Pervasive developmental disorder

(Redirected from Pervasive development disorder) Developmental disorder; related to autism "PDD" redirects here. For dementia associated with Parkinson's disease, see Parkinson's disease dementia. For other uses, see PDD (disambiguation). Not to be confused with PDD-NOS or Developmental disorder. Medical condition

Pervasive developmental disorder
Specialty	Psychiatry, pediatrics

The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), was a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. It was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) (from 1980 to 2013), and the International Classification of Diseases (ICD) (until 2022).

The pervasive developmental disorders included autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), childhood disintegrative disorder (CDD), overactive disorder associated with mental retardation and stereotyped movements, and Rett syndrome. The first four of these disorders are commonly called the autism spectrum disorders; the last disorder is much rarer, and is sometimes placed in the autism spectrum and sometimes not.

There is a division among doctors on the use of the term PDD. Many use the term PDD as a short way of saying PDD-NOS. Others diagnose the general category label of PDD because they are hesitant to diagnose very young children with a specific type of PDD, such as autism. Both approaches contribute to confusion about the term, because the term PDD is intended by its coiners and major bodies to refer to a category of disorders and not be used as a diagnostic label.

The terminology PDD and ASD is often used interchangeably and varies depending on location.

The onset of pervasive developmental disorders occurs during infancy, but the condition is usually not identified until the child is around three years old. Parents may begin to question the health of their child when developmental milestones are not met, including age appropriate motor movement and speech production.

The fifth edition of the DSM removed PDD as a category of diagnoses, and largely replaced it with ASD and a measure of the relative severity of the condition. The eleventh edition of the ICD also removed the category.

Signs and symptoms

Symptoms of PDD may include behavioral and communication problems such as:

Difficulty using and understanding language
Difficulty relating to people, objects, and events; for example, lack of eye contact, pointing behavior, and lack of facial responses
Unusual play with toys and other objects.
Paranoia, a characteristic form of social anxiety, derealization, transient psychosis, and unconventional beliefs if environment or routine are changed without notice
Repetitive body movements or behavior patterns, such as hand flapping, hair twirling, foot tapping, or more complex movements
Difficulty regulating behaviors and emotions, which may result in temper tantrums, anxiety, and aggression
Emotional breakdowns
Delusional or unconventional perception of the world
Maladaptive daydreaming

Degrees

Children with PDD vary widely in abilities, intelligence, and behaviors. Some children do not speak at all, 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—loud noises, lights—are common.

Diagnosis

Diagnosis is usually made during early childhood. Individuals who received diagnoses based on the DSM-IV maintain their diagnosis under the autism spectrum disorders. However, an editorial published in the October 2012 issue of American Journal of Psychiatry notes that, while some doctors argue that there is insufficient evidence to support the diagnostic distinction between ASD and PDD, multiple literature reviews found that studies showing significant differences between the two disorders significantly outnumbered those that found no difference.

The World Health Organization’s International Classification of Diseases, 10th edition (ICD-10) categorized PDD into five distinct subtypes, each with their own diagnostic criteria. The five subtypes, childhood autism, atypical autism, Rett syndrome, Asperger syndrome and childhood disintegrative disorder, are characterized by abnormalities in social interactions and communication.

The disorders were primarily diagnosed based on behavioral features, although the presence of any other medical conditions is important, it is not taken into account when making a diagnosis.

Before the release of the DSM-5, some clinicians used PDD-NOS as a "temporary" diagnosis for children under the age of five when, for whatever reason, they are reluctant to diagnose autism. There are several justifications for this. Very young children have limited social interaction and communication skills to begin with, so it can be difficult to correctly diagnose milder cases of autism in toddlers. The unspoken assumption is that by the age of five, unusual behaviors will either resolve or develop into diagnosable autism. However, some parents view the PDD label as no more than a euphemism for autism spectrum disorders, while the PDD label makes it more difficult to receive aid for early childhood intervention.

Classification

The pervasive developmental disorders were:

Pervasive developmental disorder not otherwise specified (PDD-NOS), which includes atypical autism, and is the most common (47% of autism diagnoses);
Typical autism, the best-known;
Asperger syndrome (9% of autism diagnoses);
Rett syndrome; and
Childhood disintegrative disorder (CDD).

The first three of these disorders are commonly called the autism spectrum disorders; the last two disorders are much rarer, and are sometimes placed in the autism spectrum and sometimes not.

In May 2013, the Diagnostic and Statistical Manual–5th Edition (DSM-5) was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperger syndrome, Rett syndrome, and CDD, has been removed and replaced with the general term of autism spectrum disorders (ASDs). The American Psychiatric Association has concluded that using the general diagnosis of ASD supports more accurate diagnoses. The grouping of these disorders into ASD also reflects that autism is characterized by common symptoms and should therefore bear a single diagnostic term. In order to distinguish between the different disorders, the DSM-5 employs severity levels. The severity levels take into account required support, restricted interests and repetitive behaviors, and deficits in social communication.

PDD and PDD-NOS

There is a division among doctors on the use of the term PDD. Many use the term PDD as a short way of saying PDD-NOS. Others use the general category 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 a diagnosis. To further complicate the issue, PDD-NOS can also be referred to as "atypical personality development", "atypical PDD", or "atypical autism".

Treatment

Further information: Autism spectrum § Treatment

Medications are used to address certain behavioral problems; therapy for children with PDD should be specialized according to the child's specific needs.

Some children with PDD benefit from specialized classrooms in which the class size is small and instruction is given on a one-to-one basis. Others function well in standard special education classes or regular classes with support. Early intervention, including appropriate and specialized educational programs and support services, play a critical role in improving the outcome of individuals with PDD.

References

^ World Health Organization (1992). The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. World Health Organization. ISBN 92-4-154422-8. OCLC 28294867.
^ Lord C, Cook EH, Leventhal BL, Amaral DG (2000). "Autism spectrum disorders". Neuron. 28 (2): 355–63. doi:10.1016/S0896-6273(00)00115-X. PMID 11144346. S2CID 7100507.
^ Johnson CP, Myers SM, Council on Children with Disabilities (2007). "Identification and evaluation of children with autism spectrum disorders". Pediatrics. 120 (5): 1183–215. doi:10.1542/peds.2007-2361. PMID 17967920.
^ National Dissemination Center for Children with Disabilities (NICHCY) (October 2003) Disability Info: Pervasive Developmental Disorders (FS20). Archived 2008-03-09 at the Wayback Machine Fact Sheet 20 (FS20)
Autism Health Center. "Pervasive Developmental Disorders (PDDs)". WebMD. Retrieved 2013-06-29.
Posar, Annio; Resca, Federica; Visconti, Paola (2015). "Autism according to diagnostic and statistical manual of mental disorders 5(th) edition: The need for further improvements". Journal of Pediatric Neurosciences. 10 (2): 146–148. doi:10.4103/1817-1745.159195. ISSN 1817-1745. PMC 4489060. PMID 26167220.
^ This article incorporates public domain material from NINDS Pervasive Developmental Disorders Information Page. National Institutes of Health.
^ Baird, G.; Douglas, H. R.; director, a.; Murphy, M. S. (2011-10-21). "Recognising and diagnosing autism in children and young people: summary of NICE guidance". BMJ. 343 (oct21 1): d6360. doi:10.1136/bmj.d6360. ISSN 0959-8138. PMID 22021468. S2CID 31196910.
American Psychiatric Publishing. "Autism Spectrum Disorder" (PDF). American Psychiatric Association. Retrieved 4 July 2013.
Jon Baio, EdS, National Center on Birth Defects and Developmental Disabilities, CDC (2012). "Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008".
Autism Research Institute. "DSM-V: What Changes May Mean". Retrieved 29 June 2013.

External links

CDC's "Learn the Signs. Act Early." campaign - Information for parents on early childhood development and developmental disabilities
NINFS Pervasive Developmental Disorders Information Page

Classification	D ICD-11: 6A02.Z ICD-10: F84 ICD-9-CM: 299 MeSH: D002659 DiseasesDB: 33524
External resources	eMedicine: ped/1780

v t e Autism
Main	Causes Diagnosis Epidemiology Epigenetics Heritability History Memory Pathophysiology Sex and gender Societal and cultural aspects Therapies
Diagnoses	Pervasive developmental disorder Autistic disorder Asperger syndrome Pervasive developmental disorder not otherwise specified Childhood disintegrative disorder High-functioning autism
Associated conditions and phenomena	Alexithymia Autism and LGBTQ identities Autistic burnout Autistic catatonia Autistic masking Autistic meltdown Echolalia Echopraxia Emotional dysregulation Hyperlexia Infodumping Late talker Monotropism Nonverbal autism Pathological demand avoidance Pronoun reversal Savant syndrome Special interests Stimming Sensory overload
Comorbid conditions	Avoidant/restrictive food intake disorder Attention deficit hyperactivity disorder Anxiety disorder obsessive–compulsive disorder Developmental coordination disorder Epilepsy Intellectual disability Sensory processing disorder Global developmental delay Developmental verbal dyspraxia
Associated syndromes	22q13 deletion syndrome Angelman syndrome CHARGE syndrome Cohen syndrome Cornelia de Lange syndrome DiGeorge syndrome Down syndrome Fetal valproate spectrum disorder Fragile X syndrome MECP2 duplication syndrome Neurofibromatosis type I Noonan syndrome Multiple hamartoma syndrome Rett syndrome Smith–Lemli–Opitz syndrome Timothy syndrome Tuberous sclerosis Williams syndrome
Related issues	Autism rights movement Critical autism studies Discrimination Double empathy problem Employment Multiple complex developmental disorder Neurodiversity TEACCH program Twice exceptional Violence and autism
Controversies	Facilitated communication Lancet MMR autism fraud MMR vaccine Rapid prompting method Thiomersal Chelation Combating Autism Act Autistic supremacism
Diagnostic scales	Autism Diagnostic Interview Autism Diagnostic Observation Schedule Childhood Autism Rating Scale Gilliam Asperger's disorder scale
Screening scales	Autism-spectrum quotient Childhood Autism Spectrum Test Ritvo Autism and Asperger Diagnostic Scale
Lists	Autism-related topics Fictional characters Schools
Accommodations	Autism-friendly Sensory friendly
Category

Mental disorders (Classification)

Adult personality and behavior

Sexual	Ego-dystonic sexual orientation Paraphilia Fetishism Voyeurism Sexual anhedonia Sexual anorexia Sexual maturation disorder Sexual relationship disorder
Other	Factitious disorder Munchausen syndrome Fear of intimacy Gender dysphoria Intermittent explosive disorder Dermatillomania Kleptomania Pyromania Trichotillomania Personality disorder

Childhood and learning

Emotional and behavioral	ADHD Conduct disorder ODD Emotional and behavioral disorders Separation anxiety disorder Movement disorders Stereotypic Social functioning DAD RAD Selective mutism Speech Cluttering Stuttering Tic disorder Tourette syndrome
Intellectual disability	X-linked intellectual disability Lujan–Fryns syndrome
Psychological development (developmental disabilities)	Pervasive Specific

Mood (affective)
Bipolar Bipolar I Bipolar II Bipolar NOS Cyclothymia Depression Atypical depression Dysthymia Major depressive disorder Melancholic depression Seasonal affective disorder Mania

Neurological and symptomatic

Autism spectrum	Autism Asperger syndrome High-functioning autism PDD-NOS Savant syndrome
Dementia	AIDS dementia complex Alzheimer's disease Creutzfeldt–Jakob disease Frontotemporal dementia Huntington's disease Mild cognitive impairment Parkinson's disease Pick's disease Sundowning Vascular dementia Wandering
Other	Delirium Organic brain syndrome Post-concussion syndrome

Neurotic, stress-related and somatoform

Adjustment

Adjustment disorder with depressed mood

Anxiety

Phobia	Agoraphobia Childhood phobia Social anxiety Social phobia Anthropophobia Specific social phobia Specific phobia Claustrophobia
Other	Generalized anxiety disorder OCD Panic attack Panic disorder Stress Acute stress reaction PTSD

Dissociative

Somatic symptom

Physiological and physical behavior

Eating	Anorexia nervosa Bulimia nervosa Rumination syndrome Other specified feeding or eating disorder
Nonorganic sleep	Hypersomnia Insomnia Parasomnia Night terror Nightmare REM sleep behavior disorder
Postnatal	Postpartum depression Postpartum psychosis
Sexual desire	Hypersexuality Hypoactive sexual desire disorder

Psychoactive substances, substance abuse and substance-related
Drug overdose Intoxication Physical dependence Rebound effect Stimulant psychosis Substance dependence Withdrawal

Schizophrenia, schizotypal and delusional

Delusional	Delusional disorder Folie à deux
Psychosis and schizophrenia-like	Brief reactive psychosis Schizoaffective disorder Schizophreniform disorder
Schizophrenia	Childhood schizophrenia Disorganized (hebephrenic) schizophrenia Pseudoneurotic schizophrenia Simple-type schizophrenia
Other	Catatonia

Symptoms and uncategorized
Impulse-control disorder Klüver–Bucy syndrome Psychomotor agitation Stereotypy

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