PDD-NOS: A “Garbage Can” Diagnosis?

PDD-NOS may be the least understood disorder on the autism spectrum

Although Americans are becoming more educated about autism, ASD (autism spectrum disorder) remains difficult to define (let alone diagnose) with pinpoint accuracy. And within the spectrum is an even more confounding disorder: PDD-NOS. The initialism is as frustratingly nebulous as the condition for which it stands: Pervasive Developmental Disorder-Not Otherwise Specified. We asked psychiatric nurse and founder of ACCESS Nursing Services Louise Weadock, who also founded Access Sensory Kids, an integrated-therapies program for children located in Chappaqua, to help us unravel the puzzle that is PDD-NOS.

Q: How does PDD-NOS differ from other spectrum disorders?
A: PDD-NOS became the diagnosis applied to children or adults who are on the autism spectrum but do not fully meet the criteria for another ASD, such as autistic disorder (“classic” autism) or Asperger syndrome. A developmental disorder is generally caused by an interruption or delay in neuro-cognitive growth and development. This causes wide changes in how one receives, codes, stores, and retrieves information and stimuli processed through their neural pathways. PDD-NOS can occur in conjunction with a wide spectrum of intellectual ability. Its defining features are significant challenges in social and language development.

Q: To many, PDD-NOS seems like a “catchall” term for what doctors can’t define.
A: Professionals refer to PDD-NOS as “sub-threshold autism.” It’s a bucket diagnosis they assign to one who has some but not all characteristics of autism or who has relatively mild symptoms—for instance, significant symptoms in one core area, such as social deficits, but mild or no symptoms in another core area, such as restricted, repetitive behaviors. Yes, it is the “garbage can” for those behaviors we know are neuro-cognitively based but do not meet criteria for a “classic” autism diagnosis. —Carol Caffin

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For more from this interview and on PDD-NOS, visit us on the web at westchestermagazine.com.


Some Classic ASD symptoms
â—   Vacillating hypo-/hyper-sensory  sensitivities to sound, vision, taste, textures, smells, and spatial awareness
â—   Difficulty with verbal communication
â—   Difficulty with non-verbal communication, such as making eye contact and understanding gestures and facial expressions
â—   Difficulty with social interaction
â—   Unusual ways of playing with toys, such as lining them up instead of pretend play.  
â—   Difficulty adjusting to changes in routine or familiar surroundings
 â—  Repetitive body movements or patterns of behavior, such as hand-flapping, spinning, and head-banging

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