Diagnostic Features
The essential feature of Generalized Anxiety Disorder is excessive anxiety and worry (apprehensive expectation), occurring more days than not for a period of at least 6 months, about a number of events or activities (Criterion A). The individual finds it difficult to control the worry (Criterion B). The anxiety and worry are accompanied by at least three additional symptoms from a list that includes restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and disturbed sleep (only one additional symptom is required in children) (Criterion C). The focus of the anxiety and worry is not confined to features of another Axis I disorder such as having a Panic Attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder (Criterion D). Although individuals with Generalized Anxiety Disorder may not always identify the worries as "excessive," they report subjective distress due to constant worry, have difficulty controlling the worry, or experience related impairment in social, occupational, or other important areas of functioning (Criterion E). The disturbance is not due to the direct physiological effects of a substance (i.e., a drug of abuse, a medication, or toxin exposure) or a general medical condition and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder (Criterion F).
The intensity, duration, or frequency of the anxiety and worry is far out of proportion to the actual likelihood or impact of the feared event. The person finds it difficult to keep worrisome thoughts from interfering with attention to tasks at hand and has difficulty stopping the worry. Adults with Generalized Anxiety Disorder often worry about everyday, routine life circumstances such as possible job responsibilities, finances, the health of family members, misfortune to their children, or minor matters (such as household chores, car repairs, or being late for appointments). Children with Generalized Anxiety Disorder tend to worry excessively about their competence or the quality of their performance. During the course of the disorder, the focus of worry may shift from one concern to another.
Prevalence
In a community sample, the 1-year prevalence rate for Generalized Anxiety Disorder was approximately 3% and the lifetime prevalence rate was 5%. In anxiety disorder clinics, approximately 12% of the individuals present with Generalized Anxiety Disorder.
Course
Many individuals with Generalized Anxiety Disorder report that they have felt anxious and nervous all of their lives. Although over half of those presenting for treatment report onset in childhood or adolescence, onset occurring after age 20 years is not uncommon. The course is chronic but fluctuating and often worsens during times of stress.
Generalized Anxiety Disorder
Children with generalized anxiety disorder (or overanxious disorder of childhood) worry excessively about all manner of upcoming events and occurrences. They worry unduly about their academic performance or sporting activities, about being on time, or even about natural disasters such as earthquakes. The worry persists even when the child is not being judged and has always performed well in the past. Because of their anxiety, children may be overly conforming, perfectionist, or unsure of themselves. They tend to redo tasks if there are any imperfections. They tend to seek approval and need constant reassurance about their performance and their anxieties (DSM-IV). The 1-year prevalence rate for all generalized anxiety disorder sufferers of all ages is approximately 3 percent. The lifetime prevalence rate is about 5 percent (DSM-IV).
does your child fit here
if not get a second opinion
Generalized Anxiety Disorder
Children with generalized
anxiety disorder (or overanxious disorder of childhood) worry
excessively about all manner of upcoming events and occurrences. They
worry unduly about their academic performance or sporting activities,
about being on time, or even about natural disasters such as
earthquakes. The worry persists even when the child is not being judged
and has always performed well in the past. Because of their anxiety,
children may be overly conforming, perfectionist, or unsure of
themselves. They tend to redo tasks if there are any imperfections.
They tend to seek approval and need constant reassurance about their
performance
Thats a pretty great summary of Dale.
Does Dale have any other "symptoms"? I only ask because my son qualifies
for both a dx of an ASD, AND General Anxiety disorder.
I am not doubting your Dr. Just making sure your kiddo is getting the right
interventions.
Congrats, if he's not developmentally delayed. Anxiety is rough, but can be
controlled through medication and good cognitive-behavioral therapy. Kids
really take to this kind of therapy very well, as it helps them make sense of
their feelings and what to do about them. 
IF you are not feeling comfortable--either w/ the med rx or the diagnosis--
get a second opinion. I wouldn't take a 2nd step unless I was totally
onboard, especially if you doubt the dx at all. Did you discuss your
concerns w/ this doc? Perhaps if you send him a list of the symptoms you
see, therapist evals, observations, etc. that don't fit into GAD, any PDD red
flags you are concerned about, etc. & discuss w/ him. Maybe he can explain
them to you, and how it is GAD but can look like PDD. Then you'll have a
better understanding, feel 100% about things, perhaps start Zoloft & things
will go great for your child. OR, perhaps the doc will review everything else
& maybe himself realized it is PDD, w/ or w/o GAD. I would talk to the
diagnosing doc, then if I still didn't feel right, get a 2nd opinion. Keep us
posted.My son has also been dx with anxiety, but ASD was ruled out by many doctors. Thank you for sharing your son's dx. Can you tell me what made the doctor think it's NOT ASD?
IMHO GAD is easier to treat and manage than ASD. There are psychiatrists and psychologists that specialize in just treating anxiety so perhaps your son can get a very good doctor to help him through this.
All the best to you...It sounds like GAD can be a component or comorbid with ASD like SID is to ASD. For me, I would not accept GAD if my child had the following:
Long standing and historically significant language problems
Ongoing communication problems with pragmatic language
Poor peer relatedness with known peers
Prominent sensory issues
Coordination and gait issues
To me the stress of coping with the above symptoms would likely contribute to GAD. By only treating GAD it would not address the causal issues IF ASD was the cause.
Medication is not always the best option. Prescription drugs can cause physical side affects over the longterm which may outweigh its benefits. I am not a Doctor nor am I saying that you shouldnt give your son zoloft. All I am saying is that prescription drugs may not be the best option. Also consider that in the USA precriptions are given by Doctors as if it were candy. The things I would ask are...How Long is your son going to take them?? And also ask your Doctor what are the longterm side affects from taking zoloft...then maybe just monitor your son closely over the first few months and take it from there....also look for natural alternatives as well...good luck...
Adam's anxiety was dibilitating. In fact until they could control his anxiety, they didn't dx him ASD. Meds are great, but also get him in some good therapy. With meds and therapy Adam is doing soooo much better. Because of the therapy, t has taught him to control his anxiety, we have not had to raise his medication. He is on a very low dose. The SCHOOL determines the classification after they've conducted a multidisciplinary evaluation. This has nothing to do with your son's medical diagnosis. However, both the results of the school eval and the medical eval should be presented at the IEP meeting. In order to start the ball rolling, send a letter TODAY to the school and ask that your son be evaluated for possible special education services. From the date on that letter (say in the body of the letter that they should consider the letter your consent to evaluate) to the day that necessary services must be in place in school is 60 days. Of course, they might determine that your son does not need any services. In order for that to be less likely to happen, hone your advocacy skills by reading FROM EMOTIONS TO ADVOCACY. You can purchase the book at www.wrightslaw.com If you have questions and concerns about medicating your child, try to talk to the doctor again. Another option is the book "Straight talk about psychiatric medications for kids", which was recommended by autism experts on autism.about.com and given 5 out of 5 stars by Amazon customers. Here's the amazon link, but your local library might have it:
http://www.amazon.com/Straight-about-Psychiatric-Medications -Revised/dp/159385031X/ref=sr_1_11/104-5219620-8195900?ie=UT F8&s=books&qid=1188305668&sr=8-11
Good luck with everything.
Anxiety goes along with ASD but ASD does not have to be present for anxiety to exist. Yes, GAD can certainly be co morbid with ASD. However, there need to be other issues besides anxiety for ASD to be dx'd. An anxiety disorder can qualify a child for school services under the classification of ED. Some schools may also give the classification of Other Health Impaired. The key is to get your son both the medical intervention he needs and any support he needs at school by getting him classified if he's not already classified. Once he's been getting these interventions for a while, if you see little improvement, you might want to seek out an autism specialist, or at least get a second opinion from another child psychiatrist. My husband and I talked last night. He will try out the meds to see if that helps him with his "freaking out". If we still see other "quirks" we will then bring him to the autism center at UMDNJ. His LCSW said if he gets a dx of ED he will get extra help at school. I am calling the dr today to find out if thats how he will classify it.
I disagree that doctors give meds out like candy. That has not been our experience with medication for our son at all (over the past 8 years). However, our psychiatrist never medicates a child under 60 lbs. unless it's a really, critical emergency (seizures, for example) and only after good behavior plans have been tried and have failed. We all must remember that "natural" is not synonymous with "safe," either. Arsenic is totally natural!
I also would like to say that, as a parent who has medicated her child for issues that could not have been addressed in any other way and whose child would never be able to live in the outside world if he did not have medication, I really and truly resent the attitude that many on this board have expressed that giving children medication is somehow an easy out or something that only parents who have failed do. Of course, I'll defend to the death those people's right to have this attitude and to express it here, but I have to say that medicating my son HELPS him in ways that no other treatment ever could. Our decision was made based on the recommendations of an autism expert who is VERY conservative in his prescriptions and who ALWAYS recommends using psychological interventions FIRST. He also uses half the recommended lowest dose to start and raises the dose VERY slowly. It took 6 months to get our son to a dose of Risperdal high enough to eliminate his tics (age 8, 80 lbs). So characterizing American doctors as handing out pills like candy is simply incorrect. I know lots of doctors and have not met a single one who approaches medicating kids this way. Have you actually MET a pediatric doctor who is willing to hand out pills like candy? This idea is one promolgated by the media to fill publications and the airwaves on slow days, IMHO. Please to not say that my medicating my son is giving him drugs like candy. It is not!
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