?PDDNOS

[amom560]

I have a son who will be 5 soon and am really confused if he is presenting with normal behaviour or something to worry about.  He has never been the most social kid, gets very focused in what he is playing with etc. However, he does seem to take interest in other kids but just doesn't really know what to say to them I guess.   He reads very well and understands what he is reading.  He counts without difficulty to well over 100.  He seems to understand verbal language but doesn't always follow through with instructions given to him, needs constant reminders and sometimes needs to be warned that he'll get a timeout if things are not done.  He can be active at times but would never consider him           hyperactive.  He never had any speech delays but seems to have difficulty expressing himself sometimes, grammar is off.  I can understand him and most of what he says is completely appropriate but he seems to have difficulty phrasing his sentences.  He is sometimes disruptive in his preschool and has difficulty transitioning at the beginning of the class and during clean-up time.  A psychologist that he see's suggested he may have PDDNOS but a psychiatrist disagreed.  Who is right?  I need to know in order to organize schooling for him. Is there anyone out there that has some experience with kids like this that may give me some insight.  Is this just a normal almost 5 year old or is there some pathology?

[amom560]

Thanks so much.  I'm really new at this so every bit of info helps.

[mjthewriterdad]

Who is right?  
It seems as if you have a difference of opinion among professionals.  For some reason, many professionals tend to avoid pegging children on the autistic spectrum. One idea is that the psychiatrist is more conservative untill he observes more?  You describe your boy to be a borderline case.  Some things indicate just normal but introverted 5 year old personality.  Other things may MAY be symtomatic of PDD/autism.

When organizing school for him, the school will perform their own evaluation upon request.  Make sure the school has access to the psycologist/psychiateist records.  

Bear in mind, the schools definition of autsm is not as specific as the definition a psychologist or psychiatrist uses.  Psychologists and psychiatrists use the definition given by the DSM-IV-TR.  OTOH, schools use the definition given by federal IDEA law.  

The IDEA definition is more general.  The DSM has very specific criteria set.  When I look at it it it's like ordering the two entree lunch special from Wong's  Wok.   It says things like:  "A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)"  Where A B C are lists of behavioirs or developmental milestones or whatever.....   So if you have the egg roll, but not the fried rice with two entrees, it's not a lunch special?  Oh and what to drink?   Want fried won-ton with that?

You can always agree or disagree with the schools findings.  When you disagree, you have an opportunity to get yet annother opinion.  

Just a side-note:  I find time-outs more effective to STOP inapproprate behavior rather than getting things done.  A more effective way is "Hey Bud, you can watch Barney when all the toys on the floor are in the box"  I found "pick up your toys or you're gettina a time-out" seldom works.