PDD or Bipolar | Autism PDD



This is the link for the online test.

Many of the members here have taken the PDD assessment at www.childbrain.com and we've found that, as long as our answers were scrupulously honest, the score matched what we and others have believed our child to be.  It's definitely worth taking.The 2 are SO not mutually exclusive. Some 30% of kids on the spectrum have
bipolar, according to "the bipolar child". And the authors think that there's


Hi all,

Like cutieheather24 I am new here, and I am also questioning my son's diagnosis. My son is just over 4 years old and he loves going to and is doing quite well at pre-school.

Just to provide some bakground on my son; he eats well, sleeps well, makes good eye contact, he is not afraid of loud noises, he doesn't have sentivity towards touching particular things, he doesn't throw tantrums, he is not hyperactive, he is not a fussy eater, he doesn't have stoamch problems, he is not in his own world, he responds to us when we call him etc. etc. 

Having regard to all this, when his teacher said we should take him to a paediatrician, we were surprised. But we went along with the idea to be on the safe side. We came home with a preliminary diagnosis of PDD. Our world was turned upside. His main areas of concern from the standpoint of the pre-school and the peadiatrician were  1). making nosies 2). delayed gross motor skills, (he can't catch a ball well) and 3). problems with making friends. Do these areas of concern justify a diagnosis of PDD? I also took the PDD questionnaire and he scored 44

He is currently being reviewed by a team of specialists as he presents to them as they put it "a very interesting case".

Having undergone the first of many tests to come, the result on the test was that cognitively, my son is performing at one year above the average for his age group, whereas concerning gross motor skills he is performing one year below the average for his age group.

I am still waiting for the team to complete all of the assessments and to come back with a more final diagnosis be it; PDD, high functioning autism or Asperger's Syndrome. The only thing so far that anyone is certain about is that my son is not a typical case of any one thing.

I guess at the end of the day, giving a name to whatever he has is not so vital, considering either way, he has been recommended to and has just started at an Intervention Centre.

Maybe my son has other sypmtoms I have overlooked as his parent, maybe I am playing down his symptoms to make him more "normal" and therefore make myself feel better. I really am not sure. Has anyone felt this way? Any advice?

Love from,




Our psych tells us that the difference between bipolar and PDD is the mood swings. Also---hypomanic/manic cycles.

My son was dx anxiety at 4y--SSRI's made him hypomanic.

5yo--bipolar, anxiety.

6yo--we added HFA/AS.

Because he doesn't "appear" like your normal AS kid---doesn't talk like that, poor in verbal skills, etc. She still thinks he's more bipolar then any ASD.

We are told over and over again that we won't know for sure until middle school age.

Here are the criteria for PDD:

  1. Asperger's syndrome
  2. Qualitative impairment in social interaction, as manifested by at least two of the following:
    1. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
    2. failure to develop peer relationships appropriate to developmental level
    3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
    4. lack of social or emotional reciprocity

  3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:
    1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
    2. apparently inflexible adherence to specific, nonfunctional routines or rituals
    3. stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)
    4. persistent preoccupation with parts of objects

  4. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
  5. There is no clinically significant delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
  6. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
  7. Criteria are not met for another specific pervasive developmental disorder or schizophrenia.


  1. PDD NOS
    This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills or when stereotyped behavior, interests, and activities are present but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. For example, this category includes "atypical autism" – presentations that do not meet the criteria for autistic disorder because of late age at onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

How does your child do with which criteria he has?

I have never known an adult with autism. I'm sure that they are able to manage their symptoms--so we don't really know whose ASD or not.

Bill Gates is Aspergers. Would you have ever known that? I sure wouldn't had.

As for the bipolar dx---what signs of bp does he have?

My son has lots of the aspergers criteria---but the Drs gave him the dx only to get him more services at school. He fits the criteria--but.....he isn't the "typical" aspergers kid. In fact---I'm starting to believe that my son only has:

Anxiety--ocd, general, repetitive behaviors. Which could be the cause of his limited interests.

Sensory issues---which could be the cause of the repetitive behaviors along with anxiety.

Expressive language disorder--which could be the cause of the social delay.

But when you have all these together--you have an ASD. I'm still in hopes that he will develop and grow out of his symptoms.

Some things are pretty severe--anxiety, ocd, limited interests. But then the social--he's quite engaged with others---when he wants to be. But then--he does much better with adults or older kids then anyone his age.

I've come to the conclusion that it really doesn't matter the dx--what matters is the therapy. As long as my son continues to get the services he needs---I could care less about the dx.


Hello, I'm sorta new too.  But my daughter was DX as being bipolar when she was 6 or 7.  I had a very hard time trying to find her a MD so when I received the DX I was ok with it, and my mother is bipolar so it seemed to make sense.  After a ton of meds and a lot of things that did not work I found a MD that DX her as PDD-NOS. The difference (I was told) is that when a person is bipolar and they become manic there is nothing that can trigger that.  In other words, when my daughter does not get her way or she is over stimulated she will tantrum/meltdown, and at some point she will calm down (sometimes it seems like a lifetime

My daughter is 12 and we have only had the PDD DX for a year and it has been bitter sweet.  It's a Blessing to know what we are dealing with, BUT there are so many things that I thought would work themselves out when she got older (such as hygene, social settings etc) if I had known she was PDD when she was youger I could have been working on these things, but I take each day for what it's worth and thank GOD that it's no worse.

I hope this has helped you!  Good luck and God Bless!

Hi Holly_WA,

Thanks for your reply, having regard to the criteria you provided, I think my son falls within PDD-NOS, that is atypical autism. I think this is a more accurate description of what is going on with him.

I think the problem for the professionals has been that he has so few symptoms, and even then, they are of such a mild degree. I think the whole issue may be whether they are prepared to say that he is even on the spectrum or not.

But even when I think of "atypical autism" and what this means, I wonder, if there is something wrong with that. I mean if the symptoms of a child are similar but not typical of autism, then shouldn't the diagnosis be that they simply don't have autism?

I guess I am struggling with the term "autism" because its such a label. And that seems to be the perogative of some health professionals, that is to give a name to things.

I still have my concerns about my son. Mostly my concerns are for the future. Will he be alright? Will he have a somewhat normal life? Will he be able to love and be loved?

It seems to me that children who are on the spectrum are much easier to pick out than adults who are on the spectrum. I have never met an adult with autism. Does this mean that when children with autism grow up their symptoms fade? Or does it mean that they are able to manage their symptoms much better in order to fit in?

I'd be interested to know your perspective or experiences with autistic adults.





We can't choose what our kids were born with.  IF our kids are born with an autism spectrum disorder (autism, PDD-NOS or Asperger's Syndrome), shying away from fully accepting it will only HARM our children. The sooner we accept the truth of their needs (we don't have to have an official diagnosis to know what their NEEDS are), the sooner they can get the help necessary to perhaps even CHANGE their brain pathways. The longer it takes for us to accept what they have, the worse it will be for them.  I KNOW it's hard to get a firm diagnosis, but don't make it harder by denying the diagnosis when it comes.  All three of these dx's are variations on a theme. Within each, there are kids who are higher functioning and ones who are lower functioning and it's hard to say until a child is much older what the real deal is in terms of functioning.  Young kids are all over the lot in development and are VERY hard to test.  That's why I like the system at www.childbrain.com because it doesn't really give a dx, just a DEGREE of Pervasive Developmental Disorder ( the MEDICAL category all these dx's fall under).  To me, knowing the degree of disability is more important than knowing the EXACT dx. heather where did you take the online test for pdd? my son was diagnosed already but  i would like to take it. i would appreciate the link. thanks! my msn messenger is mosesjr_mommy@msn.com or aol is mdjr511 in case you are anyone with a pdd nos child wants to talk . have agreat day!

Our son's psychiatrist, who is a reknown expert in autism, tells me he sees A LOT of kids who have been misdiagnosed as bipolar.  He believes, that although pedicatric bipolar disorders exists, it is WAY overdiagnosed.  ADHD is  SYMPTOM that is part of many kids with and autism spectrum disorder. As is OCD and anxiety.  In ASD kids, these are not truly separate disorders but a part of the ASD. (For example, the OCD symptoms in ASD kids is something they enjoy. True OCD victims HATE performing their obsessions.)

My BEST advice to you would be to go to a psychiatrist, neurologist, developmental pediatrician or neuropsychologist who SPECIALIZES in autism for a diagnosis.  Bipolar disorder often runs in the families of kids with ASD.  But that doesn't mean that ASD is the same as bipolar.  HOwever, they are both neurobiological disorders.  If you don't know what doctor to take your child to, call your local chapter of the Autism Society of AMerica and maybe they will be able to help you.  Or even post a request about your area here.

To me, this kid sounds typical PDD. Get him into early intervention for autism, and, if you can, get the diagnosis as it will open the door to services at school. You'll probably need to see a NeuroPsych. So many won't say the "a" word. It's very frustrating. Lots of kids here are diagnosed with bipolar or ADHD first when the PDD is staring the professional in the face. Tzyoya, where are you?

I am kind of new to the board too and am going through the same thing! My BN  has dx of pdd-nos and sensory related issues. Is extremely impulsive which could be adhd  but not sure. I have bipolar so still watching BN because does have my emotional sensitivity. I was picky eater like BN but was never as overactive. Took BN to autism specialist. Very helpful! Your son sounds very similar to my child. Strongly recommend speech therapy, OT and whatever services you can get. The sooner the better. Hope this helps.

"The difference (I was told) is that when a person is bipolar and they become manic there is nothing that can trigger that.  In other words, when my daughter does not get her way or she is over stimulated she will tantrum/meltdown, and at some point she will calm down (sometimes it seems like a lifetime

You are talking about 2 different things here. A tantrum/meltdown is not a manic episode. In children--its irritabilty or true mania/hypomania. I don't think you would need to "calm" a manic person. When my son was hypomanic/manic---he was bouncing off the walls, not sleeping, talking fast, etc. There was no need to "calm" him. I just tried to keep him safe.

A meltdown/tantrum isn't even the words to describe a "rage". I consider the raging the part of bipolar that is the "depression" part. In children--the symptoms are different then depression in adults. It is shown as irritability, defiance, anger, etc.

Children also have "mixed" states. Those are not fun!! It is a mix of the depression and mania. So....you have this kid whose bouncing off the walls, jumping from the light fixtures, climbing on top of roofs and cars, not sleeping, etc-----and irritable, defiant, angry, etc----all at the same time!!!

You are describing your childs meltdowns as "sensory" or profoked. That is pretty much normal. For example--my son at 3-4yo would scream--in anger for 6 hours on/off---for no reason. I would just call his name and it would throw him into a rage. (A rage-----destruction of property, breaking things, injury to themself or others--they also appear to "look" possessed). My son did this for 6 hours!!! I couldn't even call him to lunch without him flipping out. It wasn't a constant 6 hours---just every 10 min or so he would have a 10 min rage. Thank goodness those days are over. Now he's just up to 1 hour raging with 30 min of restraining.

As for mania--they don't get out of the manic episode until its done. Just like they don't get out of the depression (or irritability) until its over.

my son was dx with pdd nos , but when i really heard what that was a was shocked. psychologist said my son is autistic but he doesnt have the classic autism. my son has a milder autism because he doesnt have the major symptoms of an autistic child. which when i heard autistic i said but he is not in hs own world, he likes ppl etc.... which them he explained thats why my son is not diagnosed with autism . thats why they use pdd -nos  . i thought my son had adhd but in the last few months i have read a lot and spoken to a few professionals and i found out he doesnt have adhd at all.


my son symptoms are:

delay speech ,his IQ was 69% accordng to evaluation for CPSE (sp. ed school)  

temper tantrums

anxiety (bites nails)

he lines up toys

obsessed with trains, cars ,trucks

spin wheels

repeat last words of what you ask him or tell him. (echolalia)

change of settings makes him cry ,scream ,tantrums

covers his face from ppl sometimes

he is aware of what is happening around him and what you say.


well these are the most imp.ones that i can remember. he was very hyper and couldnt sit still but now he does . he eats more calm than before. he doenst thing at less speed. his appetite is poor now but doc. says its normal. he doesnt line up everything anymore. he would do this  everyday day and night.

he was accepted in school he does from 8:45 to 2:15pm. no tantrums at school , some whining in the mornings when he gets there and is taken away by teacher but not so frequent , he is sleeping better. tantrums i still get and anxiety is realy bad at doctors and when places are crowded with tonz of ppl.

still gave problems wshing his teeth. somedays he takes a bath fine,others he screams during whole bath . he is very stubborn so it doesnt matter his fave toy is there he dont care.  his language has improved. everyday he says a new word or even sentence. he has only been in school 2 weeks. psychologist is very happy to hear he has changed cause there is a psychologist in hs school 3 times a week. i spoke toher when he started and she even has a daughter with pdd nos ,so she knows how scared  i was sending him to school for hours. now he takes the bus home!!! im so happy. if the tantrums would go away and he would talk more, that would be a big achievement for next year. but he does expresses himself a lot lately. he only got IE in spring for 9 weeks but since he hit 3 they had to stop services. he got them late because his ex - ped though he never had problems.


so if you as  mom think something is wrong ,get a second opinion please. get your child evaluate by 2 at least. my son just turned 3 in may and he is getting service already and you will see a difference. but you have to continue it at home.


i would like to hear about other parents with pdd nos kids, write your lil story like i did,so we can all read about your situation and compare. smooches!




Lisa -- Ritalin can be like a miracle for certain kids.  The GOOD thing about Ritalin is that you can take your child on an off, depending on the situation he's in.  It can help kids focus far better in school.  It's gotten a bad rap because, when the media has a down week, they hit on Ritalin. Notice that now that there is a raging war, we see little about the "negatives" of Ritalin.  You should actually be asking your son's doctor about the down side.  The UP side is that it REALLY helps with behaviors, impulsivity and lack of focuse. All these things can be VERY detrimental in school if they cannot be controlled. Which is what your doctor is saying.  The down side is that Ritalin can suppress appetite (that was its first use), some kids get cranky when the Ritalin wears off, but that lasts only about half an hour and it doesn't happen to all kids.  Ritalin can be addictive, but so can plenty of medication. YOU are in control of it, so that has no possibilty of happening. Heck, coffee is addictive because caffeine, ounce for ounce, is one of the most addictive drugs in th world.  To me, the positive effects of Ritalin FAR outweigh these negatives.  I think your doctor is giving you good advice.

Hi Diana,

Your precious child sounds quite similar to my little one who is four except that he doesn''t have tantrums when there is a new situtation, he quite welcomes this as he is overwhelmingly bored.

Having seen the paediatrician this morning, she has precribed a low dose  of Ritalin (methylphenidate hydrochloride)just to calm his hyperavtivity down a bit. I am hesitant to give him medication, but the doctor insisted that it would be a mistake to not medicate him, as he has a high IQ, and with the medicine, he would be calmer, learn more and reach his potential. Is this really true? Has anyone ever used Ritalin before? Does it have any adverse side effects? I really would be most interested to hear your replies.

Thanks heaps,






Thanks tzoya.

It took me ages to find where I put this question concerning Ritalin, in order to read the response. But yeah, I finally found it today, and its good to read your perspective on things.

I actually went to the Pharmacy and bought the Ritalin. Its currently sitting on top of the medicine cupboard in my home. I have't given it to him yet. I'm still really unsure what to do.

1. Im worried about him improving in some areas like overactivity and impulsivity etc., and at the same time it affecting other areas like his speech abilities decreasing, I have heard this can happen (although I am not certain if it was with Ritalin specifically)

2. I am worried about him being addicted to it, and moreso myself getting addicted to life being smoother and easier when he is on Ritalin. Maybe I'll reach a stage where I will never want him stop taking it for fear of things going back to the way the were. (i.e very difficult).

3. I am worried about long term side effects to his little body. He is only 4 years old.

4. I am delaying giving it to him, because he is currently at Kindergarten, and he only plays there mostly. I wanted to wait until he went to school and needed to concentrate because he was actually learning somthing important.

Any suggestions/advice?

Perhaps I should have a trial period?



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