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Old 04-13-2009, 02:28 PM   #11
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Re: Pervasive developmental disorder? *long*

Developmental pediatricians may use some but not a full comprehensive battery as that is not their specialty. Developmental peds usually refer out to a clinical psych, neuropsych even the school district to conduct the evaluations they are unable to do. I guess it's possible to have a D.P who is qualified in assessments but they would have to have a dual degree

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Old 04-13-2009, 06:04 PM   #12
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Re: Pervasive developmental disorder? *long*

I'm not sure why the pedi told you that. Pervasive developmental disorders are all the disorders that are grouped with autism. So, autism, PDD-NOS, Asperger's, Rett Syndrome, and Childhood disintegrative disorder are all the disorders that fall under the umbrella term of pervasive developmental disorders (also known as the spectrum). So, it wouldn't make since for him to tell you that your child didn't have autism, but may have pervasive developmental disorder, unless he was talking about PDD-NOS (pervasive developmental disorder, not otherwise specified).

I would see if you could find a neuro-psych who specializes in autism if you are seeking a diagnosis. The wait list may be long. The one my son was diagnosed by had year wait list (which turned into 1.5 yr wait). We got in when we did only because of a cancellation.
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Old 04-13-2009, 07:50 PM   #13
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Re: Pervasive developmental disorder? *long*

I'm no help for you but I was glad you posted. My little guy turned 3 in March and still has just a handful of words. We have seen a neurologist and are going to a developmental pedi in July...I'm dreading and wanting a diagnosis so I can deal with what we have. Your story did give me some hope that it may not be Autism, or at least not on the severe end
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Old 04-13-2009, 10:00 PM   #14
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Re: Pervasive developmental disorder? *long*

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Originally Posted by ladylee View Post
Developmental pediatricians may use some but not a full comprehensive battery as that is not their specialty. Developmental peds usually refer out to a clinical psych, neuropsych even the school district to conduct the evaluations they are unable to do. I guess it's possible to have a D.P who is qualified in assessments but they would have to have a dual degree
I think your information is incorrect. Developmental Pediatricians are trained to diagnose behavioral disorders in children. Here's a little bit from CHOP about their fellowship program: http://www.chop.edu/consumer/jsp/div...c.jsp?id=75540

Developmental Pediatricians have an MD (obviously), plus a 1 year internship in Peds, a 2 year residency in Peds, and a 3 year fellowship only in Developmental Peds. That's a lot of training in behavioral pediatrics. While getting my son diagnosed we have seen 2 child Psychs and 2 developmentalists, and the knowledge base of the child psychs was so-so, but the Developmentalists have both blown me away. For one thing, the psychologists used a cookie cutter 30 minute screening test for my ds, lpus the same sensory screening test that he has done a gazillion times (it is geared towards sensory avoiders, not seekers, so they are useless for my kid). Both the Developmentalists spent 2 hours on the Bailey and the CARR for him, and then spent another hour just giving me suggestions, like companies that provide wearable GPS systems for kids with developmental disabilities if they tend to wander off, like my son does. One of the psychs told me that he has asperger's, because she didn't know that Asperger's doesn't present with a speech delay, and the other just said he has autism, and walked out without being able to answer any of my questions.

That's not to say that there is no value in psychologists. My degree is in psych with an emphasis in child development, so I obviously am partial to psychology, but after watching what my dh has learned to get his board certification in Peds (and he's only a general pediatrician), I have come to realize how little I know. An on top of that, how little he really knows since he is just a generalist. It's going to be interesting to see how much more specialty training he gets once he starts his fellowship and subspecializes.

The bottom line of what I'm trying to say is, a Ped Neurologist, Child Psychologist or Ped Developmentalist are all qualified to diagnose autism. I choose to take my son to a Ped Developmentalist, personally, but that may not be a good fit for everyone. I feel like my son has gotten more detailed care from that specialty, but that's just us.
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Old 04-14-2009, 06:15 AM   #15
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Re: Pervasive developmental disorder? *long*

Sorry OP for getting OT.
PP - You have such wonderful information!! You seem extremely knowledgeable. I looked back on the first page and see that I stated that Develomental Peds don't give ANY standardized assessment instruments. I shouldn't have said any as that information is wrong - sorry.
I know they give behavior rating scales and certain developmental rating scales all the time. My most recent post was correct, however.

Developmental peds are highly qualified individuals. All I am saying is that they are not qualified to give a lot of the assessment instruments that a psychologist can give.That is why there is usually a team approach in diagnosis.

I am a school psychologist and work very closely with developmental peds. Where did I say that D.Pediatricians don't diagnosis? We look for the developmental peds for an accurate diagnosis. I only said developmental pediatricians can't give the a lot of the assessment instruments that psychologists give. They are the ones who contact me and ask me to give specific assessment instruments that they don't normally give such as intelligence tests. We help each other.

I don't know any developmental pediatricians who can give intelligence tests, comprehensive academic tests and memory assessment instruments. They can give behavioral rating scales (i.e., BASC, Connors) and developmental instruments (i.e, bailey and I think Vineland Adaptive). - This is #3 on your link under educational goals for developmental pediatricians.....Provide instruction in the administration and interpretation of a variety of developmental and behavioral assessment tools for a range of ages and disabilities. Developmental and behavioral assessment instruments are not all considered a "comprehensive evaluation" although they are extremely helpful. The developmental pediatricians usually start from there, provide a diagnosis and often refer to a clinical or neuropsychologist. Sometimes the local developmental peds ask me and other school psychs to give specific tests if a more comprehensive neuropsych evaluation is not warranted.


On a personal level, I got a lot more information from a developmental pediatrician regarding behavior than I did from a clinical psych. I got more standardized information from the clinical psych that the developmental psych was able to give (not qualified in giving those comprehensive battery of tests). My son initially went to the developmental pediatrician who diagnosed my son with Autism and then referred him to a clinical psych for a more comprehensive assessment.

I highly encourage parents to see developmental peds even before neuropsych and clinical psychs. They have such indepth knowledge and are wonderful in diagnosis and helping individuals understand behavior. They have provided many good ideas for parents who are struggling with behavior in children.


Another great team member is a speech/language pathologist!! They specialize in communication disorders. I am frequently asking speech/language pathologists information. I think a developmental pediatrician, a neuropsychologist, speech pathologist and an occupational therapist (due to possible fine motor and sensory issues concerning a child on the spectrum) make a wonderful team for kids on the spectrum.

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Old 04-14-2009, 06:41 AM   #16
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Re: Pervasive developmental disorder? *long*

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Both the Developmentalists spent 2 hours on the Bailey and the CARR for him, and then spent another hour just giving me suggestions, .
PS - What is CARR? Do you mean CARS (Childhood Autism Rating Scale)? CARR is an assessment instrument I have never heard before. Perhaps that is a test we don't give but developmental peds typically give.

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Old 04-14-2009, 07:56 AM   #17
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Re: Pervasive developmental disorder? *long*

Thanks ladylee, I'm actually learning a lot, though I have to read some stuff more then once

My Pedi hasn't seen much of DS, only twice since we started this whole journey with DS. He has a very thick accent so I'm doing my best to translate what he says. I think I need to see him again by myself and see what he has to say.

Our speech therapist is wonderful but extremely busy, we don't see her as much as I would like. I will need to touch base with her quite a bit over the next few months as she is moving in July. I want her to be aware of what the Pedi said/suggested before she goes so we can have as much info as possible for her replacement.

I'm just so torn on this whole matter. DS is making so much progress over the last few months that it just astounds me. He's speaking in full sentences WITH grammar. ("This is a picture of Daddy," he said the other day!!) I feel like I'm starting to be able to connect with him, whereas before I always felt like here was some barrier there, I always felt like I was speaking to someone who didn't GET that the language was important, you know??

He's social, makes eye contact, his tantrums are lessening, and he's def not awkward or clumsy. the only traits that he is exhibiting at this point is the rocking and the lining up of toys. And as I mentioned before, there is a history of that behavior as well as late talking.

I think this is why the Pedi isn't pushing for us to be seen/assessed ASAP ( he said come back to see him in a year) Right now we are just going to focus on Preschool and seeing what kind of funding and help he will get while he is there.

Thanks mamas There is a lot of info here that is very helpful, I just need to re-read and absorb some of it.
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Old 04-14-2009, 09:51 AM   #18
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Re: Pervasive developmental disorder? *long*

If it was really just a speech delay and the lining things up/rocking then there really may not be a concern about autism.

Typical children do line things up and rock. It's when those things are in combination with the other things that a spectrum disorder is suspected. About the lining up things or the rocking, if you tried to stop him from doing those things or moved his lined up cars, how does he react? That's more important than the lining up. If he throws a complete tantrum and you can't calm him over his routine of rocking or lining up things being interrupted, then you may have something to be more concerned over.
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Old 04-14-2009, 10:23 AM   #19
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Re: Pervasive developmental disorder? *long*

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If it was really just a speech delay and the lining things up/rocking then there really may not be a concern about autism.

Typical children do line things up and rock. It's when those things are in combination with the other things that a spectrum disorder is suspected. About the lining up things or the rocking, if you tried to stop him from doing those things or moved his lined up cars, how does he react? That's more important than the lining up. If he throws a complete tantrum and you can't calm him over his routine of rocking or lining up things being interrupted, then you may have something to be more concerned over.
He gets upset when you move his toys, but I think it's because you are interrupting his play. I myself like to line things up and have things just so.

A lot of his rocking almost seems habitual, like he rocks when he is watching TV, or if he is bored (sits on the chair and essentially does sit-ups, I'm not sure how to explain it.) If he is upset he will rock, he does it if I reprimand him. I think it's his outlet for expressing himself, because he doesn't have the WORDS to express his needs/emotions.

I haven't been actively trying to stop him from rocking, but lately I have been going to him and talking him down, and hugging him and he has been responding to that. But if I were to just try and stop him without talking or offering sympathy he would get more upset because that has been how he has dealt with his emotions.

He never used to respond to emotional advances, he was never comforted simply because I picked him up. DD is totally different, she is very snuggly and was always calmed just be being held. She is very free with her love, lol. I personally think that DS is learning those behaviors from her, YKWIM?
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Old 04-19-2009, 12:11 AM   #20
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Re: Pervasive developmental disorder? *long*

I have a six year old on the spectrum...
First, I have to say this. The parent always knows. You can hope and wish but if you are concerned that he has it then he probably does. Hoping it's not and looking at his strengths not his weaknesses is not helpful. I know because that's what I did! I was worried starting around 18 months too and took him to EI myself. They assured me he did NOT have autism because he had joint attention, was social, blah blah blah. Fact is unless your child has classic autism and fairly impaired, no one wants to say OH yes, it's autism at 2 or 3. You'll get "boys talk later" "late talkers in the family" and so on. And yes, your child is improving because kids gain new skills all the time, autistic or not. I was happy to go along thinking my son wasn't autistic because I didn't want him to be. So I believed what they told me but deep down I knew things weren't right. It wasn't until my son was almost four that we got a diagnosis for ASD from a dev. ped. and that's because my son was getting so aggressive from frustration. My son actually has Asperger's or HFA--however you want to define it and he also meets the criteria for PDD. Basically that just means he's social, talks, wants friends and isn't classically autistic. Most people don't know he has autism unless they're around him a while or they see him with peers. You can't look at how he is with adults, you need to see his behavior with peers or compared to peers because that's the real eye opener. And getting upset if you move his stuff is very typical of ASD kids. Remember, it's a spectrum so some kids are really high functioning and some are not. Yours is probably high functioning. And there are lots of things worse than autism. People with autism have lots of great strengths and positives too. My son is doing great and yours will too. It's not a death sentence or the end of the world, it's just a difference. Don't lose valuable time hoping he doesn't have it. Assume he does, demand qualified people look at him and get the early intervention NOW that will help him rather than "wait and see" like many people will tell you. Waiting does nothing and can really hurt.
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