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MummaFi
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06 Feb 2011, 8:46 am

Can someone explain to me the difference in severity between aspergers and PDD-NOS?

I mean....which one is more severe in terms of impairments or closest to classic autism?



Thanks :D



azurecrayon
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06 Feb 2011, 9:07 am

its a spectrum, even within the individual diagnoses its still a spectrum. so it depends on the individual.

the diagnosis is not determined by severity, but basically just fulfilling a set number of traits. how severe those traits impair the individual isnt part of the diagnosis. classic autism must fulfill at least 6 of the basic categorical traits and additional traits, asperger's must fulfill 3 categorical traits and additional traits, pdd-nos just means they dont fulfill the correct number of categorical traits to be diagnosed classic or asperger's, or they dont fulfill the additional traits, or they dont show them in the correct pattern (for instance instead of 2 from A and 1 from B to get asperger's diagnosis, they have 1 from A and 2 from B and thus dont fulfill asperger's criteria).

severity of impairment isnt determinable by the diagnosis either. some with asperger's or pdd-nos may be more severely impaired than those with classic autism. a higher number of displayed observable traits doesnt mean more severe impairment.

so i guess the answer to your question is "neither" reliably. which i suppose is one reason they are doing away with the multiple diagnoses and going to one diagnosis with varying levels of severity.


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C - 8 yrs NT
N - 15 yrs school dx AS


MummaFi
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06 Feb 2011, 9:55 pm

AH! Thanks for that clarification.

I guess that we will have to wait until 2013 for the DSM V to be published before we can truly say exactly what LEVEL of impairment my kids have? :)



BonnieBlueWater
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06 Feb 2011, 11:22 pm

My son was recently diagnosed with Aspergers as opposed to PPD-NOS because the psychologist said in terms of the school system - I;ll have an easier time getting services with an "Asperger" label.... You might want to consider this,,,



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07 Feb 2011, 5:50 am

MummaFi wrote:
Can someone explain to me the difference in severity between aspergers and PDD-NOS?

I mean....which one is more severe in terms of impairments or closest to classic autism?



Thanks :D


Neither has anything to do with level of severity. A diagnosis of PDD-NOS is given when a person may meet some, but not all of the diagnostic criteria of AS, or some, but not all of the diagnostic criteria for autism.



azurecrayon
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07 Feb 2011, 9:53 am

MummaFi wrote:
I guess that we will have to wait until 2013 for the DSM V to be published before we can truly say exactly what LEVEL of impairment my kids have? :)


even then it may be difficult unfortunately. the severity levels as they currently stand seem pretty..... vague? confusing? for instance, i dont see a distinctive, clear difference between
lvl 3--"very limited initiation of social interactions and minimal response to social overtures from others"
lvl 2--"limited initiation of social interactions and reduced or abnormal response to social overtures from others"
lvl 1--"difficulty initiating social interactions and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions"

it is all still going to be subjective based on who is doing the observation. but instead of getting AD or AS or PDD-NOS mixed up, we will get LVL 1 or LVL 2 or LVL 3 mixed up. it doesnt help that they break the categories down into two, social communication and restricted interests & repetitive behaviors. so you may end up with two different levels of severity for the two categories for the same person. i dont know how they plan to rectify the level discrepancy, or if they plan to.

another issue is that someone may, in just ONE category, fall into two different severity levels. for instance, my son is very verbal and high functioning, but his social deficits are so severe that in his peer group he would probably qualify as lvl 3 as listed above in the social communication category. however for the verbal part of the social communication severity scale, he more closely matches lvl 2 or even lvl 1.

overall, i think the consolidation of multiple asds into one listing of asd is good, however i dont see that they will be able to reliably and accurately place people on a severity scale with only 3 levels. thats not much better than LFA and HFA used currently. there are so many ways that autism affects someone, ways that their functioning is impaired depending on the situation, that virtually no one can fit just one severity level at all times.

heck, one major trait of autism is the meltdown, which i know for my son and SO, drops them at least one full severity level down the scale when it happens =) in some instances, two severity levels! i anticipate in my household, the phrase for a difficult day is going to change from "he's having an autistic day" to "he's having a lvl 3 day". based on this mornings getting ready for school, today is a solid lvl 2.


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partner to: D - 40 yrs med dx classic autism
mother to 3 sons:
K - 6 yrs med/school dx classic autism
C - 8 yrs NT
N - 15 yrs school dx AS


MommyJones
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15 Feb 2011, 12:31 pm

My son was diagnosed with PDD-NOS, however the original evaluator gave him an ASD diagnosis to help with the school, because they said that PDD-NOS won't help him get services. For the record, ASD didn't either. They also said that he would have been diagnosed with Aspergers if it wasn't for his language delay. That is the ONLY criteria that distinguished the two for him, but it's my opinion he is more Aspergers..primarily because he has a strong desire to have friends and be a part of a group, he just doesn't have the pragmatic skills to be terribly successful, particularly in a non structured environment. He is extremely intelligent but he has a real hard time using Language. It's not natural for him at all. He also was 15 weeks premature and I would bet the language delay would not have happened if he were born full term. In addition, it has been suggested that he's not on the spectrum at all, but that he's gifted. 8O

It's all so subjective, and there are so many spectrums within the spectrum that you can have 2 completely different people with the same "diagnosis". I gave up on trying to figure out where exactly my son fits in all of this, and I just focus on the things that he needs help with. I find that far more useful, and I also feel that if you limit yourself to the label you may be overlooking something outside of that label that you need to address.

Like all kids, my son is really good at some stuff and has a really hard time with others...I nurture one and support the other and hope I am doing the right things along the way.



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16 Feb 2011, 6:33 pm

My son was diagnosed as PDD-NOS/possible Aspergers when he was 2.5 yrs old. Now that he is 5.5 many, but not all of the Aspergers traits are starting to come out. I am with MommyJones. I quit trying to fit him into a category. Now I mainly tell people that he has mild autism. That seems to work just fine. As far as services with the school, the early diagnosis was very helpful for us, and my son is making big strides in some areas, and not so much in others. My son does not seem to have classic autism, and he does not seem totally Aspie either, so I think PDD-NOS for us is somewhere in the middle.



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21 Feb 2011, 1:58 am

My daughter was diagnosed with PDD-NOS at age four (she's currently five), though the psychologist explained the diagnosis was only temporary till she could be better evaluated at a later age. He personally thought she would probably fit more into the Asperger's category. While it is true my little girl doesn't have all the symptoms of Asperger's, in my personal opinion, autism encompasses such a wide spectrum that trying to fit people into little boxes is just knit picking. I think a lot of people who are diagnosed with PDD-NOS probably are actually Aspies.

-Bill, otherwise known as Kraichgauer



loramath
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21 Feb 2011, 6:23 am

Each kid is so different from one another, even if they are diagnosed the same. I feel we are just trying to fit them inside concepts because "spectrum" isn't so easy to manage for us, doctors and our governments.

Fortunately, you can find parents and therapists that know they should just focus on strengths and weaknesses on every kid, ignoring what "should" a kid with this diagnosis be.

Basically, no preconceived ideas is the way to go.



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21 Feb 2011, 11:28 pm

MummaFi wrote:
I guess that we will have to wait until 2013 for the DSM V to be published before we can truly say exactly what LEVEL of impairment my kids have? :)


A book does not know what level of impairment your child has. You are the best person to judge the level of impairment while your child is young, but it takes a lot of self-education, patience, and observation. Ultimately it will be up to your child to say what level of impairment s/he has, but s/he may not be able to do that until s/he is an old enough or even an adult.



loramath
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24 Feb 2011, 5:12 am

Exactly, no book will tell you. Basically a human being is such a huge collection of skills, and each one of these skills can be affected in so many different ways and degrees ...

My suggestion is usually: try to focus on those skills that will enable your kid to fully function on his own at school/work and with other NT people, at least to some extent. He/she will probably have to start learning a few basic things way ahead of other kid's of his/her same age, so that he ends up knowing them fully well at the same age.

Don't worry about the future too much, because only time will tell and no doctor will be able to do it. Each kid development is unique, for good and for bad.

Sorry about my english, it's not my first language. I hope you understand it.



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04 Mar 2011, 6:10 pm

MommyJones wrote:
My son was diagnosed with PDD-NOS, however the original evaluator gave him an ASD diagnosis to help with the school, they also said that he would have been diagnosed with Aspergers if it wasn't for his language delay. That is the ONLY criteria that distinguished the two for him, but it's my opinion He is extremely intelligent but he has a real hard time using Language. In addition, it has been suggested that he's not on the spectrum at all, but that he's gifted. 8O

It's all so subjective, and there are so many spectrums within the spectrum that you can have 2 completely different people with the same "diagnosis". way.

Hi mommyjones,
Thanks for your post, my daughter is in exactly the same position as your son. She is extremely bright and I am getting fed up with the spectrum label business. Our pediatrician advised us shell get more funding under ASD and later we could rediagnose when she is more verbal. We want the best for our kids and the dsm spectrum labels are neither helpful or really informative. We are playing games to get funding at school.



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04 Mar 2011, 9:23 pm

PDD-NOS is EXACTL:Y what it says! NOT OTHERWISE SPECIFIED! So it is worse AND better than AS! Basically it is a catch all for PDD items not otherwise noted.



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05 Mar 2011, 12:07 am

I was diagnosed with severe PDD/with autistic traits. The only thing that kept me from getting a classic autism dx is that I am highly imaginitive, and engaged in alot of imaginitive play, and that I did not set strict routines for myself, but I do better with them, and I hate change but I get bored with sameness too. All the other criteria applied. My mom had no idea untill I was in my 20's that pdd was on the autism spectrum and I was diagnosed when I was eight!


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