Pervasive Developmental Pervasive Developmental Disorder (PDD)Disorder (PDD)

Autism is one of five disorders that falls Autism is one of five disorders that falls under the umbrella of PDD, a category of under the umbrella of PDD, a category of neurological disorders characterized by neurological disorders characterized by “severe and pervasive impairment in “severe and pervasive impairment in several areas of development.” several areas of development.”

The term "PDD" is widely used by The term "PDD" is widely used by professionals to refer to children with professionals to refer to children with autism and related disorders; however, autism and related disorders; however, there is a great deal of disagreement and there is a great deal of disagreement and confusion among professionals concerning confusion among professionals concerning the PDD label. the PDD label.

http://www.autism-society.org

Why the PDD confusion?Why the PDD confusion?

As no medical tests can be performed to As no medical tests can be performed to indicate the presence of autism or any indicate the presence of autism or any other PDD, the diagnosis is based upon the other PDD, the diagnosis is based upon the presence or absence of specific behaviors. presence or absence of specific behaviors.

Most importantly, whether a child is Most importantly, whether a child is diagnosed with a PDD (like autism) or diagnosed with a PDD (like autism) or a PDD-NOS, his/her treatment will be a PDD-NOS, his/her treatment will be similar.similar.

– http://www.autism-society.org

PDDPDD

Autistic Disorder (299.00 DSM-IV) Asperger’s Disorder (299.80 DSM-I

V)

Rett’s Disorder (299.80 DSM-IV) Rett’s Disorder (299.80 DSM-IV) Childhood Disintegrative Disorder Childhood Disintegrative Disorder

(299.10 DSM-IV) (299.10 DSM-IV) PDD-NOS (299.80 DSM-IV) PDD-NOS (299.80 DSM-IV)

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

Ocali.orgOcali.org

Prevalence of Autism Prevalence of Autism Spectrum Disorders (ASD)Spectrum Disorders (ASD)

The prevalence of ASD is increasing. Recent The prevalence of ASD is increasing. Recent research shows 1 in 150 individuals have research shows 1 in 150 individuals have ASD (Autism Society of America, 2007 ASD (Autism Society of America, 2007 http://www.autism-society.org; Centers for http://www.autism-society.org; Centers for Disease Control and Prevention, 2007). This Disease Control and Prevention, 2007). This means that as many as 1.5 million Americans means that as many as 1.5 million Americans are believed to have some form of ASD. are believed to have some form of ASD.

Autism is growing at a rate of 10-17 % per Autism is growing at a rate of 10-17 % per year. (U.S. DOE) year. (U.S. DOE)

Incidence is 4 times more prevalent in boys Incidence is 4 times more prevalent in boys Autism knows no racial, ethnic, or social Autism knows no racial, ethnic, or social

boundaries, and family income, lifestyle, and boundaries, and family income, lifestyle, and educational levels do not affect the chance educational levels do not affect the chance of the occurrence of autism.of the occurrence of autism.

Ocali.orgOcali.org

Characteristics of Characteristics of AspergersAspergers

Kids with Aspergers can show unusual Kids with Aspergers can show unusual social styles, even lack of eye contact social styles, even lack of eye contact in interactions, or poor social skills.in interactions, or poor social skills.

Difficulty making friends/lack of Difficulty making friends/lack of appropriate peer relationshipsappropriate peer relationships

Difficulty reading or communicating Difficulty reading or communicating through non verbal social cues, such through non verbal social cues, such as facial expressions (body as facial expressions (body language).language).

Characteristics of AspergersCharacteristics of Aspergers

Have difficulty introducing Have difficulty introducing themselves into groups of people or themselves into groups of people or conversations.conversations.

Limited understanding that others Limited understanding that others may have thoughts or feelings may have thoughts or feelings different from his own.different from his own.

Inflexibility about routines, especially Inflexibility about routines, especially when changes occur unexpectedly.when changes occur unexpectedly.

Characteristics of Aspergers Characteristics of Aspergers (cont.)(cont.)

Obsessive focus on a narrow interest.Obsessive focus on a narrow interest. Sensitivity to loud noises, crowded places and Sensitivity to loud noises, crowded places and

touch.touch. Lack of organizational abilities.Lack of organizational abilities. Unusual curiosity about their Unusual curiosity about their

environmentenvironment No clinically significant language delayNo clinically significant language delay No clinically significant cognitive delayNo clinically significant cognitive delay No clinically significant adaptive delayNo clinically significant adaptive delay

Impairment in Impairment in CommunicationCommunication

Literal use of languageLiteral use of language– Confused by expressions- “cat got your tongue?”Confused by expressions- “cat got your tongue?”– Confused by shades of meaning/ambiquityConfused by shades of meaning/ambiquity– Expansive vocabulary often hides poor Expansive vocabulary often hides poor

understandingunderstanding– Lack of reciprocity in conversation- talks “at Lack of reciprocity in conversation- talks “at

you”you”– Misses non-verbal cues (body language)Misses non-verbal cues (body language)

LJ Cohen @2000-2004LJ Cohen @2000-2004

Impairment in Social Impairment in Social InteractionsInteractions

Social difficultiesSocial difficulties– Difficulty in negotiating with peersDifficulty in negotiating with peers– Anxiety in social (group) settingsAnxiety in social (group) settings– Difficulty with transitionsDifficulty with transitions– Wants friends but doesn’t know Wants friends but doesn’t know

the rulesthe rules– Often an easy target for bullying Often an easy target for bullying

due to naivetydue to naivety– Cohen @2000-2004Cohen @2000-2004

Communication TipsCommunication Tips

Invite them to join in the Invite them to join in the conversation.conversation.

Expect low points in the conversation, Expect low points in the conversation, you may have to pick up the slack.you may have to pick up the slack.

Don’t assume they can read your Don’t assume they can read your body language. body language. Be Direct.Be Direct.

Explain your feelings.Explain your feelings. Don’t overwhelm them with multiple Don’t overwhelm them with multiple

steps. steps. LJ Cohen @2000-2004LJ Cohen @2000-2004

Accommodating the Accommodating the EnvironmentEnvironment

Establish clear expectationsEstablish clear expectations Use visual supports Use visual supports

– Lists, sequencing of tasks, visual calendars, Lists, sequencing of tasks, visual calendars, written schedules, and written notification written schedules, and written notification of changes.of changes.

Supervise unstructured timeSupervise unstructured time Develop “circle of friends”Develop “circle of friends” Work collaboratively with parentsWork collaboratively with parents Be aware of sensitivity (sound, touch, Be aware of sensitivity (sound, touch,

smell)smell) LJ Cohen @2000-2004LJ Cohen @2000-2004

Tools for TeachersTools for Teachers Stress ManagementStress Management

– Help them to label their emotionsHelp them to label their emotions– Have cool down strategiesHave cool down strategies– Have a safe place where they can go Have a safe place where they can go

Use of structure/rulesUse of structure/rules– Concrete rules for the class/groupConcrete rules for the class/group– Structured schedule (daily/weekly) or Structured schedule (daily/weekly) or

routineroutine– Display prominently rules/schedulesDisplay prominently rules/schedules– Refer to the rules frequentlyRefer to the rules frequently– Adapt routines and rules when needed but Adapt routines and rules when needed but

give advanced warning and noticegive advanced warning and notice LJ Cohen @2000-2004LJ Cohen @2000-2004

AS: An Invisible disabilityAS: An Invisible disability

““If you just applied yourself…”If you just applied yourself…” You’re so smart, why cant you You’re so smart, why cant you

just…”just…” How can you be so clueless…”How can you be so clueless…” He’s bright but lazy…”He’s bright but lazy…” She lives in her own world…”She lives in her own world…”

LJ Cohen @2000-2004LJ Cohen @2000-2004

ReferencesReferences Asperger’s Syndrome: A Guide for Parents and Asperger’s Syndrome: A Guide for Parents and

Professionals, Tony Attwood, 1998, Jessica Kingsley Professionals, Tony Attwood, 1998, Jessica Kingsley PublishersPublishers

Asperger Syndrome: Practical Solutions for a Difficult Asperger Syndrome: Practical Solutions for a Difficult Moment, Brenda Smith Myles & Jack Southwick, 1999, Moment, Brenda Smith Myles & Jack Southwick, 1999, AAPCAAPC

Asperger Syndrome: A Practical Guide for Teachers, Asperger Syndrome: A Practical Guide for Teachers, Cumine, Leach & Stevenson, 1998, David Fulton Cumine, Leach & Stevenson, 1998, David Fulton PublishersPublishers

Ohio Center for Autism and Low Incidence Ohio Center for Autism and Low Incidence http://www.OCALI.org/http://www.OCALI.org/

LJ Cohen @2000-2004LJ Cohen @2000-2004

Sources for Further Sources for Further InformationInformation

Tony Attwood’s homepage www.tonyattwood.com Tony Attwood’s homepage www.tonyattwood.com Sensory Integration International http://home.earthlink.net/~sensoryint/Sensory Integration International http://home.earthlink.net/~sensoryint/ American Hyperlexia Association http://www.hyperlexia.org/ American Hyperlexia Association http://www.hyperlexia.org/ Wrightslaw website--advocacy for children with disabilities Wrightslaw website--advocacy for children with disabilities

www.wrightslaw.org/ www.wrightslaw.org/ Face Blind!Face Blind! By Bill Choisser, an online book www.choisser.com/faceblind/ By Bill Choisser, an online book www.choisser.com/faceblind/ Social Skills resources by Carol Gray Social Skills resources by Carol Gray

http://www.thegraycenter.org/carol_gray.htmhttp://www.thegraycenter.org/carol_gray.htm Meeting the Needs of Children with Autistic Spectrum Disorders. Jordan Meeting the Needs of Children with Autistic Spectrum Disorders. Jordan

and Jones, 1999, David Fulton publishersand Jones, 1999, David Fulton publishers ““The Morning News” Publication of the Jenison Public Schools, ed. Carol The Morning News” Publication of the Jenison Public Schools, ed. Carol

Gray. To subscribe, call (616) 457-8955Gray. To subscribe, call (616) 457-8955 Pretending to Be Normal. Liane Holliday Willey, Jessica Kingsley Pretending to Be Normal. Liane Holliday Willey, Jessica Kingsley

Publishers, 1999Publishers, 1999

LJ Cohen @2000-2004LJ Cohen @2000-2004