Autism/PDD/Aspergers

Studies show an early diagnosis and intervention are key to an appropriate and effective treatment plan for someone with an autism spectrum disorder, or ASD. Although there is no medical test to determine a diagnosis, according to the Autism Society of America, an accurate diagnosis must be based on observation of the individual's communication, behavior and developmental levels.*

Pervasive Development Disorder – Not Otherwise Specified, or PDD-NOS, or just PDD for short, Asperger’s Syndrome, or AS and autism are considered to be a part of a wide-range or spectrum, of psychological conditions.

While they do carry some overall similarities, many parents may be confused on the differences between, and symptoms of conditions of an autism spectrum disorder. While autism is at the core of ASDs, there are other defining characteristics that set each condition apart.

PDD

The onset of PDD is usually prior to three years of age and parents may observe symptoms in the child’s infancy stages which include socialization and communication issues. This also includes:

  • Difficulty using and understanding language
  • Repetitive movements such as hand flapping, foot tapping or toe-walking
  • Difficulty relating to people or events; a lack of eye contact or refrains from using gestures such as pointing to things
  • Difficulty dealing with changes in routine or familiar surroundings

Asperger's Syndrome

Asperger’s Syndrome begins in infancy or childhood and is characterized by significant difficulties in social interaction and restrictive and repetitive patterns (rather than a single symptom) of behavior and interests. Due to the seemingly lack of social interaction, older individuals with Asperger’s often appear to be, or are commonly considered socially awkward. Other symptoms include:

  • Impaired nonverbal behaviors such as a lack of facial expression, eye contact, posture and gesture
  • ‘Selective Mutism’ where the child may speak excessively to a few people and not at all to others.
  • Hyperlexia – this is where a person may have a superior vocabulary but has difficulty understanding sarcasm and figurative language, in which case individuals instead interpret everything literally (‘I’m so hungry I could eat a horse,’ ‘It’s raining cats and dogs,’ etc.)

Autism

Like its counterparts, autism begins in infancy and a child can be diagnosed as early as 18 months of age. Autism affects one’s social communication and interaction as well as presents restricted and repetitive activities and interests. Children with autism often have a delay in their language skills, will lack age-appropriate social skills and can also be extremely lethargic or overly active. Other early signs of autism include:

  • Failing to respond to his or her name, child appears deaf or makes little to no eye contact
  • Resisting change or transitions, and requires sameness
  • Refraining from using gestures (pointing) and facial expressions (playing peek-a-boo) to communicate
  • Scripting words or phrases from television or radio
  • Preferring to be alone
  • Demonstrates repetitive play behavior such as watching the tires spin on a toy car, rather than actually rolling the car
  • Showing little to no thematic play behaviors such as pretend play (using a banana as a phone)
  • Acting out obsessive compulsive behaviors
  • Failing to recognize dangerous or unsafe situations, such as running into the street
  • Food selectivity issues where he or she prefers dry, crunchy foods or has a very limited diet of only 5-10 food items
  • Expressing toileting concerns including a fear of having a bowel movement on the toilet, even after he or she is toilet trained
  • A dislike to be touched by others or a preference for deep pressure contact such as tight hugs
  • Often throwing tantrums
  • Displaying gross motor and fine motor deficits

The services provided at Behavioral Consulting vary depending on the need or the child. A child who displays characteristics of PDD-NOS or autism typically require a Verbal Behavior Program in which an initial assessment of language and communication skills is conducted and therapy is then provided a minimum of 10 hours per week in a 1 to 1 setting. The therapy is targeted around teaching functional skills (language, communication, social, and play skills), improving compliance, decreasing the frequency of problem behaviors, and reducing obsessive compulsive behaviors.

For a child with Asperger’s Syndrome, typically the child does not show signs of a language or communication deficit. Therefore, a Behavior Reduction Program is usually recommended. This involves conducting an interview with the parents to determine the needs of the family. Then, observations are conducted of the child and a behavior plan is developed. The goals for a child with AS include improved social/attending skills, reduced problem behavior, and increased flexibility with environmental changes.

*This is not a complete listing of signs and symptoms of an autism spectrum disorder, nor does it replace a formal diagnosis, rather it is meant as a helpful tool for parents who may have concerns regarding their child’s development and skill acquisition. If you feel your child is not advancing at the rate of his or her peers, please contact us to schedule an assessment or make an appointment with your developmental and behavioral pediatrician.