Pervasive Developmental Disorders

It can be difficult to know at first if a child has a pervasive developmental disorder (PDD). PDDs are a wide spectrum of social and communication disorders, including play with the same toy over and over. And maybe he doesn't look at people when they talk with him. At preschool, he's just not mixing in with the others.

If a child's behaviors seem to interfere with the establishment of relationships and communication with others, the child should be evaluated for a language disorder or for possible PDD.

PDDs refer to a broader group of neurobiological conditions, known as autistic spectrum disorders, that are characterized by delayed development of communication and social skills.

Perhaps the most noticeable feature of a PDD is a problem with communication, including using and understanding Asperger syndrome, which is a high-functioning form of autism in children who generally have high IQs, and childhood disintegrative disorder, in which a child may develop fairly normally until 18 to 36 months and then begin to regress, especially in speech and social interaction. Other PDDs include Rett syndrome and a disorder called PDD-not otherwise specified, or PDD-NOS. All of these conditions, to varying degrees, affect communication skills as well as a child's cognitive skills and behavior.

What Causes PDDs?

The causes of PDDs are unknown. Many scientists believe they stem from biological and neurological problems in the brain. They may also have a allergies, excessive amounts of yeast in the digestive tract, and exposure to environmental toxins.

What is known is that PDDs are not caused by what used to be known as "the cold mother" in psychological studies (earlier notions that these disorders developed because of the emotional detachment of a child's parents have been debunked).

Diagnosing PDDs

More recent research suggests that a PDD's onset can be recognized in a child before the age of 3 years. If a child has difficulty with social interaction and communication and exhibits repetitive behavior, often a doctor or specialist will refer to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV), which contains criteria for diagnosing PDDs.

Treating PDDs

Early intervention is important in treating a PDD. Although there's no cure, there is hope for children with these disorders. The key is to identify and start working with these kids early.

The main goal is to maximize communication with kids with an autistic spectrum disorder. Through behavior modification, parents and teachers work to lessen the child's atypical behaviors and to improve speech and communication.

Therapy for children with PDD should be individualized because each child's disorder is distinct and presents specific needs. Some kids with these disorders do well in small classes with lots of one-on-one attention. Others do well in standard classrooms with support.

And although the main treatments are educational and behavior modification interventions, medication may have a role in some cases. For some children, medication may help with problems of obsessive-compulsive behaviors, and mood swings.

The goal of treatment is to get children with PDDs to a point where they can be mainstreamed into a regular classroom. They may also require special programs and support services, including gastrointestinal problems, but some researchers noticed that a small group of children with autism and gastrointestinal symptoms seemed to show some improvement in communication and social interaction after secretin was given. Further studies have not shown significant improvement in autistic behaviors and secretin is not considered an effective treatment for autism.

The use of gluten-free and casein-free diets have been reported to show some positive results in treating some children with PDD, although more research has to be done. Other individualized education plan (IEP) for your child. You'll want to incorporate social skills and communication into the program, and most experts agree it should be highly structured. Maximized speech and language intervention is important, as is the use of behavior modification and rewards to try to stop problem behaviors and to encourage all types of communication.

Encourage your child with hugs and verbal praise, as well as rewards that stimulate social interaction (like a trip to the Rhonda Walter, MD
Date reviewed: May 2004