What is Pervasive Development Disorder- Not Otherwise Specified? What are the symptoms and treatments of PDD-NOS? And how can AC Cares assist a family in dealing with the symptoms of PDD-NOS?

Pervasive Development Disorder – Not Otherwise Specified (PDD-NOS) is defined as a group of disorders characterized by impairment in the development of social interaction, verbal and non-verbal communication, imaginative activity, and a limited number of interests and activities that tend to be repetitive. Autism Spectrum Disorder (ASD), Asperger’s Syndrome, Rett Syndrome, and Childhood Disintegrative Disorder must be ruled out before Pervasive Development Disorder- Not Otherwise Specified is considered. It is only diagnosed when a child has several of the characteristics of the aforementioned disorders but does not fully meet the criteria.

Common difficulties often (but not always) experienced by those with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS):

  • Poor understanding of the conventions of social interaction.
  • Immature play skills/interests.
  • Resistant to change and very rigid in routine.
  • Poor non-verbal communication.
  • Poor understanding of instructions, questions, and/or jokes.
  • Poor fine motor skills
  • Poor gross motor skills..
  • Difficulties accessing the school curriculum.
  • Poor conversational skills and may talk too much or too little.
  • Poor ‘listening’ skills, despite intact hearing.
  • Fails to notice that other people are not interested in what they are saying.
  • Finds it difficult to understand the non-verbal language/cues of others (such as facial expressions, gestures, and/or body movements) or the rules of social behavior.

PDD-NOS is not included in the DSM-5. Thus, it is unlikely to be diagnosed by a physician. It now falls under the ASD umbrella and receives a severity rating. If your child was diagnosed with PPD-NOS prior to 2013, a reevaluation and updated diagnosis and treatment recommendations may be beneficial.

Routine developmental screenings are an essential health measure. Physicians should regularly evaluate a child’s continual development. The American Academy of Pediatrics recommends all children be screened for ASD between 18 and 24 months of age. Abnormalities uncovered during screening should prompt further investigation. Screenings may be performed by your pediatrician or they may send you to a developmental pediatrician, psychologist, or neurologist. Despite regular testing for ASD during infancy and early childhood, symptoms may not become evident until later in adolescence. If symptoms appear after a negative diagnosis, consider getting reevaluated.

While there are no universal symptoms of PDD-NOS (now ASD), generally children with PDD-NOS experience challenges in one or more of the following categories: social and emotional, language and communication, sensory processing, adaptation to the environment, or cognitive. Social and emotional challenges may include poor social skills, difficulties in interacting meaningfully, reluctance to give eye contact, and an apparent lack of desire to share activities with others. Language and communication challenges may include difficulty understanding or using appropriate forms of communication including verbal language, body language, facial expression, tone of voice, and gestures. Sensory processing challenges may include difficulty processing sensory information, over-sensitivity to surroundings, or an inability to screen out irrelevant stimuli. Challenges with adaptation to environments include difficulty with interpreting and processing new information, adverse reactions to small changes to routine, and difficulty coping with change. Cognitive challenges include learning difficulties and poor memory and attention span.

What causes PDD-NOS?

The cause of PDD-NOS (now ASD) is still unknown. While we do not know all of the causes of ASD, we have learned that there are likely many causes for multiple types of ASD. There may be many combinations of environmental, biological, and genetic factors that make a child more likely to have an ASD. Children who have a sibling with ASD, individuals with fragile X syndrome or tuberous sclerosis, children who were born to mothers who took certain prescription drugs (like valproic acid and thalidomide), and children born to older parents are at greater risk for having ASD).

Treatments

There is no standard treatment for PDD-NOS (now ASD). Therapies are used to minimize symptoms and maximize abilities. An early and accurate diagnosis greatly improves rates of success. Patient-centric individualized approaches are the protocol. Depending on an individual’s needs this may include educational, behavioral, occupational therapy and/or speech therapies. A collaborative effort between the patient, health care team, and caretakers leads to the best results.

There are a variety of treatment options available for ASD, which includes PDD-NOS.

There is no medication approved to treat Autism Spectrum Disorder or PDD-NOS. However, certain psychiatric medications can help control secondary symptoms. Antipsychotics, such as Risperidone and Aripiprazole, are used to control irritability and aggression, while stimulants, such as methylphenidate, atomoxetine, and clonidine, are used to control hyperactivity, impulsivity, and inattention. Medical intervention for the treatment of epilepsy – which is common with PDD-NOS – can also be helpful.

In addition to psychiatric medication, there are a number of other treatment options available to those with ASD (including PDD-NOS). These modalities include behavioral therapy, family counseling, speech and language therapy, and educational therapy. Often a combination of these therapies needs to be honed before the right balance is reached.

Behavioral therapy is one intervention used for people with ASD (including PDD-NOS) This focuses on either increasing the ability to communicate effectively or reducing the behavioral problems. Speech and language therapy can be an important first step to improving communication skills. However, further social skills training, to help people with autism (including PDD-NOS) recognize and interpret the gestures and figures of speech other use to express emotion, is often necessary. For those with ASD (including PDD-NOS) to excel in all aspects of their daily life, an individual intensive educational program may be necessary for some patients.


Pediatric home care
is available through The ​​Care at Home Medicaid Waiver for Developmentally Disabled Children

What can parents do to help?

Children develop skills at their own pace but parents should remain cognizant of their child’s development and look out for delays. Parents should ask their child’s therapists about the best ways to support their development at home. Therapists will likely give recommendations to parents for particular games or activities to work on at home to speed up the process of achieving certain skills. Providing opportunities for suitable fine motor activities, giving your child toys to help improve grasping and gripping skills, encouraging children to be active participants in daily activities such as dressing, bathing, or brushing teeth, and informing oneself about the condition and possible solutions are great ways to play an active role in supporting a child with poor fine motor skills.

How can we help?

At AC Cares, we can assist the family in dealing with PPD-NOS in many ways. These would include:

Whether you are searching for a qualified doctor, treatment options, or a nutritionist, we have vetted, knowledgeable medical professionals to assist you on your journey.
Dealing with PPD-NOS can be overwhelming and confusing for families, and we have the latest information on everything from new treatment options to medical trials to help our families in need.
Meeting with others facing similar challenges can provide a lifeline to those who feel alone, and our support groups and moderators are there to walk with you on this journey.
Group seminars and workshops on topics ranging from getting the support needed for your child at school to safety measures in the home provide instruction to prepare you for your role as advocate and caregiver.