Differences in Diagnosis - what is the difference exactly?

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My five year old son is formally diagnosed with PDD-NOS.

We realized there was something wrong when he was having speech delays. Also, he wasn't attending well at "circle time" at the family drop in center.

He otherwise likes to play with other kids (somewhat) and never suddenly regressed.

He attends regular preschool and has a support person. When the support person is away due to illness, he can actually function okay at the preschool with just the regular supervision of the teachers.

He attends speech therapy.

He is verbal - he can state his needs and make comments about the environment. He has a sense of humour and can understand some simple jokes.

He has a resistance to toiletting and wears diapers. However, he verbally tells me when he needs a diaper change. He also verbally tells me "I don't want to use the toilet. I just like wearing diapers."

He is affectionate and likes hugs and kisses. He enjoys playing on the playground with other kids.

Sooooooooooo

What is the difference between autism and PDD-NOS. What is "mild autism" Can PDD-NOS be mild too?

Often when I read articles or even anecdotal things on WP, children diagnosed with PDD-NOS seem, how to say, less functioning and have more behavioral problems. Is there less and more severe PDD-NOS?

Thanks.

Hello CanadianRose,

PDD-NOS is a "catch all" diagnosis when an individual has developmental differences that are noticeable enough to receive a diagnosis, but the symptoms/presentation does not fit a more-standard category. Therefore, those diagnosed with PDD-NOS are all over the map in ability levels and how they are affected.

Your son's language delay might be more more in line with something called "specific language impairment," which is believed by some researchers to be related to autism spectrum disorders, but tends to impact language, working memory, organization, reading, writing, and sometimes math, with perhaps less impact on socialization (although the communication difficulties can still cause socialization problems).

I have no diagnosis, but had the difficulties you mention your son having. Happy to say that I "grew out of" a toilet training delay and have worked hard to improve my communication skills.

Z

My son was diagnosed with PDD-NOS ten years ago (he is now 14). My impression was that a child is diagnosed with PDD-NOS when they have some of the characteristics, but not all, of the spectrum of symptoms of autism. Your child as you describe him sounds much like my child, and yet your child sounds less-severely challenged than mine in some ways, and more severely in others (just in the toileting area). Since you have an early diagnosis, your child will have a pretty good shot of improving as he ages.

I've researched and read so much over the years, and it would seem that mild autism/high-functioning autism/pdd-nos/asperger's can all be interchangeable at times. Sometimes people associate asperger's to children who have no speech delay, but have repetitive behaviors, lack of eye contact, fixated interests, etc. My son didn't really have a speech delay as much as he was acquiring language fairly well, and then at age 3 he stopped acquiring so much.

He had help (an aide) in the first three years of elementary school, and then aide's were slowly phased out in four and fifth grade. He has had no aides in middle school, and for the last two years, no specialized classes at all. I found that speech therapists at school were our biggest allies, as they tended to know more about the autism spectrum than the other school administrators. We still have our challenges at school, but they are less due to his pdd-nos, and more due to inattentive add problems that we are just discovering now. There's always something!

There are levels of functionality that range from the obviously unable, to the seemingly 'nearly normal' disabled - but I have an objection to the term 'mild', because, although many use it when first diagnosed, or to describe their child whom they don't want to see as imperfect, having lived with it for many many years while being told I was just like everybody else and (almost) believing it - the long term psychological, emotional and social effects of AS dysfunction are anything but mild.

I have actually wondered the same thing. If a child falls somewhere in between Asperger Syndrome and classic autism, would that fall under the PDD-NOS umbrella as well? My DS has some traits that make him seem NT (fabulous eye contact -- maybe TOO much eye contact, and he smiles a lot) but others that seem more severe than AS (significant speech delay, VERY rigid behaviors, often completely tunes us out, seems to have learning delays as well as speech and motor problems, and fills all his toys with spit bubbles). He only recently began talking and stopped lining up toys. He scored a 25 on the SCQ, but at another evaluation with a different person, they were impressed with his eye contact and pointing (new within the last few weeks) and suggested he may have global delays but not autism. I am SO confused and would really just like to get all his therapies and school accommodations squared away so that I can actually HELP HIM FUNCTION. Based on him being kind of all over the place, trait-wise, I am kind of going under the assumption he'll be classified as PDD-NOS. I do what people have described as "floor time," but I'm sure I am probably not doing it right and just hope I don't make it harder for him when he DOES get therapy.

My understanding is that pdd-nos is not given to kids who fall between one part of the spectrum and another (ie, Aspergers and HFA), but rather is given (as another poster mentioned) when there is clearly a significant developmental issue, but the symptoms do not present in a manner that clearly fits an Autism (or other) diagnosis. So for example, you may have a child with significant speech delays, low muscle tone, sensory processing problems, etc but if that child does not present with Aspergers symptoms (normal to high IQ, inability to read social cues, intense focus on limited subjects) or other more classic signs of autism (absense of eye contact, lack of social interaction, spinning wheels/opening doors/lining things up, etc) then they may receive the pdd-nos label.

has sufficient symptoms of the autism spectrum to warrant a diagnosis but may be excluded from the current criteria for autism or asperger syndrome. for example, a child may have classic asperger syndrome but be excluded from that diagnosis because they had a significant early language delay. a child may also be missing one characteristic from autism or asperger syndrome classifications (usually not in the social skills area) and would be deemed "subthreshold" in one diagnostic area. If the child met all other criteria except that one, PDD-NOS would also be appropriate.

If you look at the meaning of the initials...... PDD NOS (Pervasive Developmental Disorder Not Otherwise Specified). You can plainly see that it is a "sitting on the fence" type of thing. I have seen kids that are non verbal and with obvious serious sensory dysfunction that still have this diagnosis. Just my personal opinion but I think it should be done away with as a diagnosis. I also do not embrace the High functioning and low functioning stuff recently as I think some parents use it as bragging rights or something. I do acknowledge the difference between typical autism (the kind you are born with) and regressive autism (start to develop a typically and then loose language and engagement). I also agree that there are some differences between "autism" and Asperger's but in a way we are basically in the same boat. I may not have the same sensory issues or other "symptoms" as another person but I can relate because I have my own. My doctor, after reviewing my childhood through me and family says that If I were a child now I would probably be diagnosed as typical or kanner autism but I was passed over because I managed to progress (she can learn, go figure!).....and now Im considered Asperger's. Views change, diagnoses change, when I was a kid there was no middle ground...there was no Asperger's. I was just the stupid, weirdo, gross, ret*d. When Temple Grandin was a child they called it infantile schizophrenia and told her Mother that she didnt give her enough affection. When my son was little they didnt believe in childhood Bi Polar disorder. Just like me, we manage to progress...little by little.
NO ONE needs to agree with me (even though I tend to like it when they do )....just my views.