1. Pervasive spectrum
disorders
Tammy Marie Baker RN
Pediatric Series 2012

2. 299.80 Pervasive Developmental
Disorder
299.80 Pervasive Developmental Disorder, Not Otherwise Specified (PDD-
NOS)This category should be used when there is a severe and pervasive
impairment in the development of reciprocal social interaction or verbal and
nonverbal communication skills, or when stereotyped behavior, interests, and
activities are present, but the criteria are not met for a specific pervasive
developmental disorder, schizophrenia, schizotypal personality disorder, or
avoidant personality disorder. For example, this category includes "atypical
autism" --presentations that do not meet the criteria for autistic disorder because
of late age of onset, atypical symptomatology, or sub threshold symptomatology,
or all of these.

3. pervasive developmental
disorders (PDD)
Group of disorders characterized by delays in the development of socialization and communication skills.
Symptoms as early as infancy, typical age of onset is before 3 years of age
Symptoms may include problems with understanding and using language; difficulty relating to people, objects, and events
Characteristics include difficulty with changes in routine or familiar surroundings, and repetitive body movements or behavior patterns
evidenced
Autism is the most characteristic and best studied PDD
Other Classifications of PDD include Asperger's Syndrome, Childhood Disintegrative Disorder, and Rett's Syndrome
Abilities, intelligence, and behaviors vary widely Children with PDD
Some children do not speak others speak in limited phrases or conversations, and some have relatively normal language development.
Repetitive play skills and limited social skills are generally evident
Unusual responses to sensory information, such as loud noises and lights, are also common.

4. Treatment:
There is no known cure for PDD
Medications are used to treat specific
behavioral problems
Therapies are individualized to child's needs
IEP for individual child's needs

5. Diagnosis of PDD
There are no blood tests or brain tests (EEG,
CAT scan, MRI, PET scan) that conclusively
identify the presence of autism.
Diagnosis is based on DSM criteria and
multidisciplinary Evaluations

6. Multidisciplinary Diagnostic Team
■ Child psycholog!ts
■ Child psychiat"#s
■ Speech pa$olog!ts
■ Developmental pe%at"cians
■ Pe%at"c neurolog!ts
■ Au%olog!ts
■ Physical $erap!ts
■ Special education teachers

7. Evaluation Process
Autism Spectrum Disorder
Diagnosing an autism spectrum disorder is not a brief process.
There is no single medical test and multiple evaluations and tests are necessary.
Parent interview
In the first phase of the diagnostic evaluation, you will give your doctor background information about your child’s medical, developmental,
and behavioral history. If you have been keeping a journal or taking notes on anything that concerned you, turn over that information.
The doctor will also want to know about your family’s medical and mental health history.
Medical exam
The medical evaluation includes a general physical, a neurological exam, lab tests, and genetic testing. Your child will undergo this full
screening
to determine the cause of his or her developmental problems and to identify any co-existing conditions.
Hearing test
Since hearing problems can result in social and language delays, they need to be excluded before an autism spectrum disorder can be
diagnosed.
Your child will undergo a formal audiological assessment where he or she is tested for any hearing impairments, as well as any other hearing
issues or sound sensitivities that sometimes co-occur with autism.
Observation
Developmental specialists will observe your child in a variety of settings to look for unusual behavior associated with the autism spectrum
disorders.
They may watch your child playing or interacting with other people.
Lead screening
Because lead poisoning can cause autistic-like symptoms, the National Center for Environmental Health recommends that all children with
developmenta
l delays be screened for lead poisoning.

8. prognosis and interventions
Early intervention is essential
IEP for School
Supportive Educational and Medical services
are individualized
Life expectancy is not affected

9. other evaluations
Speech and language evaluation – A speech pathologist will evaluate
your child's speech and communication abilities for signs of autism, as well
as looking for any indicators of specific language impairments or disorders.
■ Cognitive testing – Your child may be given a standardized intelligence
test or an informal cognitive assessment. Cognitive testing can help
differentiate autism from other disabilities.
■ Adaptive functioning assessment – Your child may be evaluated for
their ability to function, problem-solve, and adapt in real life situations.
This may include testing social, nonverbal, and verbal skills, as well as the
ability to perform daily tasks such as dressing and feeding him or herself.
■ Sensory-motor evaluation – Since sensory integration dysfunction often
co-occurs with autism, and can even be confused with it, a physical
therapist or occupational therapist may assess your child's fine motor,
gross motor, and sensory processing skills.

10. What does PDD look like?

11. the five Pervasive Developmental
Disorders
Listed below are the diagnostic criteria for the five Pervasive Developmental Disorders
(PDDs), also known as Autism Spectrum Disorders (ASDs), as defined by the Diagnostic and
Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV), published by the
American Psychiatric Association, Washington D.C., 1994, the main diagnostic reference of
mental health professionals in the U.S.
Autistic Disorder
299.80 Pervasive Developmental Disorder, Not Otherwise Specified
299.80 Asperger's Disorder
299.80 Rett's Disorder
299.10 Childhood Disintegrative Disorder

12. 299.10 Childhood Disintegrative Disorder
299.10 Childhood Disintegrative Disorder
A. Apparently normal development for at least the first 2 years after birth as manifested by the presence of age-appropriate verbal and nonverbal
communication, social relationships, play, and adaptive behavior.
B. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas:
(1) expressive or receptive language
(2) social skills or adaptive behavior
(3) bowel or bladder control
(4) play
(5) motor skills
C. Abnormalities of functioning in at least two of the following areas:
(1) qualitative impairment in social interaction (e.g., impairment in nonverbal behaviors, failure to develop peer relationships, lack of social or emotional
reciprocity)
(2) qualitative impairments in communication (e.g., delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive
use of language, lack of varied make-believe play)
(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms
DD. The disturbance is not better accounted for by another specific pervasive developmental disorder or by schizophrenia.

13. 299.80 Rett's Disorder
A. All of the following:
(1) apparently normal prenatal and perinatal development
(2) apparently normal psychomotor development through the first 5 months after birth
(3) normal head circumference at birth
B. Onset of all of the following after the period of normal development:
(1) deceleration of head growth between ages 5 and 48 months
(2) loss of previously acquired purposeful hand skills between ages 5 and 30 months with the subsequent development of
stereotyped hand movements (i.e., hand-wringing or hand washing)
(3) loss of social engagement early in the course (although often social interaction develops later)
(4) appearance of poorly coordinated gait or trunk movements
(5) severely impaired expressive and receptive language development with severe psychomotor retardation

14. Educational graph of PPd-NOS Placement

15. statistics
the Interactive Autism Network (IAN)