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Q: My child has been diagnosed with PDD-NOS. What is PDD-NOS? Is it the same thing as autism?

A: PDD-NOS stands for Pervasive Developmental Disorder – Not Otherwise Specified. Essentially, it is a diagnosis that means “on the autism spectrum, but not falling within any of the specific categories of autism.”

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Within the DSM IV, a manual that practitioners use to diagnose neurological disorders, there are five disorders that fall under the category of Pervasive Development Disorder (PDD): autism, Asperger syndrome, Rett syndrome, fragile X syndrome, and PDD-NOS. A child would be diagnosed with PDD-NOS if he has symptoms of Pervasive Developmental Disorders, but not enough of any of the four specific disorders to receive a diagnosis.

Thus, your child does have PDD, but he does not have autism, Asperger syndrome, Rett syndrome, or fragile X syndrome. As a result, he received the catch-all diagnosis of PDD-NOS.

Many of the disorders that fall into the category of PDD have overlapping symptoms. Below, I have explained some of the symptoms that are particular to each one of the four specified disorders in the DSM IV.

 

Autism:

  • Late talking (after the age of two), and other developmental delays by 30 months
  • Chooses to play alone, rather than interact with others
  • Repetitive movements such as rocking, spinning, or hand-flapping

 

Aspergers syndrome:

  • Above average verbal capabilities
  • Obsession with complex topics such as patterns or music
  • Scripted, robotic, or repetitive speech

 

Rett syndrome:

  • Half or more of children with Rett syndrom have seizures
  • Normal verbal development until around 12-18 months, then a subsequent loss in the ability to communicate
  • Slowed growth, especially apparent in head size at six months of age

 

Fragile X:

  • In males, decreased IQs; in females, variable IQs
  • Social anxiety when placed in situations in which they are forced to interact with others
  • Spoken language often characterized by stuttering and omitted sounds in a sentence

 

Right now, physicians do not agree on when exactly a child should be diagnosed with PDD-NOS, autism, or Asperger syndrome. Thus, it is possible for the same child to receive different diagnoses from different doctors even as he exhibits exactly the same symptoms.

Regardless of the diagnosis, research has shown that children with Pervasive Developmental Disorders have significantly better results when treated from an early age. In fact, studies show that children who began treatment at the age of two had fewer than half of the symptoms as compared to children who began treatment after the age of eight.

Treatments for PDD-NOS vary depending on the range and severity of the symptoms. However, some typical and effective treatments include:

  • Play therapy: Through play (a child’s natural mode of expression), children learn to cope with emotional issues. In this way, children can manipulate the world on a smaller scale, something that cannot be done on everyday basis.
  • Sensory integration therapy: Through a gradual introduction of adverse stimuli, children become used to situations that might have otherwise made them uncomfortable. (For example, some children with PDD might not tolerate the noise the scissors make during a haircut. A trained specialist would slowly integrate the scissors, the noise, and then the noise near the child’s head in order to make haircuts more bearable).
  • Social skills training: Coaching in non-verbal communication and everyday interactions can help children gain the essential skills to make friends and pay attention to teacher that do not come naturally because of PDD. This can greatly improve the child’s social experience for the rest of his life.

 

You did a great thing by taking your son to get a diagnosis because it is the first step towards getting treatment. With help, children with PDD-NOS can lead full (if complicated) lives.

 

Q: I keep hearing about non-verbal learning disability. What does this mean?

A: Children with non-verbal learning disability (NVLD) wrestle with issues similar to children with Aspergers Syndrome (AS), a syndrome on the autistic spectrum. In reality, those with AS and those with NVLD share many characteristics; however, NVLD is a much milder disorder.

Kids with NVLD are very verbal and often do not have academic problems until they get to the upper grades in school. When they are younger, the biggest sign of the disability is their struggle with social skills. So, how can you recognize a child with NVLD? Here are some attributes of those with NVLD:

 

Disadvantages:

  • Attention to detail, but misses the big picture. Children with NVLD are great at picking up the minor elements of a story or a conversation, but often lose the overall idea.
  • Great decoding skills with trouble comprehending reading. The actual words are not a problem for those with NVLD; however, understanding the content of the story can be problematic.
  • Difficulty with non-verbal communication. Body language, facial expression, and tone of voice will often be misinterpreted or ignored.
  • Poor abstract reasoning. Those with NVLD think very concretely and have trouble with ideas that are conceptual or intangible.
  • Poor social skills. Because of the inability to read non-verbal cues and to think abstractly, many children with NVLD struggle with making and keeping friends.
  • Fear of new situations. Children with NVLD fail to adapt quickly to new places or circumstances and therefore fear entering unfamiliar settings.

 

Advantages:

  • Great vocabulary and verbal expression. A huge asset of children with NVLD is verbal expression – they are wonderful at expressing ideas and manipulating language.
  • Excellent memory skills. Attention to detail, when coupled with an exceptional memory, yields children who are shockingly able to recall events.

 

There are several things that parents can do in order to help their children better adjust to living a life with NVLD. One of the most important things that a parent can do is provide consistency: in location, time and activity. Keep the home environment predictable and familiar. Therefore, if you always eat dinner at the kitchen table and do homework in the dining room, try not to vary from that routine. In addition, provide structure and routine throughout the day, marking time through different activities: benching negel vasser, brushing teeth, getting dressed, and eating breakfast in the same unsurprising order daily.

If you must vary the routine, prepare your child in advance for those changes through logical explanations. If prepared in advance, the transition will ultimately be a lot smoother.

In terms of schooling, the best way to help children with NVLD is assist your child in learning organizational and time management skills. Help him come up with checklists and to-do lists in order to make sense of his activities and allow him to easily adapt from situation to situation.

Lastly, when dealing with social skills, consider explicitly teaching him about non-verbal communication. While most children instinctively pick up non-verbal cues, children with NVLD need to be coached in these skills. Consider getting him social skills training in order to help him make friends and interact with his peers. If you choose to work with your child on social skills – remember to nurture his unique individuality while still correcting the deficits in his communication skills.

While NVLD is a learning disability that affects children both academically and socially, its manifestations are relatively mild. With a little bit of help, children with NVLD can live happy, full, and social lives.

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An acclaimed educator and social skills ​specialist​, Mrs. Rifka Schonfeld has served the Jewish community for close to thirty years. She founded and directs the widely acclaimed educational program, SOS, servicing all grade levels in secular as well as Hebrew studies. A kriah and reading specialist, she has given dynamic workshops and has set up reading labs in many schools. In addition, she offers evaluations G.E.D. preparation, social skills training and shidduch coaching, focusing on building self-esteem and self-awareness. She can be reached at 718-382-5437 or at rifkaschonfeld@gmail.com.