Pervasive Developmental Disorder

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What is Pervasive Developmental Disorder

What was once thought to be a more rare condition is fast growing in diagnosis across the country. Specifically, pervasive development disorders are part and parcel of the autism spectrum, and are influencing the way we teach children and diagnose them sooner rather than later. Such disorders include Asperger’s, autism/autism pervasive developmental disorder, Rett’s disorder which commonly affects girls in the very early stages of development and is evident prior to birth, and pervasive developmental disorder not otherwise specified, or for the ongoing purpose of discussion, abbreviated to PDD-NOS, and child disintegrative disorder.

Pervasive Developmental Disorders are any type of developmental inhibiting disorders which disallow a child to grow and function normally like other children their own chronological age. It is on point here, that chronological is used, as every child develops differently at their own pace, but children with developmental disorders are significantly behind their peers of the same chronological age rather than emotional, mental, physical or intellectual age. Every one of the previously mentioned disorders will, usually by age two, but sooner if more severe, make itself known to the parents and pediatrician who care for the child. In all of these cases social and emotional development are behind, and the child or children diagnosed as such cannot make age appropriate social contact with their parents or even other children. The world around them is too much to handle and they are isolated islands unto themselves.

Rett’s Syndrome

Much more recent education about Autism and Asperger’s has led to a national and international position to study pervasive childhood developmental disorders. For example, Rett’s syndrome, which affects exclusively little girls, has recently been found through genetic study to have a basis in cell mutation, and therefore infant and toddler girls who have this disorder can now be diagnosed much sooner through genetic testing and receive much needed assistance and support faster than they would have without this discovery. Rett’s appears very autistic like in nature at the early onset in that child development seems fairly normal until the child reaches her first or second birthday and the physical, intellectual, verbal and mental deterioration begins. Rett’s is still in contention in the medical field however, with whether or not it can be included in the autism spectrum.

Autism and Asperger

Autism and Asperger’s is still being studied and some believe there is also a possibility of genetic abnormality that occurs in early development. However, fact findings have not yet proved this and the theories of what causes these two similar disorders has not been wheedled down enough to say for sure what causes them. Autism, autism spectrum disorders and types of autism are all important parts of autism education during autism awareness month, which is April of every year since the 1970′s when the first cases of autism were noted in published medical journals. Just think of it; if everyone in the entire world donated a dollar to the research for understanding autism symptoms, signs of autism, causes of autism and treatments for autism, all of the children affected by it could have a cure or a significant progression in their treatment of their disorder. Wouldn’t that be something?

Child Disintegrative Disorder

A more disturbing disorder than any above is child disintegrative disorder. A child develops normally, as is the case with all the other pervasive developmental disorders, but suddenly begins to regress and lose all the abilities they had learned. Some children may even be able to vocalize what is happening to them, which is incredibly frightening for them and their families. In these instances, it is often the child describing hallucinations or other mental issues that would not ordinarily be associated with a toddler or pre-schooler. There are some causes that connect with its onset but nothing specific is thought to cause it directly and completely. Like all pervasive developmental disorders, there is no cure and the only treatments available are therapeutic, although some medications might also be prescribed to handle the psychotic elements and seizures involved with this disorder.

Pervasive Developmental Disorder Not Otherwise Specified PDD-NOS

Noticeable delays in development without a diagnosis of the previous four disorders results in a diagnosis of PDD-NOS. This is really a “lump the rest in here” category as most psychiatrists will note the delays but test results will not be able to completely ascertain, genetically or otherwise, what is a solid diagnosis for these children. That’s not to say they don’t meet the criteria for a pervasive disorder or autism/Asperger’s, it’s just a means to verify there are problems but nothing’s completely conclusive.

The total sum of education we have on these disorders is relatively new and all need further extensive research. Research requires money and more time and more money. Awareness brings the money that will, hopefully, bring the answers.

Autism Spectrum Disorders

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What Is Autism

Autism Spectrum Disorders are fast becoming the most pervasive child development disability around. More common than Down’s Syndrome and Cerebral Palsy, autism spectrum disorders affect one in every four children in the United States. Out of those children, three out of four will be boys. Because the disorders have numerous conditions affecting child growth and development, no two children with autism are exactly alike and no two children with autism disorders have the same issues. It’s a complicated spectrum which requires numerous specialists and tests to properly diagnose and confirm the diagnosis. Most children with autism look completely normal from birth, and there is no prenatal test to check for the disorders, which only complicates the process as no pediatrician can look at a child and readily see that he or she will develop an autism disorder.

Types of Autism

Because it’s difficult to determine just where on the spectrum a child with autism falls, there are several sets of diagnostic criteria as well as four major categories of autism. The four major categories of autism are: Autism, Aspergers, Autism Spectrum Affective Disorder and Pervasive Developmental Disorder-Not Otherwise Specified or PDD-NOS. In all cases children start their development after birth at a reasonably normal rate. Some might be slightly slower than their peers but since a child’s developmental markers are met at a slightly different age for every child, this is not an immediate concern. It becomes a concern however when the child in question can’t smile, focus on objects, sit up or walk, or interact with parents by the time he is a year to a year and a half old. Routine well baby visits with a pediatrician will help document whether the child is developing normally or should be referred to a specialist. Since many of these issues can also be attributed to other developmental delay disorders, all the other disorders have to be ruled out before Autism is considered.

Autism Symptoms

Straight up, “run of the mill” Autism addresses delays in more than one important area of development and usually has to be present in two to three areas for an extended and well-documented period of time. Children with Autism of the “regular” variety have speech delays and communication issues, either in their receptive or expressive communication, or both. They may be nonverbal all together, or they may make noises like humming, screaming, whining, or something akin to wordless singing. Conversely they will also exhibit advanced academic skills beyond that of children of the same chronological age. Repetitive movements like rocking on stationary furniture, spinning nonstop, wringing or flapping of the hands are characteristic of a child with autism and are done as a means of self stimulation and sensory input. Delays in toilet training, walking, running, throwing a ball, etc. are also possible as the muscle groups haven’t found a way to work together that the child with autism both understands and is comfortable with. A child with autism may also be sensory defensive, i.e., sounds, tastes, textures, sights, and smells may overwhelm and hyper stimulate them or the opposite end is also true where the child can’t make things loud enough(even though their hearing is excellent) or soft enough, or hard enough, or the texture of their food needs to be coarser or the tub water needs to be slightly less than tepid before they’ll get in. This has a lot to do with the fact that children with autism lack effective sensory filters and can’t filter and process everything separately. They may also be extremely picky eaters or suffer from pica, an eating disorder where unusual substances like dirt, oil, metal or other potentially harmful things are consumed if not removed from their reach. Fixations similar to obsessive-compulsive disorder that last from a few weeks to a few years are not uncommon either.

Asperger In Children

The child with Asperger’s on the other hand, will appear to develop in a completely normal fashion, hitting all the right development marks and even learning to speak at the right time. Speech is the biggest component in diagnostics when it comes down to assessing whether a child has autism or Asperger’s. The easiest thing to remember about the two is that Asperger’s children speak when they’re supposed to, children with autism do not. Because children with Asperger’s are not diagnosed until later in life because their developmental milestones are all hit on time, it makes it significantly harder to provide corrective therapy for them. Usually a parent will notice that their child of eight or nine doesn’t get along with his peers or that they have very few, if any, friends. Unlike a child with autism who doesn’t make eye contact a child with Asperger’s will, but it is often unsustainable and lasts seconds to a minute or two. They have trouble with expressions of speech, metaphors, idioms, and similes, which higher functioning and verbal children with autism also encounter. Language has to be direct and free of these types of verbal expression in order for these children to be understood and to understand those addressing them. It can be very frustrating for friends and family to alter the way they think and talk in order to make themselves understood to children with Aspbergers and high-functioning autism, but habitually it gets easier.

Probably the most frightening thing for parents of children with Asperger’s and high-functioning autism is when their child or children develop aggressive behaviors that are either hurtful to the child himself or to others. Forty years ago, such behaviors landed them in an institution; now early intervention and therapy can really help. It is still a good idea, however, to keep potential weapons out of the reach of children who are expressing anger and frustration with acts of violence.

Autism Spectrum Affective Disorders are argued by professionals to not exist. They feel that the child has to fall into a more specific category and level of functioning. Most times this diagnosis is only used in conjunction with a primary diagnosis of Down’s Syndrome or other more prominent and serious developmental delay. Thus the children with this secondary or tertiary diagnosis exhibit autism like behaviors, such as high intelligence quotients, hyperlexia, or outstanding rote memory skills in conjunction with diagnoses that should involve mental retardation.

Finally, Pervasive Developmental Disorder-Not Otherwise Specified, or PDD-NOS abbreviated, is the diagnosis handed to children who obviously fall within the spectrum but not enough evidence exists to make a clear cut diagnosis between Asperger’s and autism itself. Oftentimes little girls, who typically are thought to not be able to develop autism as it has been seen as a “boys’ developmental delay disorder”, but still exhibit autistic tendencies like their brothers or male peers will be diagnosed as PDD-NOS. As the child grows and his or her development can be more readily documented and tested by professionals, this diagnosis is changed to something more specific or dropped all together if it seems the child was just delayed for other causes and has caught up to his or her peers. Children who are diagnosed with PDD-NOS have a lot of the earmarks for autism or Asperger’s; delayed physical development, delayed social development, delayed language or ability to adequately express themselves, self-abuse or abuse of others, and significant hyper development of academics.

So what can be done if you discover that your child has an autism spectrum disorder? Lots, if it’s diagnosed early and you have plenty of medical documentation to back it up. Even high-functioning children with autism can get Federal Social Security and Disability Income, if the evidence shows that they problems they face are severe enough to interfere with everyday activities. Also, every state is a little different, but long term care waivers for children with autistic disorders have to be applied for before the child turns seven, eight or nine. These waivers then allow for long term care to be planned for and planned ahead, and in-home intensive therapy sessions with specially trained therapists aid the family, as well as the child into coping, managing and growing into a fairly well-adjusted and potentially productive adult, depending on the severity of the disorder and the patience, persistence and training of the therapist.

Some states will also add funds to the Federal SSDI funds every month for families that struggle financially and/or have more than one child with special needs. This fiscal assistance, in turn, helps parents find suitable childcare if they work or respite when they need a break from the challenges of the day with their child. The money is also used to shelter, care for, clothe, feed, and supply the child with an autistic spectrum disorder anything else they would need during the year, including co-pays for medicine and doctors’ visits. This makes a big impact on how children with these needs can stay at home rather than being institutionalized like they were so many years ago.

Many children with autism are also mainlined into the public schools now. This means that, if they can understand, talk and learn they spend time more inside a standard classroom than they do in a special education room. This aids them in learning the social skills they need to function later on and they are more of intellectual sponges than even their peers. They quickly learn everything and absorb even more because they do not have the filters everyone else has. Obviously then this is both a burden and a gift for them, a two-edged sword that can be managed with a good teacher at the head of the room.

Technology also plays a part in how these children communicate. Because of iPads and Smart Boards, these children can take what was once a paper and velcro system of communicating and apply it through technology. It is obvious to anyone who’s observed them that technology, for whatever reason, makes sense to these kids. Theoretically, it is because technology doesn’t require them to interact with humans nor provide eye contact nor make sense of phrases like “it’s raining cats and dogs” that children with autism spectrum disorders find it so much easier to communicate through and iPad or Smart Board. It does unfortunately defeat the purpose of treating the autism’s social and communicative hindrances, unless the child is completely nonverbal.

What Really Causes Autism

Lastly, it must be said. No one knows what causes autistic disorders. There are several theories but no one has the proof yet. What they do have are brain scans of children and adults with autism that clearly show a difference in structure and size, so medical scientists are working off of that proof to find the cause. In short it is a neurological issue, in that there is brain damage so to speak. There are no medications to prevent it, no medications to treat it, and nothing to cure it. It is more prevalent now, today, because more children are being diagnosed sooner and recorded in the data files of medicine, not that it’s more prevalent because something current is the cause. The most recent and highly probable theory is that the mothers who have children with autism were extremely stressed and depressed during the pregnancy, which raised certain levels of biochemicals in the body and altered the child’s brain development in utero. There appears to be some link genetically as well, as some families have more than one child affected by an autistic spectrum disorder. There remains an insurmountable task by medical researchers to sift through all the true evidence and weed out the junk science to find that which causes the brains of these children to stop growing and functioning normally. With the advancements of genetic maps of genomes and hereditary conditions, as with Rhett’s Syndrome, which has been determined to have genetic marker codes and thought by some doctors to be part of the Autism Spectrum disorders, there will no doubt one day be an answer to the bizarre and confusing riddle that is Autism Spectrum Disorders, and hopefully a cure or prevention will follow.