Thursday, November 29, 2012


Pervasive Development Disorder Non-Specific

Deficits in Social Behavior

"Some infants with PDDNOS tend to avoid eye contact and demonstrate little interest in the human voice. They do not usually put up their arms to be picked up in the way typical children do. They may seem indifferent to affection and seldom show facial responsiveness. As a result, parents often think the child is deaf. In children with few delays, lack of social responsiveness may not be obvious until well into the second or third year of life." Damien was never what you would call a clingy child unless he was very sleepy or sleeping. We had to teach Damien what emotions were. We often felt that Damien may have a hearing problem. We had him tested and he passed with a 98% on his hearing test. This lead to speech therapy. Now he knows when he is supposed to laugh, smile and cry, however, you can tell it is not sincere. He laughs because others are laughing , he smiles because others smile first and he cries because he knows he is supposed to but there are never tears.

"In early childhood, children with PDDNOS may continue to show a lack of eye contact, but they may enjoy a tickle or may passively accept physical contact. They do not develop typical attachment behavior, and there may seem to be a failure to bond. Generally, they do not follow their parents about the house. The majority does not show normal separation or stranger anxiety. These children may approach a stranger almost as readily as they do their parents many such children show a lack of interest in being with or playing with other children they may even actively avoid other children. A lack of response to other people's interest and emotions, as well as a lack of understanding of humor, often results in these youngsters saying or doing things that can slow the development of friendships." When you hug Damien, he does not hug back. When tickled, he doesn't laugh and very seldom does he even crack a smile. The scariest thing about his behavior is he will talk to anyone even if he has not ever met him or her before. He knows no stranger. No matter how much we try to teach him not to talk to strangers, he does anyway. Damien will only play with other children when prompted to. Children often will not play with Damien because they feel he is rude and odd.

Impairment in Nonverbal Communication

"In early childhood, children with PDDNOS may develop the concrete gesture of pulling adults by the hand to the object that is wanted. They often do this without the typical accompanying facial expression. They seldom nod or shake their heads to substitute for or to accompany speech. Children with PDDNOS generally do not participate in games that involve imitation. They are less likely than typical children to copy their parents' activity.

Some children do develop imitative play, but this tends to be repetitive.

Generally, children with PDDNOS are able to show joy, fear, or anger, but they may only show the extreme of emotions. They often do not use facial expressions that ordinarily show subtle emotion." We are lucky if we get any kind of emotion out of Damien.

Impairment in Understanding Speech

"Children who have less severe impairments may follow simple instructions if given in an immediate context or with the aid of gestures (e.g. telling the child to "put your glass on the counter," while pointing to the counter)." I have to give Damien explicit instructions on what needs to be done. If I ask him to do something, I have to go through all of the steps. For example, Damien wants a glass of milk, and wants to get it for himself. I have to say "go get you cup out of the cabinet. Put it on the counter. Open the fridge. Get the milk out. Take off the lid. Pour the milk in the cup. Put the lid back on the milk. Put the milk in the fridge. Close the fridge." If I leave out any of these, he forgets. I have often forgotten to tell him to put the lid back onto the jug and have found the milk in the fridge with no lid. He has finally learned all of the steps to getting himself milk and I don't have to instruct him on it anymore.

"Humor, sarcasm, and common sayings can be confusing for individuals with the most mild PDDNOS." Damien does not get joke at all. When people try to pick on him, he says, "you better be kidding;" or he will ask, "are you just kidding."

Impairment in Speech Development

"Infants with PDDNOS may begin to babble in their first year but them stop. A child says words or phrases repeatedly without a communicative purpose." They may get their comments out of context. "For instance, when the child is asked "How are you?" he or she may answer "You are fine." This was a tough one to correct. Damien would either answer questions in this manner or just repeat the question. "Odd breathing rhythms may produce staccato speech in some children.

  1. some objects may be labeled by their use
  2. new words may be coined
  3. prepositions, conjunctions, and pronouns may be dropped from phrases or used incorrectly

Their speech does not usually convey imagination, abstraction or subtle emotion. They may talk excessively about their special interests, and they may talk about the same pieces of information whenever the same subject is raised. Ordinary to-and-fro conversational chatter is lacking. Thus, they give the impression of talking "at" someone, rather than "with" someone.

Unusual Patterns of Behavior

  1. resistance to change Many children are upset by changes in the familiar environment. Some children line up toys or objects and become very distressed if these are disturbed.
  2. ritualistic or compulsive behaviors rigid routines (e.g., insistence on eating particular foods)" Damien must have peanut butter-jelly sandwiches and a bowl of cereal every day. "Some children develop preoccupations.
  3. abnormal attachments to odd objects" Damien must have a dinosaur around at all times he often acts as if he is a dinosaur.
  4. unusual responses to sensory experiences may seem under responsive or over responsive to sensory stimuli." Damien doesn't really like to be touched. one of the only ways we can get him calmed down is to get a cold wet wash cloth and roughly rub it on his face. "They may be suspected of being deaf or visually impaired. They avoid gentle physical contact, yet react with pleasure to rough-and-tumble games. They carry food preferences to extremes with favored foods eaten to excess. They limit their diet to a small selection and do not seem to know when they are full.

The typical motor milestones may be delayed but are often within the normal range. Young children with PDDNOS usually have difficulty with imitation skills such as clapping hands. They may exhibit grimacing, toe walking, lunging, jumping, darting or pacing, head banging. In some cases the behaviors appear only from time to time; in other cases they are present continuously.

Intelligence and Cognitive Deficits

Generally, children with PDDNOS do very well on tests requiring manipulative or visual skills or immediate memory, while they do poorly on tasks demanding symbolic or abstract thought and sequential logic.

Associated Features

The emotional expression of some children with PDDNOS may be flattened, excessive, or inappropriate to the situation."

These are the traits that only pertain to Damien.

Also, many different disorders may fall under PDDNOS. Damien has all of the following: clinical depression, audio processing delay, ADHD (attention deficit hyperactive disorder), COBPD (childhood onset bipolar disorder), descriptive behavior of childhood with anxiety, OCD (obsessive compulsive disorder), ODD (oppositional defiant disorder). I have also found similarities in Damien's behavior with Autism and Asperger's disorder. The most important thing that I have found being stressed with all of these is that the "parents do not cause any of these disorders." So those of you that may think that I must have done lots of drugs or drinking while pregnant or that I must abuse my child, you are absolutely wrong. I get that a lot. Anyway, if I did cause this, why is Dylan so much different. The only problem he has is excessive whining.

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