Pervasive Developmental Disorder (PDD)

Pervasive Developmental Disorder (PDD)

Pervasive Developmental Disorder is a general term that refers to a group of five disorders characterized by delays in  the development of multiple basic functions including socialization and communication. The five disorders are the following:

• Pervasive developmental disorder not otherwise specified (PDD-NOS)
• Autism, the best-known
• Asperger syndrome
• Rett syndrome; and
• Childhood dis-integrative disorder (CDD)

PDD is noticed as early as infancy and its specific onset is prior to three years of age. The disorder does not affect life expectancy.

From: http://en.wikipedia.org/wiki/Pervasive_developmental_disorder

PDD-NOS: General Information

One of the five disorders classified as Pervasive Developmental Disorder (PDD). The disorder is characterized by impairment in social interaction,  poor verbal and non verbal communication skills, or the presence of stereotyped behavior, interests and activities. In PDD-NOS, symptoms are present but are not severe enough to meet the criteria for another disorder under the PDD umbrella. PDD-NOS is also called atypical autism.

It is not always true that PDD-NOS is milder than autism; some symptoms may be milder while others may be more severe.

From: http://en.wikipedia.org/wiki/Pervasive_developmental-disorder_not_otherwise-specified

Diagnosis

Diagnosis
Social Impairment	-Possess difficulty making friends or become a part of a group. -Tend to avoid eye contact -Unable to relate with other people. -Lack interest in making friends or become a member of a group -Prefer to spend time alone
Communication Impairment	-Difficulty with managing self-expressions. -Inability to interpret verbal or non-verbal cues, such as facial expressions, jokes, or forms of emotional expression.
Repetitive Behavior	-Perform the same behavior, such as lining up objects in a row or obsessively talking about the same subject,  in a repetitive manner. -Obsessed with taking certain foods, playing certain methods or routines.

From:  http://www.aspergerstestsite.com/411/pdd-nos-criteria-symptoms/#.UZVQorWkons and  http://en.wikipedia.org/wiki/Pervasive_developmental_disorder_not_otherwise_specified

Test

 There is a limited number of tests available for people to conduct self-diagnosis of PDD-NOS. It is very difficult to diagnose PDD-NOS since it is a general term for many conditions within the Autism Spectrum.  One of the common tests used for PDD-NOS assessment is the Geneticquotient test.

  

Below is a link to a PDD assessment scale/ screening questionnaire. It should be used as basic tool for PDD-NOS identification. One is highly recommended to take the patient to a medical professional for further confirmation.

http://www.childbrain.com/pddassess.html

From:  http://www.childbrain.com/pddassess.html and http://www.aspergerstestsite.com/411/pdd-nos-criteria-symptoms/#.UbJQWflJ4f0

 

PDD-NOS Resources

JanyaGirl website: resource for people with PDD-NOS
http://jaynagirl.cwd-cragin.com/

PDD-NOS on Facebook
https://www.facebook.com/OurPDDNOS

Rett Syndrome: General Information

Rett Syndrome, also called cerebroatrophic hyperammonemia, is a neuro-developmental disorder that mostly affect females but it has been found in male patients as well. It is characterized by small hands and feet, a deceleration of the head growth rate, repetitive and specific hand movements, such as putting hands into the mouth repeatedly.  Patients affected by Rett Syndrome are prone to gastrointestinal disorders. Up to  80% of people with Rett Syndrome have seizures. Poor verbal and/ or motor skills, scoliosis, growth failure, and constipation are common as well.

From: http://en.wikipedia.org/wiki/Rett_syndrome

Diagnosis

Scientists develped a genetic test to complement the clinical diagnosis, which involves searching for the MECP2 mutation on the child's X chromosome.

A highly specific set of guidelines are used for Rett Syndrome assessmet. The set of guidelines are divided into three types of clinical criteria: main, supportive, and exclusion. The presence of any of the exclusion criteria negates a diagnosis of classic Rett syndrome.

Main diagnostic criteria or symptoms: -partial or complete loss of acquired purposeful hand skills -partial or complete loss of acquired spoken language -repetitive hand movements (such as hand wringing or squeezing, clapping or rubbing) -gait abnormalities, such as toe-walking or an unsteady, wide-based, stiff-legged walk.

Supportive criteria:-scoliosis -teeth-grinding -small cold hands and feet in relation to height -abnormal sleep patterns -abnormal muscle tone -inappropriate laughing or screaming -intense eye communication -diminished response to pain.

From: http://www.ninds.nih.gov/disorders/rett/detail_rett.htm#221333277

Prevalence
Rett syndrome is mostly found in females, affecting about one out of 10,000 to 15,000 girls. Rett syndrome in boys is extremely rare. Most males who are born with the condition die shortly after birth.

Warning Signs

Warning Signs
Language	-Impaired communication and cognitive abilities.  -Loss of the ability to speak at around 12 to 18 months.
Compulsive hand movements	-Engagment in repetive hand movement, such as -hand wringing -hand washing -hand clasping -hand clapping or tapping -moving the hands towards the mouth
Apraxia (Loss of ability to perform task or movements.)	-Loss of the ability to perform motor skills, such as walking or crawling, eye gazing and speaking.
Breathing irregularities	-Apnea (breath-holding) -Hyperventilation (over breathing) -Air swallowing
Other neurological symptoms	-Seizures -Sleep disruption -Tremors -Excess salivation -Cognitive disabilities
Symptoms affecting other parts of the body	-Gastrointestinal problems, such as reflux and constipation -Heart rhythm abnormalities -Orthopedic problems such as scoliosis -Microcephaly (small head size) -Low muscle tone -Dystonia (abnormal muscle tone and position) -Toe walking -Teeth grinding -Difficulty with chewing

From: http://www.ninds.nih.gov/disorders/rett/detail_rett.htm#221333277

Rett Syndrome in The Classroom

In the classroom, children with Rett syndrome requires assistance in many areas, such processing speed, memory, and listening comprehension skills. To help children with Rett syndrome increase their processing speed, the educator should provide additional time for the students to respond and complete homework. Oral speech should be paired with visual presentation. The educator should also assess the students to determine greatest area of need with processing and to determine an attainable goal for the student to work on. For memory skill improvement  educator should practice repetition during classes and constantly check students for understanding. Try to avoid using complex instructions. To boost the students' listening comprehension skills, extra time for processing of oral information should be provided. Oral instructions paired with visual ones will increase the level of understanding in students. Educator can also provide notification to the students to focus on listening before important information is given. Many more helpful tips can be found at the following website:: http://www.teachspeced.ca/index.php?q=node/756

From: http://www.teachspeced.ca/index.php?q=node/756

 

Rett Syndrome Resources

International Rett Syndrome Foundation (IRSF)

https://www.rettsyndrome.org/

Rett Syndrome Website
http://www.bundlings.com/irsg.htm

 

Child Dis-integrative Disorder: General Information

 

CDD, also known as Heller's Syndrome is a rare condition characterized by late onset (> age of 3) of developmental delays in language, social function, and motor skills. The cause of the disorder is presently unknown. 

CDD is similar to autism and it is sometimes considered a low-functioning form of it. However, an apparent period of fairly normal development is often noted before a regression in skills or a series of regressions in skills. As a result, many children are already somewhat delayed when the disorder becomes apparent. 

From: http://en.wikipedia.org/wiki/Childhood_disintegrative_disorder

Diagnosis

The most common criteria: Loss of previously acquired skills. To identify whether a child has CDD, he or she must show at least two of the following criteria:

• Loss or reception of receptive Language Skills (language understanding)
• Loss or reception of expressive language skills (spoken language) therefore cannot partcipate in a conversation, may stop talking at some point.
• Loss or reception of social or self-help skills (cannot be comformted by parents or understand the emotions of others, show no interests in pretend play)
• Loss or reception of motor Skills
• Loss or reception of bowel or bladder control, if previously established
• Inability to start a conversation
• Poor communication with nonverbal signals (smiles, gestures, nodding the head, etc)
• Loss of interest in establishing relationships with other people
• Engagement in strange, repetitive behavior and strict routine
• Development of seizures

Note: One difference that separates CDD from all other PDD disorders is that a CDD patient must develop normally for at least two years before loss of skills occurs, and the loss must occur before age them. 

From: http://www.minddisorders.com/Br-Del/Childhood-disintegrative-disorder.html and http://autism.lovetoknow.com/Childhood_Disintegrative_Disorder

Test

The health care provider should determine whether the child has CDD. The most important sign of CDD is the loss of developmental milestones. In general, the patients lose functions in at least two areas of development. Several tests exist to help detect CDD. These are:

• Medical history examination
• Genetic tests
• Neurological Examination
• Communication and Language test
• Blood test for lead poisoning
• Hearing test
• Vision test
• Behavior inventory
• Developmental test

From: http://www.ethosbodyandmindclinic.com/childhood-disintegrative-disorder-hellers-syndrome and http://cmccare.org/Health-Library/HIE%20Multimedia/1/001535.htm

How Can CDD Affect My Child?

Children with CDD lose normal communication skills, non-verbal behaviors and previous skilled they have already learned. The development of children with the disorder appear to be normal for the first two years of life, but they then lose skills in areas such as language, play, and bowel control. They also suffer from impaired social interaction and communication. Performance of repetitive acts is common among CDD patients. 

From: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002502/ and http://behavenet.com/childhood-disintegrative-disorder

CDD in the Classroom

Some of the practices educator may use to educate children with CDD are stated below:

• Use task variation, educator should try assign different tasks to a student to avoid the development of repetitive behaviors.
• Provide precise, positive praise so that students feel more confident about their performance.
• Use meaningful reinforcements
• Use age-appropriate materials during lectures
• Provide opportunities for choice
• Break down oral instructions and use various ways to present concepts (visually, orally, ,and physically)
• Use concrete examples and hand-on activities
• Introduce unfamiliar tasks in a familiar environment
• Direct and broaden fixations into useful activities
• Maintain a list of individual strengths and interests. Then keep the students aware of their specific strengths and let them shine in the area that interests them. 

From: http://education.alberta.ca/media/511995/autism.pdf, Chapter 5: Class Instruction

 

CDD Resources

Autism Program at Yale
http://childstudycenter.yale.edu/autism/research/Regression.aspx

Mayo Clinic: CDD

http://www.mayoclinic.com/health/childhood-disintegrative-disorder/DS00801

Ohio Health
https://www.ohiohealth.com/Diseases-and-conditions/Mental-health/Childhood-disintegrative-disorder/