Pervasive Developmental Disorder (PDD)

1. Pervasive Developmental Disorder (PDD) • Autism is one of five disorders that falls under the umbrella of PDD, a category of neurological disorders characterized by “severe and pervasive impairment in several areas of development.” • The term "PDD" is widely used by professionals to refer to children with autism and related disorders; however, there is a great deal of disagreement and confusion among professionals concerning the PDD label. http://www.autism-society.org

2. Why the PDD confusion? As no medical tests can be performed to indicate the presence of autism or any other PDD, the diagnosis is based upon the presence or absence of specific behaviors. Most importantly, whether a child is diagnosed with a PDD (like autism) or a PDD-NOS, his/her treatment will be similar. • http://www.autism-society.org

3. PDD • Autistic Disorder (299.00 DSM-IV) • Asperger’s Disorder (299.80 DSM-IV) • Rett’s Disorder (299.80 DSM-IV) • Childhood Disintegrative Disorder (299.10 DSM-IV) • PDD-NOS (299.80 DSM-IV)

4. Autism According to the Individuals with Disabilities Education Act, or IDEA 2004, Autism is a developmental disability that significantly affects verbal and nonverbal communication and social interaction. It is generally evident before age 3 and adversely affects a child’s educational performance. Other characteristics often associated with autism include engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. Ocali.org

5. Prevalence of Autism Spectrum Disorders (ASD) • The prevalence of ASD is increasing. Recent research shows 1 in 150 individuals have ASD (Autism Society of America, 2007 http://www.autism-society.org; Centers for Disease Control and Prevention, 2007). This means that as many as 1.5 million Americans are believed to have some form of ASD. • Autism is growing at a rate of 10-17 % per year. (U.S. DOE) • Incidence is 4 times more prevalent in boys • Autism knows no racial, ethnic, or social boundaries, and family income, lifestyle, and educational levels do not affect the chance of the occurrence of autism. Ocali.org

6. Characteristics of Aspergers • Kids with Aspergers can show unusual social styles, even lack of eye contact in interactions, or poor social skills. • Difficulty making friends/lack of appropriate peer relationships • Difficulty reading or communicating through non verbal social cues, such as facial expressions (body language).

7. Characteristics of Aspergers • Have difficulty introducing themselves into groups of people or conversations. • Limited understanding that others may have thoughts or feelings different from his own. • Inflexibility about routines, especially when changes occur unexpectedly.

8. Characteristics of Aspergers (cont.) • Obsessive focus on a narrow interest. • Sensitivity to loud noises, crowded places and touch. • Lack of organizational abilities. • Unusual curiosity about their environment • No clinically significant language delay • No clinically significant cognitive delay • No clinically significant adaptive delay

9. Impairment in Communication • Literal use of language • Confused by expressions- “cat got your tongue?” • Confused by shades of meaning/ambiquity • Expansive vocabulary often hides poor understanding • Lack of reciprocity in conversation- talks “at you” • Misses non-verbal cues (body language) LJ Cohen @2000-2004

10. Impairment in Social Interactions • Social difficulties • Difficulty in negotiating with peers • Anxiety in social (group) settings • Difficulty with transitions • Wants friends but doesn’t know the rules • Often an easy target for bullying due to naivety • Cohen @2000-2004

11. Communication Tips • Invite them to join in the conversation. • Expect low points in the conversation, you may have to pick up the slack. • Don’t assume they can read your body language. Be Direct. • Explain your feelings. • Don’t overwhelm them with multiple steps. LJ Cohen @2000-2004

12. Accommodating the Environment • Establish clear expectations • Use visual supports • Lists, sequencing of tasks, visual calendars, written schedules, and written notification of changes. • Supervise unstructured time • Develop “circle of friends” • Work collaboratively with parents • Be aware of sensitivity (sound, touch, smell) LJ Cohen @2000-2004

13. Tools for Teachers • Stress Management • Help them to label their emotions • Have cool down strategies • Have a safe place where they can go • Use of structure/rules • Concrete rules for the class/group • Structured schedule (daily/weekly) or routine • Display prominently rules/schedules • Refer to the rules frequently • Adapt routines and rules when needed but give advanced warning and notice LJ Cohen @2000-2004

14. AS: An Invisible disability • “If you just applied yourself…” • You’re so smart, why cant you just…” • How can you be so clueless…” • He’s bright but lazy…” • She lives in her own world…” LJ Cohen @2000-2004

15. References • Asperger’s Syndrome: A Guide for Parents and Professionals, Tony Attwood, 1998, Jessica Kingsley Publishers • Asperger Syndrome: Practical Solutions for a Difficult Moment, Brenda Smith Myles & Jack Southwick, 1999, AAPC • Asperger Syndrome: A Practical Guide for Teachers, Cumine, Leach & Stevenson, 1998, David Fulton Publishers • Ohio Center for Autism and Low Incidence http://www.OCALI.org/ LJ Cohen @2000-2004

16. Sources for Further Information • Tony Attwood’s homepage www.tonyattwood.com • Sensory Integration International http://home.earthlink.net/~sensoryint/ • American Hyperlexia Association http://www.hyperlexia.org/ • Wrightslaw website--advocacy for children with disabilities www.wrightslaw.org/ • Face Blind! By Bill Choisser, an online book www.choisser.com/faceblind/ • Social Skills resources by Carol Gray http://www.thegraycenter.org/carol_gray.htm • Meeting the Needs of Children with Autistic Spectrum Disorders. Jordan and Jones, 1999, David Fulton publishers • “The Morning News” Publication of the Jenison Public Schools, ed. Carol Gray. To subscribe, call (616) 457-8955 • Pretending to Be Normal. Liane Holliday Willey, Jessica Kingsley Publishers, 1999 LJ Cohen @2000-2004