The Difference Between Aspergers and PDD-NOS

Question

My 7-year-old son has been diagnosed with ADHD. The pediatrician also thinks that he may have Aspergers or Pervasive developmental disorder not otherwise specified. After researching the two diagnoses, I see that they are very similar. What type of testing can I have done to determine what kind of help my son needs?

Answer

Like Autism and Aspergers, Pervasive developmental disorder not otherwise specified (PDD-NOS) is one of the five subtypes of the Autism Spectrum Disorders. Children diagnosed with PDD-NOS will have less social impairment than a youngster with Autism or Aspergers.

The Autism Spectrum Disorders are:

1. Pervasive developmental disorder not otherwise specified
2. Autism
3. Asperger syndrome
4. Rett syndrome
5. Childhood disintegrative disorder

To confuse matters, there is a division among therapists on the use of the term Pervasive Developmental Disorder (PDD), which is the same thing as Autism Spectrum Disorder (ASD). Many use the term PDD as a short way of saying PDD-NOS. Others use the general category label of PDD because they are hesitant to diagnose very young kids with a specific type of PDD (e.g., Autism). Both approaches contribute to confusion about the term, because the term PDD actually refers to a category of disorders and is not a diagnostic label.

PDD is not itself a diagnosis, while PDD-NOS is. To further complicate the issue, PDD-NOS can also be referred to as “atypical personality development,” “atypical PDD,” or “atypical Autism.”

Some clinicians use PDD-NOS as a "temporary" diagnosis for youngsters under the age of 5, when for whatever reason there is a reluctance to diagnose Autism. There are several justifications for this. Very young kids have limited social interaction and communication skills to begin with, thus it can be tricky to diagnose milder cases of Autism in a toddler. The unspoken assumption is that by the age of 5, unusual behaviors will either resolve or develop into diagnosable Autism.

Because of the "NOS" (i.e., not otherwise specified), it is hard to describe what PDD-NOS is, other than its being an Autism Spectrum Disorder (ASD). Some children diagnosed with PDD-NOS are close to having Aspergers, but do not quite fit the profile. Others have near full-blown Autism, but without some of its symptoms. The field of psychology is considering creating several subclasses within PDD-NOS.

To confirm the diagnosis, continue to consult with your doctor and get a referral to either a neurologist or child and adolescent psychiatrist to figure out exactly what is going on with your child. Once you have a definitive answer, you can then check for resources in your local area. Each U.S. state has different resources tied-in with the local schools. Your doctor should be able to point you in the right direction. If not, the local school district should have some referrals for you.

The Aspergers Comprehensive Handbook

Children on the Autism Spectrum and Auditory Processing Disorder

Auditory Processing Disorder (APD) is an umbrella term for a variety of disorders that affect the way the brain processes auditory information. It is not a sensory or inner ear hearing impairment. Kids with APD usually have normal peripheral hearing ability. However, they cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech.

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Aspergers Teens and Driving a Car

"My daughter is 18 and has Aspergers. Hers is particularly with anti-social behavior and thoughts. My entire family is ridiculing me for not forcing her to get her drivers license, but she is scared and doesn't want to. Should I force her to? Am I wrong?" 

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Talking To Aspergers and HFA Children About Puberty

"Our son with high-functioning autism (age 12) has never really had the 'official' discussion about what to expect in puberty. We may have waited too long at this point, but in any case, how can we approach this topic in a way that a person with his challenges can understand (he takes most things very literally by the way - and is a bit immature for his age)?"

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Auditory Integration Training: Help for Sensory Problems

Auditory Integration Training (AIT) was used in the early 1990s as a treatment for autism. It has also been promoted as a treatment for ADHD, depression, and a wide variety of other disorders. It typically involves 20 half-hour sessions over 10 days listening to specially filtered and modulated music. The American Academy of Pediatrics and three other professional organizations consider AIT to be an experimental procedure.

AIT aims to address the sensory problems such as hearing distortions and hyperacusis (i.e., oversensitive hearing), which are said to cause discomfort and confusion in children suffering from learning disabilities, including autism spectrum disorders. These hypersensitivities are believed to interfere with a youngster’s attention, comprehension, and ability to learn.

The training typically involves the youngster attending two 30-minute sessions per day, separated by a minimum of three hours, for ten consecutive working days. The youngster listens via headphones to a program of specially filtered and modulated music with wide frequency range. The program is modified for each youngster with certain frequencies of sound filtered using an electronic device, which randomly switches between low- and high-pass filtering for random durations between 1/4 and 2 seconds. The filtering device also varies the sound's intensity, creating a modulated effect. The volume is set as loud as possible without causing discomfort. If the listener has shown unusual sensitivities to certain frequencies, these may be filtered out additionally.

Although no AIT device has been approved for marketing as a medical device by the FDA, devices used only to aid education are not subject to FDA regulation.

Most AIT practitioners are speech-language pathologists or audiologists and occupational therapist. Other practitioners include psychologists, physicians, social workers, and teachers.

Parents who are seeking interventions for their Aspergers (high functioning autistic) youngster should explore the many options currently available and evaluate each one. Factors to evaluate include:

• cost and accessibility
• the benefit versus the risk
• the effectiveness of the intervention
• the timing of the program relative to other interventions that are being done
• whether it is appropriate for their particular youngster

There are some immediately recognized advantages to Auditory Integration Training:

• it can be provided as young as 3 years of age
• it only requires 10 days, with two 30 minute listening sessions each day
• the main pre-requisite skill is that the listener must accept the head-phones

Many Aspergers kids receiving special education services often have an undiagnosed problem with the way they hear and process information, thus learning and behavior may be affected by problems (e.g., hearing distortions, hypersensitive hearing, lack of coordination, processing delays, etc.),which interfere with efficient processing of sound signals.

AIT stimulates the auditory system with unique sounds that stimulate the auditory system to reduce or eliminate the problems within this system. AIT is a method of retraining the way the sounds are processed. When the Aspergers child can process sounds properly, he/she can maintain a state of alert readiness, concentration, and effective comprehension.

The auditory system is responsible for many jobs other than hearing. For example, the auditory system:

• assists in the control of eye movements
• assists in the control of the hand and fingers when writing
• contains the control center for all sensory processing
• controls balance
• controls motor planning and coordination
• enables people to use language
• help us sing on key

Thus, it makes sense that when the auditory system is not functioning effectively, many diverse problems may appear, including:

• delays in speech and language development
• difficulty with reading skills
• difficulty with vision skills
• poor balance and motor coordination skills
• poor concentration
• poor fine motor skills
• problems with sensory processing

When the auditory system is retrained, the benefits may extend well beyond just the ability to listen better. Moms and dads often report improvement in their Aspergers youngster’s ability to ride a bike, catch a ball, pronounce words, and modulate speech volume.

Other reported benefits include the following:

• children are able to attend and concentrate on the important things
• hearing sensitivity is often reduced (as a result, the child no longer needs to cover his ears or avoid crowds and noisy events)
• many children are calmer
• many children begin to color, draw and write with more skill
• many moms and dads and professionals report that the youngster’s educational progress accelerates
• many show a higher level of self-confidence
• most children begin to show increased interest in socialization
• occupational, speech/language and physical therapists comment that IEP goals are mastered much more quickly
• some Autistic kids may begin to speak for the first time
• some demonstrate less anxiety and irritability
• some quickly learn to tie their shoes or button clothes
• the need to constantly regulate sensory experiences decreases (e.g., covering the ears, wearing noise-protection headsets)
• those who have been speaking may expand to much more complex use of language

The Aspergers Comprehensive Handbook