PDD-NOS stands for Pervasive Developmental
Disorder-Not Otherwise Specified. PDD-NOS was one of several previously
separate subtypes of autism that were folded into the single diagnosis of
autism spectrum disorder (ASD) with the publication of the DSM-5 diagnostic
manual in 2013.
In the past, psychologists and psychiatrists often
used the term “pervasive developmental disorders” and “autism spectrum
disorders” (ASD) interchangeably. As such, 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 (sometimes called “classic”
autism) or Asperger syndrome. Like all forms of autism, PDD-NOS can occur in
conjunction with a wide spectrum of intellectual ability. Its defining features
are significant challenges in social and language development.
Some developmental health professionals refer to
PDD-NOS as “subthreshold autism." In other words, it’s the diagnosis they
use for someone who has some but not all characteristics of autism or who has
relatively mild symptoms. For instance, a person may have significant autism
symptoms in one core area such as social deficits, but mild or no symptoms in
another core area such as restricted, repetitive behaviors. As a diagnosis,
PDD-NOS remains relatively new, dating back only 15 years or so. As a result,
some physicians and educators may not be familiar with the term or may use it
incorrectly.
The current Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV) spells out the criteria for a diagnosis of PDD-NOS.
Unfortunately, this description consists of a single paragraph, which mainly
asserts what it is not:
"This category should be used when there is
severe and pervasive impairment in the development of reciprocal social
interaction associated with impairment in either verbal or nonverbal
communication skills or with the presence of stereotyped behavior, interests,
and activities, but the criteria are not met for a specific Pervasive
Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or
Avoidant Personality Disorder. For example, this category includes “atypical
autism” – presentations that do not meet the criteria for Autistic Disorder
because of late age at onset, atypical symptomatology, or subthreshold
symptomatology, or all of these."
Studies are suggesting that persons with PDD-NOS can be placed in one of three very different subgroups:
A high-functioning group which is around 25 %
The symptoms largely overlap with that of Asperger syndrome, but who differ in terms of having a lag in language development and mild cognitive impairment.
A second group which is around 25%
The symptoms more closely resemble those of autistic disorder, but do not fully meet all its diagnostic signs and symptoms.
Third group which is around 50%
They meet all the diagnostic criteria for autistic disorder, but whose stereotypical and repetitive behaviours are noticeably mild.
Treatment for PDD-NOS
There are a variety of treatments available for ASD, which includes PDD-NOS.
First is Applied behavioral analysis (ABA). It is the gold-standard treatment approach for autism spectrum disorder. There are several different types of ABA. At its core, ABA is concerned with reinforcing positive behaviors while discouraging negative behaviors. It is also proven by research to be a very effective treatment for autism with almost 50% of young children receiving good quality intensive ABA will be able to catch up to their normal development.
Second is speech or language therapy. This type of therapy can help with deficits in their language or communication.
Next is Occupational or physical therapy. Occupational therapy may help people with autism develop communicating and interacting skills with other people; his or her interests, activities, and play skills at home and in school. These can also help with coordination issues and also with learning day-to-day tasks such as getting dressed and bathing.
Certain medications will also help. There are no medications to treat ASD directly. However, there are medications to help treat other conditions such as anxiety and depression that often occur along with ASD.
Other than that cognitive behavioral therapy. It is a talking therapy that can help people to manage their problems by changing the way they think and behave. It is recommended that CBT could be used for the treatment of those disorders in children on the autism spectrum, as this is in line with existing National Institute for Health and Care Excellence (NICE) guidance for coexisting mental health disorders such as depression even though there is insufficient evidence to determine that.
There are also multiple option of alternative or complementary therapies such as music therapy, massage therapy, and herbal medicine. However, these alternatives might lack of research that proves them to be effective in some ways. Some may even come with significant risk, so it is important to speak with a doctor before starting one.
