PDD-NOS: What It's Called Now & How It's Diagnosed and Treated

Previously, the DSM-4 divided autism into four separate categories. These were:

• autistic disorder
• Asperger's syndrome
• childhood disintegrative disorder
• PDD-NOS

In the DSM-5, these conditions are now grouped under a single diagnosis — autism spectrum disorder (ASD).

In addition, symptoms were consolidated into two categories, which include:

• deficits in communication and interaction
• restricted or repetitive movements

When diagnosing ASD, medical professionals rate the level of support a person needs for their day-to-day functioning on a scale of one to three.

They also need to specify if symptoms are associated:

• with or without intellectual impairment
• with or without language impairment
• with a known medical or genetic condition or environmental factor that's known
• with another neurodevelopmental, mental, or behavioral disorder
• with catatonia

Previously, people were diagnosed with PDD-NOS when they didn't display symptoms consistent with a diagnosis of other conditions on the autism spectrum. Because of this, PDD-NOS didn't have well-defined diagnostic criteria.

For example, someone with PDD-NOS may have had clear problems with communication and social interaction but might not display repetitive or restricted behaviors.

Or, a diagnosis of PDD-NOS could be given to someone with mild symptoms ('high-functioning') that didn't meet all of the criteria for an Asperger's diagnosis.

Because of the variability of PDD-NOS symptoms, attempts were made to determine different subgroups of PDD-NOS.

Under the new criteria for ASD, symptoms are divided into two categories. Symptoms may vary in severity from person to person. Additionally, not everyone with ASD has all the known symptoms, although most people have several.

Social communication and interaction symptoms can include things like:

• having difficulties initiating or maintaining a conversation
• making poor eye contact or not making eye contact at all
• having a hard time expressing feelings or emotions, or not understanding the feelings of others
• not understanding nonverbal cues, such as facial expressions, gestures, or postures
• being slow to respond to someone calling out their name or trying to get their attention

Restrictive or repetitive behavior symptoms may be things like:

• engaging in repetitive behaviors, such as rocking back and forth or repeating specific words or phrases
• maintaining a specific routine and becoming upset when there are even slight changes to it
• having a greater or lesser sensitivity to sensory stimulation, such as noises or lights
• having an intense, very focused interest in specific objects or topics
• developing specific food preferences or refusing to eat certain foods

ASD is a very complex condition and not all of the causes are known. It's generally agreed that a combination of genetic and environmental factors likely play a role in causing the condition.

Genetically speaking, mutations may cause or increase the risk of developing ASD. Mutations can occur randomly or can be inherited from a parent.

Additionally ASD may be associated with certain genetic disorders such as fragile X syndrome or Rett syndrome.

As with possible genetic causes, researchers are continuing to investigate potential environmental causes and other risk factors for ASD. Some examples of topics that are being investigated include viral infections, medications taken during pregnancy, and environmental pollutants.

risks for autism

Currently the risk factors for ASD can include:

• having a sibling with ASD
• sex — boys are more likely to develop ASD than girls
• having parents that are older
• being born very premature or at a low birth weight
• having genetic conditions, such as fragile X syndrome or Rett syndrome

Some people worry that ASD may be associated with childhood vaccinations. As such, this has been a very heavy area of study over many years. However, research has shown there is no link between vaccines or their components and the development of ASD.

Children should receive regular developmental screenings as part of every routine wellness checkup.

During these screenings, the doctor will ask you questions about your child's development and assess how the child communicates, moves, and behaves.

In addition, the American Academy of Pediatrics (AAP) recommends all children be screened specifically for ASD between 18 and 24 months of age.

If they notice any signs of a possible developmental problem, they'll request a second more comprehensive screening. They may perform this screening themselves or refer you to a specialist, such as a developmental pediatrician or child neurologist.

ASD can also be diagnosed in older children, adolescents, and adults by evaluation by a primary care doctor or someone that specializes in ASD.

The severity of ASD is determined by evaluating the level of support an individual needs in order to function. These ratings are given on a scale of one to three.

Level 1 is the lowest level of severity while level 3 is the highest.

There are a variety of treatments available for ASD, which includes PDD-NOS.

Below, we'll briefly explore some of them:

• Applied behavioral analysis (ABA). There are several different types of ABA. At its core, ABA is concerned with reinforcing positive behaviors while discouraging negative behaviors.
• Speech or language therapy. This type of therapy can help with deficits in language or communication.
• Occupational or physical therapy. These can help with coordination issues and also with learning day-to-day tasks such as getting dressed and bathing.
• Medications. There are no medications to treat ASD directly. However, other conditions such as anxiety and depression often occur along with ASD. Medications can help treat these conditions.
• Cognitive behavioral therapy. Cognitive behavioral therapy can help people with ASD in dealing with anxiety, depression, or other psychological challenges they may be experiencing.
• Dietary changes. This can include things like gluten- or casein-free diets or using vitamin or probiotic supplements. Currently, most of these haven't shown proven benefit, so you should speak to your pediatrician before changing your child's diet.
• Alternative or complementary therapies. These can include a variety of things such as music therapy, massage therapy, and herbal medicine. It's important to remember that there isn't a lot of research into the efficacy of many of these therapies, while others have been shown to be ineffective. Some of these therapies may come with significant risk, so speak with a doctor before starting one.

There's currently no cure for ASD. However, early diagnosis and starting treatment sooner is important.

This will ensure that people with ASD get the help that they need and receive the tools necessary to learn to function within their environment.

No two people with ASD are the same. The outlook can depend on the symptoms that are present as well as their severity. Your doctor will work closely with you to come up with a treatment plan that's right for you or your child.

PDD-NOS was one of the categories of autism per the DSM-4. It involved symptoms that placed an individual on the autism spectrum, but weren't consistent with other categories of autism.

As of 2013, PDD-NOS is now included under the umbrella diagnosis of ASD.

ASD is typically diagnosed in young children, but can be diagnosed in older individuals as well. There are many possible treatment options available to people with ASD. Many of them focus on promoting better social and communication skills and lessening negative behaviors.

Every person with ASD is different. When deciding on a treatment plan, you'll work alongside your doctor to determine an optimal course of treatment for you or your child.