet over and over again until he calmed down. He also had a thing about turning lights off and on, off and on.
My son grew out of those things by age 4. Now he doesn't demonstrate any stims/repetitve behavior.
My son would play a "game" exactly the same way each time. Actually, three years later, he will start some things of the same way as before. My son is six and he has new stims everyday. They don't last too long, but they are annoying!!I don't think wanting to re-read a book, watch the same movie more than once, etc. are considered atypical - normal kids (heck, normal adults) to that too. It's all in the degree, I guess.
For the girls, their repetetive and stereotypical behaviors were obsessions and preoccupations with movie characters, specifically DUMBO and MONSTER HOUSE. When they were assessed, the talked a lot about these characters, and drew pictures of them, etc. Their interest in these characters were abnormal in their 'intensity and focus'. That allowed the assessor to check the box for this section of the DSM, giving them 'full autism' rather than PDD-NOS (the other sections were more obviously fulfilled).
Their other symptom in this area was adherence to non-functional routine - i.e., things had to be done a certain way or they'd become upset.
Both of these symptoms have faded with age, but they are still there - just more subtle.
Other examples might be the common stims, some of which you mentioned, memorizing lots of data (train schedules, sports stats, etc), playing with parts of a toy rather than the toy as a whole, persistently (always spinning the wheels of the truck and never rolling the truck around).
Re-reading a story book is what all kids want, so don't worry about that.
Cole didn't show any stereotypical behaviors at all until he was about 3 1/2, and it was not really repetitive. If he was watching a funny video, he'd be standing up laguhing and kind of gallop twice in place while patting his thighs 2 or 3 times. Like, thigh-slapping funny?
About a year later, he might be sitting cross legged doing an activity, and if he got excited, he'd ball his hands into loose fists and lightly pound the tops of his legs a couple times. He'd tuck his chin down toward his chest for a second while he did this - it lasted just a couple seconds.
Now at 6, he will pick up a small object, and pat it between his fingertips while they are held up close to his chin. He will do this, and sometimes walk around saying - in a guttural tone -eeee-eeee-eee. Until I filled out some autism questionaires, I had no idea that this eee-eee-eeee thing was universal!
Hope that gives you a picture.
We do not see any of these to speak of, never have, really, and if you guys are not "counting" repeating one video for hours ... that makes it even LESS so. The Kg reported that T played with "parts of puzzles," excessively.
So ... maybe that is SITUATIONAL repetetive, stereotypic behavior?
Thanks for the replies so far.
So this is what I dont quite understand: If a child has delays in communication and socialization, but not the repetitive behaviors category- why are they classified as pdd-nos or autisitic? The answer may be obvious, but am i missing something? Seems as though his "repetitive" behaviors Ryan has are pretty typical and ones i see all the time with typical kids. I dont think he meets the criteria in that area.
There are, however, other issues that Ryan has other than speech and interest in peers (such as joint attention, some sensory issues). How does that play into all of this and his diagnosis of pdd-nos?
PDD-NOS means Not Otherwise Specified ... as in, not ALL symptoms that are needed to fit the autism diagnosis are present, but enough to still be grouped in that diagnostic category.
That is what I am thinking, for T. Except, she has many INFREQUENT and low-key symptoms ...
My son got a diagnosis of atypical autism (aka pdd-nos) because there wasn't much in the category of repetitive behaviors. He actually had more than I realized, but no one asked me the right questions.
The DSM-IV criteria under this category isn't just about repetitiveness, but also about the restricted and stereotyped behaviors. Quote:
Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:
<unquote>
The childbrain questionnaire calls this category "Abnormal symbolic and imaginative play" and you might want to look at the questions they ask to see if you can uncover any more of your son's behaviors that fall in this category.
http://www.childbrain.com/pddassess.html
Good luck with everything.
Here are some examples of repetetive, stereotyped behavior as exhibited by my son, who has a straight diagnosis of autism:
--example: would carry a bag of halloween masks around all day for several weeks, regularly taking out a mask, examining it, and ask his mother a specific question regarding the mask. He would ask the same question over and over, many times throughout the day and eagerly await the same answer. Temple Grandin recalls behaving in this way as a child.
--in general: insistent upon specific ways of doing things or going somewhere. If we tried to take a different route to school, for instance, it would result in his having to take that day off from school altogether due to an inability for him to function socially for the remainder of the day.
--he often repeats a complex whole body movement, regularly. For a long time now, he pretends to wind up and deliver a baseball pitch when socializing or standing with people. He got in trouble for this once, as a teacher's aide thought that he was attempting to punch her (she didn't realize what he was doing and it frightened her a bit).
WOW I still have a lot to learn, I just thought my son having to go the same way on our highway we are on a lot was him being rigid? My son also claps three times and does a circle, on our landing on the stairs before we go down them every time is this repetetive behavior? or saying cheers before he drinks something out of a glass? Is it like OCD behavior? And shaking our hands three times and three hug, three kisses before he gets out of car for school? I'm a little stupid when it comes to this kind of stuff.The PDD NOS diagnosis is hard to wrap your head around, I agree.
Its like there are these 4 giant barrels of PDD paint you're supposed to chuck your diagnosis into, and PDD NOS is the drop-cloth they have laying out underneath those buckets. You know you need to toss the diagnosis into this particular area, but it splatters quite differently for everyone.
The title isn't of any importance, but when you are just getting started on a game plan for therapy, inclusion or reduced numbers classes, etc, its just one more confounding thing one needs to work through.
Sarah hummed..but no outward signs of repetitive behaviors we could see..she got diagnosed as autistic by developmental pediatrician..we noticed more behaviors with obsessions and rigidness this last year..she is six but not too bad...she likes something for a week or so and talks, draws, googles, dreams..ect.. about it and then the next week it is something else..she is getting into "that is not how your supposed to do that!" phrase at least 3x a day:P I never saw at 3 years anything amiss except she was so quiet and aloof.