Simply put, ASD (autism spectrum disorder) covers 5 specific disorders:
- Autistic Disorder
- Asperger's
- Rett's
- Childhood Disintegrative Disorder (CDD)
- PDD-NOS
The criteria for Autistic Disorder, Asperger's, Rett's are laid out pretty well. If your child meets some of the critieria for autistic disorder, but not enough for a dx, they get put in the PDD-NOS bucket.
Note however that diagnosis is made purely on the presence or absence of symptoms. Severity of symptoms is not a consideration when making a dx. You can have a child dx'd as autistic disorder because they exhibit the core deficits in all three areas: communication, social and repetitive/self-stimulatory behavior, yet the deficits are rather mild and the child can seem NT to the casual observer. You can have another child with PDD-NOS because they only exhibit the core defecits in 2 of the 3 areas, but the deficits can be rather severe and obvious to the casual observer.
My personal opinion is don't get too hung up on the dx. Your child is on the spectrum. Your child is unique, with individual strenghts and weaknesses. In my mind, you don't treat a diagnosis. Therapy must be individualized to focus on your child's areas of greatest need. It's normal for dx's to fluxuate over time. Many kids start out as PDD-NOS because of speech and social, and it isn't until they are older and demonstrate the sterotypical insterests that they get an autistic disorder dx. Other kids start out as autistic disorder and then catch up in some areas and then get a PDD-NOS dx. Other kids start out as PDD-NOS, or nothing, and then get an Asperger's dx later around age 6.
I hope this helps more than confuses.
Here is a previous thread that I think you'll find helpful. It is about the PDD-NOS diagnosis and what it means. I especially like Tzoya's response.
http://www.autism-pdd.net/forum/forum_posts.asp?TID=16039&am p;am p;KW=tzoya
My Heart, your story sounds so much like ours!
However, T was not dx'd by the school, even until SIX!
It's a crazy thing and much hinges on the diagnostic philosophy of who you see. The more you read, the more you will find out that is what happened. But the anger at first ... whew! Hang in there, take the reading slow ... I feel like I have done a crash course since March or so. It can be exhausting.
Actually, severity CAN be taken into consideration when making a diagnosis. A child may have 7 of the symptoms (you only need 6) but let's say, only 4 of them are severe enough to impair daily functioning. That child would most likely get a PDD-NOS diagnosis because s/he doesn't have SIX criteria that meet the severity that impairs their daily functioning. That is why my ds got a PDD-NOS diagnosis last time. The first eval the dev ped said he only had 5 of the symptoms. The second time, he had 6 but two of them were not severe enough to warrant a diagnosis of either autism or Asperger's. One symptom had developed and another had diminished in severity.
Just wanted to clarify that... PDD-NOS is a lump-together diagnosis. Some people don't agree with it because they think the doctors are just not really taking the time to figure it out and just lump these kids all together in a PDD-NOS category. While that may be true for some, I think the diagnosis perfectly fits my son because he doesn't fall neatly into any of the other categories at all, but he clearly is on the spectrum. If we didn't have that diagnosis - well, we wouldn't be getting services!
My Heart - I would guess your post partly comes from wanting to say things correctly and look like you know what you're talking about? There's a lot of info to process - and almost an entirely new language with tons of acronyms/abbreviations! It will take time - you will figure it out.
What did the doctor who diagnosed your son say - did he say he was on the mild end of the spectrum? PDD-NOS (like all forms of autism) can range from mild to severe. What really matters though is getting him services ASAP!
I'm glad you found us - welcome! I think you will find tons of good information and support here. Keep coming back - we look forward to hearing from you!
Thanks again to all! I can't tell you how happy I am to have found this forum because I have so many questions and concerns that I find myself coming stressed and overwhelemed! You all make it so much easier.
Snoopywoman you are exactly right about why I wanted to clear up things in my own mind. When my family and friends ask questions I just want to be able to explain my son's disablility correctly. To answer your question my son's dx came about in a round about way. When he was 18 months old I first had him evaluated through EI only because of a speech delay, he has no other autistic tendencies at this point. He had good eye contact, responded to his name, was interactive with family and had no stims. Although I knew it wasn't typical to only have a few words at 18 months I really thought he was just speech delayed. I even heard people say if they develop their motor skills early on they are delayed with speech. Also people always say "boys talk later" so autism wasn't even on my mind at this point. I told myself oh he'll talk by 2. So he got evaluated by EI at 18 months and no mention of autism just that he was speech delayed. He received speech 2x 30 until he was 2 1/2. Foolishly I stopped his speech at 2 1/2 and refused and eval through CPSE (how niave I was). I still just thought he was a "late-talker". But that summer things changed. He started his stims and eye contact got worse. So I opted to have CPSE evaluate him against my family's advice. My family said I was over protective and a hovering mother and that there was nothing wrong with him just that he was a late-talker. That is probably why I refused the second eval. I will never again listen to anyone else when it comes to my child I knew in my heart something wasn't right and I should have listened to my gut (you live and learn I suppose). Anyway he got eval and still no mention of autism just speech delayed and fine-motor skill delayed. So he started speech again and they gave him a SEIT 5 hours a week and OT. At this point although no one came out and said it to me I just knew he was on the spectrum. My ped wouldn't even commit to a dx. My son still wasn't making the progress he should have so I called CPSE and told them I wanted a meeting to discuss my son's progress. At this time my case manager wanted to have my son eval again because he was getting conflicting reports from his therapists. He sent a psych to evaluate him at his school and this was the first person to say the words to me mild PDD-NOS. I knew but I was still devastated.
I wanted him to tell me what everyone else was telling me that I was crazy and it was all in my head. After that I decided to bring him to a neurologist to get a formal dx. After leaving the neurologist office I felt even more empty. I felt dissappointed and let down by them- I'm not sure why but I got my official dx and was able to get him into a center-based program.
Sorry for my ranting on and on! It just has been a very long year!! Thanks for your response I really appreciate it!
ASD, PDD, AS... Seems like alphabet soup, doesn't it? You've gotten good explanations from the others, so I just wanted to add that your child has his own unique blend of strengths and weaknesses that any particular label will never really capture.
This is a marathon, not a sprint, so read up on autism in manageable doses. The important thing is to observe your child in the new light of his autism diagnosis. What's his biggest issue right now? Focus on that -- read a little, ask questions here, and above all enjoy your child.
Welcome to the forum.