Why Does My Autistic Child Have Multiple Diagnoses?

Multiple diagnoses are very common among kids with special needs

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Does Your Child Have an "Alphabet Soup" of Diagnoses?

It's not unusual for a child to receive an autism spectrum diagnosis along with such diagnoses as ADHD,  obsessive compulsive disorder, non-verbal learning disorder, and sensory processing disorder. Why does this happen? What are the rules around diagnosis?

Of course, if your child has a developmental disorder like autism and also has a medical disorder such as diabetes, it's easy to understand the need for multiple diagnoses. But what if your child has a number of symptoms, such as repetitive actions, social communication delays, inattention, and speech delays, all of these can be part of or signs of multiple disorders? If your child's symptoms are relatively mild, your child might receive several different diagnoses before anyone picks up on the fact that the symptoms might be related -- and might, together, point to autism.

Why Is It So Tough to Provide a Single Diagnosis?

Unfortunately, there are no clear cut rules for diagnosing developmental delays and differences.

In fact, according to Dr. Ann Asher of the National Institutes of Health, "We recognize there are many causes of Autism Spectrum Disorders (ASD's); with that realization there’s more willingness to dually diagnose. People will give an ASD diagnose if a child meets the criteria, along with another diagnosis. There’s no hard and fast rule about this. The answer is based on tradition."

The Problem with Multiple Diagnoses

What does this mean to you? Your child, depending on which doctor or doctors he has seen, may provide a whole alphabet soup of diagnoses to describe symptoms. This can lead to some real problems for kids, parents, and teachers.

For example:

• A doctor may provide an Asperger syndrome diagnosis to describe social and communication differences, but also diagnose ADHD to describe attentional issues. The fact that the attentional issues result from sensory problems or communications issues related to the Asperger syndrome may be ignored, and the child may be put on ritalin or a similar drug to no effect.
   
• A doctor may provide an autism diagnosis along with a diagnosis of social anxiety, ignoring the fact that the social anxiety may well be an outcome of the autism. As a result, the child may be placed on an SSRI medication (most often used to treat depression, but also used for anxiety issues), while the environment which is causing the anxiety may not be addressed.
   

• A doctor may describe a child with autism as oppositional and defiant (ODD), without looking closely into what is causing the child's oppositional behavior. As a result, the child may be placed into a class with emotionally disturbed children when better supports and tools for anxiety management would have made inclusion possible.

It's important for parents to be aware that multiple diagnoses may or may not be appropriate, and to question diagnosticians when multiple developmental diagnoses are applied to their child. While your child with autism may, indeed, have multiple disorders, it may also be the case that an autism spectrum diagnosis covers all the facts -- and that appropriate autism treatments cover all your child's needs.

_Sources:

Interview with Dr. Ann Wagner, Ph.D. Chief, Neurobehavioral Mechanisms, Division of Services and Interventions Research, National Institute of Mental Health, National Institutes of Health, U.S. Department of Health and Human Services. September, 2010.

This is a very informative site that offers webinars, the latest research and touching stories. Topics include:

• ADHD
• Anxiety
• Autism
• Bipolar
• Depression
• OCD
• PTSD
• Schizophrenia
• Other

Link:
https://bbrfoundation.org/?utm_source=eNews+List&utm_campaign=29b3101f49-eNews_2_24_2016_A_B_Test&utm_medium=email&utm_term=0_fb7d503c0e-29b3101f49-162193297&goal=0_fb7d503c0e-29b3101f49-162193297

Girls and Autism

   Sunday 21 June 2015 5:05PM

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Most people tend to think of autism as a male disorder, the character in the film Rain Man often comes to mind. But emerging research shows that girls often have different symptoms which cause them to slip through the net—misdiagnosed or not diagnosed by clinicians. We look at why girls on the autism spectrum present differently, and whether these sex differences are biological or environmental. Image: One of the best known women with autism is Temple Grandin pictured speaking at TED in 2010 (Red Maxwell, Flickr, CC BY NC 2.0) 


Why Autism Spectrum Disorders are under-diagnosed in women and girls

     Thursday 25 June 2015 1:33PM

           By: Lynne Malcolm and Olivia Willis

Many people tend to think of autism as a male disorder, but emerging research shows that girls often have different symptoms which cause them to slip through the net. These girls and women are often misdiagnosed or go undiagnosed altogether. 

With the exception of a few notable women around the world, autism is widely considered to be a disorder that affects men.

Indeed, males are generally more affected by neurodevelopmental disorders than females, and boys account for more instances of ADHD, dyslexia and dyspraxia during adolescence. It appears that this imbalance is even more pronounced when it comes to autism spectrum disorder (ASD).

But as Francesca Happe, a professor of cognitive neuroscience at the Institute of Psychiatry in London, explains, statistics tell only part of the story.

We think the social difficulties in some girls with autism may be less obvious. Some women with autism describe a strategy of copying somebody. They pick somebody in their class or workplace and they just copy everything about that person: how they dress, how they act, how they talk.

Francesca Happe, Institute of Psychiatry, King's College

‘The general prevalence suggests that about four times as many males as females get an autism diagnosis, and this varies across the spectrum,’ she says. ‘So the proportions are higher in high functioning or more subtle forms of autism, and more even at the lower end of the spectrum where there is an intellectual impairment.’

Happe says that while the gender disparity can sometimes be explained by biological or environmental factors, it is plausible that women and girls are also under-diagnosed.

‘I think we know very, very little really about how autism presents in girls and women. There are some studies, but the main problem is that the studies start in a clinic. If we are missing women and girls with autism because we are not good at recognising them, then studying those we do spot isn’t going to tell us very much about the ones we miss,’ says Happe.

Dr Janine Manjiviona, a clinical psychologist based in Melbourne, agrees that girls are under-diagnosed and misdiagnosed.

‘When you historically have a look at the whole history of autism, originally in Kanner’s descriptions, they were largely focused on males, and Hans Asperger’s clinical cases were all male,’ says Manjiviona.

‘Because [females] can present differently, they’re often not recognized as having ASD, and can be misdiagnosed.’

Evidence is emerging that autism manifests differently in females than it does in males. Happe believes girls may be better at covering up the more obvious characteristics of the disorder.

‘We think the social difficulties in some girls with autism may be less obvious. Some women with autism describe a strategy of copying somebody. They pick somebody in their class or workplace and they just copy everything about that person: how they dress, how they act, how they talk. That kind of masking strategy we don’t see very much in boys and men with autism’.

Research on women with autism suggests that they are more impaired, experience more intellectual difficulty and are generally hit harder by the disorder than their male counterparts.

Happe suspects that this is largely a result of subtler cases of female autism being overlooked by the current diagnostic system.

‘It’s an interesting question, why we might miss girls with autism, because on the face of it you might think that our expectations of social functioning are even higher for girls than for boys, and so maybe we should be more alert to these difficulties,’ says Happe.
In some ways, it’s this contrasting gender binary that leads clinicians to make diagnoses based on sex, not symptoms.

‘An example would be that when a clinician is deciding if a child has autism, they will look for rigid and repetitive behaviour, which might include unusual special interests. A boy with autism might have a fascination with electricity pylons and know all the facts about electricity pylons, and the clinician is going to go “ah-ha!”, that sounds pretty odd to me,’ says Happe.
In contrast, a young girl with autism might present with a fascination with a particular pop group, and spend time learning all the facts about that she possibly can.

‘When she says her interest is this pop group, the clinician thinks, “Well, that’s pretty normal.” So unless he digs deeper and finds out that actually she has no interest in going to hear them perform or even listening to their music … the clinician is going to be fooled into thinking, “Okay, this isn’t autism.”’

Because ASD can be missed in girls, women often don’t discover it until later in their lives. Hannah Belcher was diagnosed with ASD at the age of 23 after many years of unsuccessful therapy for other psychological conditions.

‘I think the main problem was that my symptoms weren’t as obvious as they are in males … doctors just saw my anxiety and just saw that as the main diagnosis, without really considering why is that there,’ says Belcher.
Belcher concedes that she too assumed she had an anxiety disorder and the possibility of having autism never occurred to her until she was diagnosed.

‘I studied it and I still never considered that I could have autism because my view of autism was also quite male stereotypical,’ she says.

Belcher believes that girls and women with autism mask their symptoms because of the social pressures they face growing up. The expectation to be polite and socially adaptable means girls become very good at ‘social mimicking’.

Socialisation might play a key role in how girls and women on the autism spectrum present, however, there’s growing suspicion that the underlying biology of ASD in males and females is quite different.

‘I think there are probably both biological differences and social and cultural reasons why we may not be very good at picking up autism in girls,’ says Happe.

Read more: Horses, scientists and the search for an effective autism treatment

One explanation for the unbalanced ratio is what psychologists refer to as the ‘female protective effect’.

‘We’ve done some work that suggests that girls who have autism have been hit harder or have a larger genetic dose than boys with autism,’ says Happe. ‘You can tell this because if you look at their brothers and sisters, the brothers and sisters of girls with autism are more likely to have autism or some traits of autism than the brothers and sisters of boys with autism. That’s suggesting there’s a bigger genetic hit for girls than for boys.’

Essentially, this means that while girls are less biologically susceptible to the disorder, the girls that do have ASD are affected more significantly because their genetic risk factors for ASD are stronger.

Although researchers are not clear on exactly why boys are more likely to be affected by ASD, there are a number of theories.

‘Simon Baron-Cohen has the theory of the extreme male brain, which suggests that all of us have a balance between our ability to understand other people, which he calls empathising, and our ability to understand non-social systems, he calls systemising. He says that in a male brain, the systemising is highly developed and the empathising is less good, and that autism can be thought of as a very extreme version of this,’ says Happe.

Although she describes Baron-Cohen’s theory as ‘interesting’, Happe doesn’t fully agree, and says it ‘mushes together a whole lot of things’ that are in fact ‘quite distinct’.

When trying to understand or make an ASD diagnosis, Dr Janine Manjiviona emphasises the importance of gathering comprehensive information from multiple contexts in order to prevent girls slipping under the radar or being misdiagnosed.

Manjiviona says that there are a number of other conditions which can overlap with autism, and girls are most often diagnosed when they hit puberty. As a result, there can be a crossover between the symptoms of ASD and eating disorders such an anorexia nervosa.
‘Yes, anorexia is one of the conditions that overlaps with ASD. It’s not the only condition and there are lots of co-morbidity issues with ASD, but controlling weight can be a way of fitting in, looking right, it can be part of an attempt to gain social acceptance.’
Manjiviona offers therapy to girls and women with ASD to help them deal with their concept of themselves and the anxiety associated with that.

Donna Rigoni’s five-year-old daughter Ayla suffers from autism and was referred by Manjiviona to a therapy program that aims to help prevent anxiety developing.
‘She’s in a small group of three children which are at the similar level to her on the spectrum,’ says Rigoni.

‘Ayla has been taught that you think with your brain and you feel with your heart. She understands that people have thinking bubbles above their brain. She knows that you can’t see it, but she knows that if they are looking at something, they would probably be thinking about that thing.’

‘That has been really helpful because there are days where Ayla has upset me, and I’ll say to her, “You’re hurting my heart, Ayla,” and she’ll go, “Oh, okay.” So she gets that.’
Rigoni says the social therapy has been an ‘incredible help’.

‘I think the earlier girls are diagnosed, you can give them so much more help. What I’m hoping is by the time Ayla gets to puberty, we will be prepared,’ says Rigoni.

Related: What happens when Asperger's no longer exists?

Hannah Belcher’s autism was overlooked and misdiagnosed until her early twenties, and she says it’s critical to get the right diagnosis in order to prevent inappropriate treatment.
‘I want to see better diagnosis for females overall, and I want to see more females being picked up earlier in their lives when they can get the support at school they need, and just more awareness about the issue,’ says Belcher.

‘Certainly I think it’s a definite gap in our understanding of autism that needs to be addressed.’

Happe echoes this, and suggests that further study into the gender differences seen in autism may help our overall knowledge of the ASD.

‘There are women with autism who go and speak about their experiences and are such gifted orators, so funny, so poised on stage, that people really doubt that they even have autism,’ says Happe.

‘But then if you could see that same woman trembling at the thought of having to buy a ticket at the train station or having to brush past a dog in the railway carriage to get to her seat, you see the ability of some women with autism to mask their difficulties.’

‘Even though it doesn’t fit the stereotype of autism, it doesn’t look like Rain Man or one of the portrayals of male autism in the media ... how brave they are to struggle to live in our neurotypical world.’

Source:
http://www.abc.net.au/radionational/programs/allinthemind/why-autism-spectrum-disorders-are-under-diagnosed-in-women/6570896

Are There Really More Autistic Boys Than Girls?

Updated July 19, 2015. By Lisa Jo Rudy  Autism Spectrum Disorders Expert 

Read any source on autism, and you'll learn that boys and men with the diagnosis outnumber girls and women by a factor of at least 4:1. The gender gap increases with higher functioning individuals (those who would, in the past, have been diagnosed with Asperger syndrome) to something like 11:1.

The idea that autism is a "male disorder" has become so well-established that some researchers (particularly Simon Baron-Cohen) have described autism as the manifestation of an "extreme male brain." Baron-Cohen points to traits such as apparent lack of empathy, focus on details and ordering, talents in the areas of math and science, and a preference for routine, saying that these are all manifestations of "maleness," and are also very common in autism.

Baron-Cohen and his colleagues have taken this idea to the lab, where they have explored the idea that more testosterone in the womb is likely to lead to autism. Just a little extra testosterone, he hypothesized, could be enough to push boys into autism. Some of their research suggests the possibility that this idea could hold water.
At the same time, however, other researchers have explored the question of whether autism may simply be under-diagnosed in girls. They, too, are finding some intriguing results.

At the Kennedy Krieger Institute in Baltimore, for example, researchers are finding that girls with autism are more likely to slip under the radar because they think and behave differently from boys with the disorder:
Girls struggled more with the ability to recognize social cues and interact with others. They had trouble interpreting requests made of them, took things too literally, struggled to understand jokes and couldn't read into people's tone of voice or facial expressions...

On the other hand, boys exhibited much more physical symptoms. They engaged in repetitive behaviors, like turning the wheel of a toy around and around for extended periods, as well as unusual mannerisms such as flapping their hands..

In addition, boys with autism often express fascinations with topics considered "odd" by the general population (e.g., memorizing timetables or lists of statistics) while girls with autism seem to have fairly gender-appropriate fascinations which must be examined closely in order to appear "autistic." For example, a girl with autism might express a fascination with a pop star, pin up his posters, and know everything about his daily routine  -- which appears "normal" to most parents -- but know little or nothing about his music.

Girls with autism also appear to be less likely to act out and more likely to find adaptive behaviors that allow them to function at least semi-successfully in typical settings. For example, rather than showing aggressive or hyperactive behavior (which, of course, is noticed even in preschoolers) girls with autism may withdraw, become passive, or even become depressed. 

Quiet, "shy," or passive girls are culturally acceptable, and quiet girls are rarely picked out as problem children -- especially if they have a relatively high IQ and are capable of functioning in a school setting. As a result, girls on the spectrum may not be identified as such until they reach their teen years and are completely unable to manage the complex social expectations surrounding sexuality, flirting, and romance.
It seems very likely that the number of girls with autism will appear to rise in the next few years as more girls are identified with the disorder. The question of whether those girls were always there, however, may remain open.

Sources:
Baron-Cohen S¹.The extreme male brain theory of autism. Trends Cogn Sci. 2002 Jun 1;6(6):248-254.
DeWeerdt, S. Autism characteristics differ by gender, studies find. Simons Foundation, 27 March 2014.
Dworzynski K. et al. J. Am. Acad. Child Adolesc. Psychiatry 51, 788-797 (2012)
Sarris, M. Not Just for Boys: When Autism Spectrum Disorders Affect Girls. Interactive Autism Network at Kennedy Krieger Institute, February 19, 2013.

8 Differences Between Boys and Girls with Autism

Updated July 22, 2015. By Lisa Jo Rudy  Autism Spectrum Disorders Expert 

 The diagnostic criteria for autism doesn't discriminate between boys and girls or between men and women. But recent research findings suggest that autism may look quite different in girls--so different, in fact, that it can be difficult to diagnose. One researcher at the Kennedy Krieger Interactive Autism Network raised this question in a report on Girl's with ASD: Researchers looking at differences between boys and girls with ASD have often not found much difference. Is this because there is no difference, or because only girls with ASD who most resemble boys with ASD are diagnosed and therefore included in studies?

One difficulty that researchers experience is that girls with autism seem to behave in ways that are considered acceptable -- if not ideal -- for girls as opposed to boys. For example, girls with autism may appear to be passive, withdrawn, dependent on others, uninvolved, or even depressed (just as boys do). They may become passionately and even obsessively interested in very specific areas (just as boys do), but they may not gravitate toward the "geeky" areas of technology or math. Sadly, in western culture, girls who exhibit these behaviors are more likely to be ignored or bullied than diagnosed and treated.
With all those caveats, however, research is moving forward, and providing us with more clues to ASD in girls. 


Based on recent research, here are a few of the ways in which girls with autism appear to differ from boys with autism:

1. Boys with autism tend to have very repetitive and limited areas of play. Girls with autism are less repetitive and have broader areas of play.
2. Girls with autism are more likely than boys to be able to respond to non-verbal communication such as pointing or gaze following. They are also somewhat more focused and less prone to distraction.
3. While boys' social-communication issues become challenging very early in their lives, girls may be able to manage the social demands of early childhood but run into difficulties as they enter early adolescence.
4. According to the Kennedy Krieger report, Boys with ASD may tend to engage in disruptive behavior to gain objects, while girls with ASD may tend to engage in disruptive behavior to get attention.
5. Girls with autism are more likely than boys to also suffer from anxiety and/or depression.
6. While girls with autism do have perseverative interests, they are more likely to choose interests (such as TV stars or music) that appear more typical than, for example, many boys' perseverative interests in schedules, statistics, or transportation.
7. Girls with autism are less likely to behave aggressively, and more likely to be passive or withdrawn.
8. It is fairly common for girls with autism to appear socially competent as youngsters because they are "taken under the wings" of other girls who enjoy mentoring their peers. These mentors often fade out of the picture as they enter adolescence and find other interests or groups of friends.

Sources:
DeWeerdt, S. Autism characteristics differ by gender, studies find. Simons Foundation, 27 March 2014.
Dworzynski K. et al. J. Am. Acad. Child Adolesc. Psychiatry 51, 788-797 (2012)
Nichols, Shana. A Girl's-Eye View: Detecting and Understanding Autism Spectrum Disorders in Females. Interactive Autism Network at Kennedy Krieger Institute, December 2009.
Sarris, M. Not Just for Boys: When Autism Spectrum Disorders Affect Girls. Interactive Autism Network at Kennedy Krieger Institute, February 19, 2013.

The Mindful Classroom

By Janelle Cox   Elementary Education Expert 

The mindful classroom is more than just a place where students live in the moment. It's a place where students are able to control their thoughts, communicate their feelings to their peers, and cultivate a peaceful learning environment. Mindfulness is not something new, ancient Buddhists have been practicing this technique for decades. Then yogis started to use it, and now scientists have backed up the facts and benefits of it so the public has really taken notice to it.

Here we will take a look at what's it's all about, the amazing benefits for your students (and yourself) and how you can introduce it to your classroom.

What are the Benefits of Mindfulness?
You may have read about mindfulness or heard it the news and thought, this is something for people that meditate. While it can be used in meditation, it's much more than that. Doctors use it in their practice, and dietitians recommend it to their clients who need to be mindful when they are trying to loose weight. Now, teachers are using it their classrooms to help students focus. Here are a some of the amazing benefits that research has found:

• Reduces stress hormones
• Improves attention span
• Boosts memory
• Enhances self-insight
• Improved academic performance

Just by focusing your attention and being in the moment, this calming tool can be so helpful. By calming the mind, students will be able to control their negative thoughts and learn to focus.

How Can a Teacher Introduce Mindfulness to their Students?
Now that you know a little bit about mindfulness, here are a few tips on how to introduce it to your students.

1. Breathe. Encourage students to use their breath throughout the day, or take about 10-15 minutes of class time to have students do a few deep breathing techniques. Start by having students sit comfortably, either on top of their desks or on the floor. Then have them close their eyes and focus on their breath. Have them focus on their inhales and their exhales, trying to lengthen them each time they breathe. If they feel like they are unfocused and their mind is wondering (which will happen) have them count up to ten each inhale and exhale. Once they get the hang of it, this is something that they can do by themselves throughout the day.

2. Mood Journal. An effective way to get your students to understand their moods and feelings is to have them keep a mood journal. This is a great resource to help them learn to recognize their feelings and why they are having them. Once they look back at what they wrote they can be mindful of how they feel. This will help them learn how to cope with their feelings and find a way to deal with them.

3. Chimes. Chimes are a very calming sound that when heard can help remind students to focus their thoughts on what they are doing in that moment. When students here the sound of the chimes in class they will stop what they are thinking and doing, and just know to direct and focus their thoughts. It's also a great way to get and keep your students attention.

4. Experiment. Not all students will be able to be mindful of their breathing. While with some students, breathing may be all it takes to calm their mind, others may need more. So you can experiment with a few different mindful techniques. Try having students talk a walk and listen to the sounds that they hear. Or, have them count the sounds that they hear as they walk. You can even have students listen to a song or a poem. As long as they are being mindful with what they are doing, their are using mindfulness.
The human brain is very powerful, by teaching your students mindfulness, you are giving them a tool that they can take with them, and use whenever they feel the need to reduce their stress.

6 Autism Terms That Have Disappeared from the Textbooks

By Lisa Jo Rudy

Autism Spectrum Disorders Expert 

Updated June 17, 2015.                  

Over the years, the words used to describe autism and people with autism have changed radically.  Today, there are many terms that have either been removed from diagnostic literature or retired from polite conversation.  Here are just a a few :

1. Childhood Schizophrenia.  What would cause a child to be inwardly focused, non-verbal, unable to respond appropriately to social cues?  For many years, doctors and researchers assumed that such behaviors were a result of mental illness.  While the symptoms of autism are quite different from those of schizophrenia, they are similar enough to suggest a connection.  Thus, during the 1950's and 60's, many children with more severe symptoms of what we now call Autism Spectrum Disorder were diagnosed with Childhood Schizophrenia. That diagnosis, however, has long since disappeared from the diagnostic manuals.
2. Refrigerator Mother.  How might a child become so distanced from others that he or she is unwilling or unable to communicate, make eye contact, or engage in ordinary play?   Bruno Bettleheim and Leo Kanner (the man who gave autism its name) believed that the problem related to cold, distant "refrigerator mothers" who so traumatized their children that they literally drove them into autism.  Very fortunately, later research showed that the refrigerator mother theory held no water -- but many parents were blamed, unnecessarily, for their children's autistic symptoms.
3. Infantile Autism.  The term "early infantile autism" was coined by Leo Kanner in 1943. Dr. Bernard Rimland, the parent of a child with autism, became a major player in the work of understanding and treating the disorder.  His work entitled "Infantile Autism" was an important step toward that goal.  Infantile autism referred to what might be called "severe" autism, and it entered the diagnostic manual in 1980 (with the DSM III).  In 1987, with the publication of the DSM IV, the term disappeared from common usage.
4. Asperger Syndrome (or Asperger's Syndrome).  Hans Asperger was a German pediatrician who studied the symptoms of young people who were nowhere near as disabled as those with infantile autism but who, nevertheless, had significant challenges in the areas such as social communication. Asperger's work was largely ignored (due in part to World War II) until decades later. In 1980, Asperger Syndrome became an official diagnosis in the DSM III.  In 2013, however, with the DSM 5, Asperger Syndrome ceased to be an official diagnosis.  Today, while the term is still widely used to describe what many call "high functioning autism," it is no longer a true diagnosis.
5. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).  Like many autism-related terms, PDD-NOS came into use in 1980 and disappeared again in 2013.  PDD-NOS was a catchall diagnosis intended to describe children who didn't entirely fit the autism criteria but were clearly more severely (or differently) challenged than children with Asperger syndrome.  Like Asperger Syndrome, PDD-NOS became a very popular diagnosis, with numbers soaring between 1980 and 2013. Today, of course, there are exactly zero people with a PDD-NOS diagnosis!
6. Mentally Retarded.  Even in the fairly recent past (less than one hundred years ago) people with cognitive challenges were referred to by doctors as idiots, morons, and imbeciles (depending upon their level of challenge).  The term "mental retardation" was actually coined to avoid the use of those much more negative terms. Today, as the term has gained greater negative connotations, most people have replaced it with "cognitively challenged" or "intellectually disabled."  As a side note, it's important to know that typical IQ tests are not always appropriate for people with autism -- for whom spoken language can be a challenge.  Thus, while many people with autism are diagnosed with cognitive challenges, that diagnosis is not always correct.

What is PDD-NOS?

This Article Written By Lisa Jo Rudy

Autism Spectrum Disorders Expert 

My child has been diagnosed with something called PDD-NOS. What is PDD-NOS? Is it the same thing as autism?

Answer: PDD-NOS is an outdated diagnostic category which stands for pervasive developmental disorder not otherwise specified.  In essence, it's a diagnosis that means "on the autism spectrum, but not falling within any of the existing specific categories of autism."
To explain more fully: up until May 2013, there were five disorders that fell under the category of "pervasive developmental disorders" (PDDs).

• Autism
• High Functioning Autism
• Children with Autism
• Autistic
• Autism Spectrum Disorder

These included Autism, Asperger syndrome, Rett syndrome, Fragile X syndrome, and PDD-NOS. Autism, Asperger syndrome, Rett syndrome and fragile X were all specifically described in the DSM-IV -- the manual that practitioners used to diagnose neurological 

                                     disorders. 

Once the DSM-5 was published, however, the term PDD-NOS "disappeared" from the diagnostic literature.  Most people who once had the PDD-NOS diagnosis would now be considered to have an "autism spectrum" diagnosis instead.
Here is the explanation of PDD-NOS which describes what the diagnosis WAS, before it was removed from the DSM in 2013:                                                                                                                                                     Many children have some symptoms of one PDD and some symptoms of another, but not enough of any one of the four specific disorders to receive a diagnosis. Thus, they do have a PDD -- but they do not have Rett syndrome, fragile X, Asperger syndrome, or autism.

Leading with Intelligence - The Multiple Intelligence of Teams 

This article is very informative and puts learning styles at the forefront. This article can help us better understand our coworkers as well can be kept in mind when working with students offering, "Tips for Managing this person"
    ~comments from Susan

Leading With Intelligence 
By Tyler Hayden BRM (OEE)

Learn more about Tyler Hayden   at www.tylerhayden.com

To better reach our team members leaders have long looked at personality instruments like Myers-Briggs, and we have had great results in generating management approaches based on personality profiles. Today however, we need to consider more than just personalities. We work within industries that have an employee base that have spent many years constructing who they are through years of formal education. This educational profile is the new gateway to applied leadership strategies for managers.

Write down the following eight learning styles on a sheet of paper. As you read the descriptions below jot the names of co-workers, friends and family that would have high skill in that learning domain beside those learning styles. By understanding peoples learning styles we can begin to better design training approaches, team structure, reward and recognition strategies, communication strategies, and more. Consider these eight different learning styles you'll find in your employees.

Body/Kinesthetic Learner

This intelligence indicates a well-developed sense of body control and movement while being able to handle objects skillfully. These learners express themselves well through movement. By interacting with the space around them, they are able to remember and process information. (i.e. athlete, firefighter, coach, police, dancer, actor)

Tips for Managing this person: We respond to short explanations, practicing tasks, constructing things, and setting goals. Be face-to-face with us as often as possible. We love when you champion us to actively find solutions. Let us keep "moving and doing" to keep us engaged at work. And please, be efficient with your words.


Interpersonal Learner

This intelligence indicates a keen ability to relate to and understand others. Individuals have a seemingly innate ability to see things from other people’s perspectives in order to understand how they think and feel. They often have an unprecedented ability to sense the feelings, intentions, and motivations of others. They are great organizers; although, they sometimes resort to manipulations to achieve their ends. Generally, they encourage group peace and cooperation. They use both verbal and nonverbal language to open communication channels with others. (i.e., counsellor, sales person, business person, clergy, service personnel)

Tips for Managing this person: We respond to public recognition and assignments that involve working with people. Remember that we can inspire a crowd we can bring people onside to help or demolish you. Give us an opportunity to lead projects. Please ensure that we don't work alone. Only have conversations that are conflict based in private. Finally, ensure that we "get our turn" when in a group setting.


Interpersonal Learner

This intelligence indicates a keen awareness of one’s inner state of being. These learners try to understand their inner feelings, dreams, relationships with others, and strengths and weaknesses. (i.e. researcher, adventurer, explorer, philosopher)

Tips for Managing this person: Accolades should be kept private and meaningful. We are self-motivated to do the things we are passionate about. Communicate with us in a way that allows us to "craft a response" over time i.e. email. We enjoy learning in a mentor/mentee relationship and self-reflection/discovery time. I am very good at developing visions and missions. We can tend to be "cut and dry" so please help us soften our impact on others. Finally, we are not comfortable with the "leap of faith" or risk taking, so please be sure you really mean it if you are asking us to do this.


Verbal Linguistic

This intelligence indicates a highly developed ability to use words and language effectively. Individuals have highly developed auditory skills and generally are very good speakers. Learners with a heightened Linguistic Intelligence tend to think in terms of words rather than pictures. (i.e., lawyer, teacher, sales, consultant, politician)

Tips for Managing this person: We are your go to for verbal and written communication. We love to debate you (or anyone for that matter). We like to have things documented so that we can refer to it. Please take time to consult with us to find solutions we like to be part of things if we are going to be tasked with it in our portfolio. Finally, remember that we have an opinion - please take the time to hear us.


Musical Intelligence

This intelligence indicates an increased ability to produce and appreciate anything musical. Individuals tend to think in terms of sounds, rhythms, and patterns. They are affected deeply by what they hear and can become distracted by external noise. (i.e., DJ, musician, composer, singer)

Tips for Managing this person: I get patterns and can deconstruct a larger concept very easily. I can be sensitive, so please don't push too hard I am self critical and like things done right. If at all possible, have things set out in logical patterns. We will be very excited about a product or service once it is delivered perfectly. Finally, I love to have music playing and it will often reflect how I feel, plus be careful of "external noise" it drives me crazy.


Mathematical/Logical Intelligence

This intelligence indicates a heightened ability to use reason, logic, and numbers effectively. These learners think conceptually in logical and numerical patterns, making connections between pieces of information. They are very curious about the world around them. They ask a lot of questions and enjoy experimenting. (i.e., medical personnel, accountant, scientist, researcher, engineer)

Tips for Managing this person: I really like when explanations are kept short and not full of "fluff." Give me the answer efficiently and effectively. I will like to experiment to find the best way of doing things. If you want me to get involved challenge me to find the answer (and make my success measurable). Manage me by the numbers, if we can't measure it, it doesn't exist. Please show me how your request has a logical sequence and that ultimately it is measurable and connected to "real" business objectives (a.k.a. the bottom line).


Naturalistic Intelligence

This intelligence indicates a keen ability to see the connections and cycles of natural processes. They enjoy classifying things into areas of responsibility, placement and category. They easily connect cause and effect and illustrate patterns. They appreciate knowing how things are connected to real life. (i.e. project manager, landscaper, outdoor guide, engineer)

Tips for Managing this person: I get how things are connected, cycle and flow. If you need someone to figure out the "process" of doing something I should be part of that. Classifying things into logical chunks is easy for me and I like doing it. I can really understand things better if you show me a map or chart that I can follow to measure my performance. Finally, I get the idea of cause and effect in a really deep way and I'm an awesome "big picture" thinker.


Visual/Spatial

This intelligence indicates an increased ability to perceive the visual cues. Individuals tend to think in terms of pictures and movies. In order to retain information, they need to create vivid visual images. (i.e., artist, mechanic, web/graphic designer, architect)

Tips for Managing this person: I will speak to you in terms of how I "see" the final product. I love to build, construct, draw, layout, etc a task or work item visually. We really appreciate beauty and form in our work, things are finished till they look nice. I like to have visual reminders at my workstation. If we are working on something, a chart, map, or movie is really beneficial it grounds the concept for me. Finally, show me a picture of what you are thinking wherever possible, I'll get us there and even a bit more.


Tyler Hayden is a management consultant, professional speaker, and author. He works with groups internationally building meaningful and content rich leadership and team solutions. Learn more about him at www.tylerhayden.com. Finally, if you are looking for a special tool to connect to family please explore his new inspiring book series www.messageinabottlebook.com.