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could this be pdd
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could this be pdd

i have an 8yr old daughter that im very confused about,when she was a baby she flapped all the time,seemed to hate everybody,hated routine changes,sensory issues and speech at the age of 8 not much has changed she still has language delay,sensory issues,communication delays,she also loves to open and close her hands,make repeative sounds,echolalia,she also has bad temper tantrums especially if she gets overheated,hears a sound she does not like,or if she sets up a dollhouse and someone moves anything out of place,she also lines up everything.there is alot more but thats just a little of what she does.
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Hi, I have copied the diagnositic criteria from DSM IV for autism.  Everything you mention falls under autism and sensory integration issues.  For a diagnosis of PDD your daughter would have to be too able in one of the areas below.  But she does have the language delay.  Has a Speech and Language Therapist told you it is delay and not disorder?  With delay there is a possibility that it will improve, with disorder that is for life.  If she is 8 and using echolalia that suggests a disorder and not delay.  And echolalia is present in alot of autistic children, including my son.
I would also recommend you read an article by Olga Bogdashina which is on the autism today website.  If you google her name it will bring up the article.  As your daughter has alot of autistic behaviours down to sensory issues I would recommend reading her book Sensory and Perceptual Differences in Autism and Aspergers.  An Occupational Therapist should be working with your daughter to help with these difficulties.
Please post back saying what country you are in, what type of school your daughter goes to  and why your daughter has not been diagnosed yet.
Has your daughter not been assessed yet?  If not then a multi-disciplinary team should assess her through Health.  So you need to see your local doctor or paediatrician.

The following is from Diagnostic and Statistical Manual of Mental Disorders: DSM IV]
(I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C)

(A) qualitative impairment in social interaction, as manifested by at least two of the following:

1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
2. failure to develop peer relationships appropriate to developmental level
3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
4. lack of social or emotional reciprocity ( note: in the description, it gives the following as examples: not actively participating in simple social play or games, preferring solitary activities, or involving others in activities only as tools or "mechanical" aids )

(B) qualitative impairments in communication as manifested by at least one of the following:
1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(C) restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:
1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole-body movements)
4. persistent preoccupation with parts of objects

(II) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
(A) social interaction
(B) language as used in social communication
(C) symbolic or imaginative play

(III) The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder

she goes to a regular school 3 days a week and i homeschool the other 2 but when she is in school she has a one on one,as far as her language delay i honestly ont know if they said delay or disorder i thought delay was the only word they used,but she has had a delay since i can remember and she had hardly no words untilshe was like 4.i also did the diagnostic manual on her and here is what she scored.she had 2 from A,3 from B,2 from C,and on the bottom where it says delays or abnormal functioning she had A and B.i have taken her to 3 different psychs one says aspergers,one says PDD and one says selective mutism and mood disorder.i dont know who to agree with.
The problem you seem to have is no firm diagnosis, and therefore your daughter will not be getting the right level of support, or if the level of support is appropriate, they will not be teaching her in ways she will understand or get the most benefit from.
Are the Ed Psychs you have seen been through referrals?
What diagnosis are they running with at the moment?
Although selective mutism and mood disorder and autism can be together, the problem I see is that selective mutism and mood disorder do not cause the speech delay/disorder, or social interaction problems or explain the restricted patterns of behaviour.
As it is quite possible to have these conditions together I think you need to see an Educational Psychologist who specialises in autism/aspergers.  Can you go to your GP and ask for a referral?  If you can afford to pay for it I would recommend getting an independent assessment done by an Educational Psychologist who specialises in this area.  If you contact a law firm that specialises in educational law they should be able to give you some details of professionals they have used in the past.
The benefit of getting a private independent report done is that they will give you a diagnosis and advise on the level of support and what kinds of support your child 'needs'.  A state Ed Psych will always have in mind 'what the state can offer'.  That is two different things.
Why are you home schooling.  Is it because she cannot cope to go to school full time?
If that is the case, then again you may benefit from some specialist legal advice.
If your daughter has autism/aspergers, and selective mutism, and a mood disorder then you are looking at quite a complex case, and a 'normal' mainstream school is not going to be able to cope.
im so depressed and sad right now because i feel as though im failing my daughter,i guess im just doing things all wrong.the problem i keep havin is the school they lie constantly they told me last week tha she was doing great which dont get me wrong that is great but they tried telling me she was interacting with a couple boys and i find that absoultly bull sh'''';;;t excuse my french because my daughter will not initiate any conversation without someone she has known her whole life to do it first.when we were leaving i loked at my daughter in front of the teacher and said honey whats ur new friends name and she looked at me like WHAT ARE U TALKING ABOUT,and said who mumma and i said the 2 little boys u have been talkin to and she said real meanly i havent talked to a boy.i even said mariah that would be awsome sweetie to see u make a freind but she kept saying i only talk to the teacher.i just dont understand why they would lie like that they are not hurting me they are hurting my child.i woul give my life to see my baby act like a typical 8yr old but she just wont.i also wanted to mention that as far her speech delay the school tried telling the state that it is me and her dads fault because we didnt give her enough social interaction but thatis untrue and i cry everytime i think about it because i would never intentionaly hurt my kids,she has had just as much social oportunites as my other 4 kids i even kept bringing her to playgroups when she wasyounger she just would not interact,she has also been in dance class with about 10 other girls the same girls  for 2yrs and she not once tried to make a friend i even went to the exteme of makin her friend but nope she said hi one time while i was standing there and never again talked to that little girl.during recital she went in the bathroom and a little girl told mariah to say somethng so mariah said hi and the kid told her she talks hurtful.
If it is any consolation there are many stories I hear like yours.  I recently made contact with another mother whose 8 year old son had been sent to a psychiatrist for 3 years with behavioural/mood/personality problems until he was recently diagnosed with Aspergers.  The things is, that once you factor in the difficulties that children have due to autism/aspergers then you understand the strange behaviours, supposed mood and personality problems because it is part of the disorder.  (But remembering of course that there can also be things like bi-polar along with the autism as well).
You are not failing your daughter, you are hanging on in there, taking her to be seen by people who are supposed to be specialists and they are letting you and your daughter down.
Your daughter is only a year older than my son, and I too have had him in mainstream school and have only just appointed a solicitor because of his lack of progress and the Education Authority and its professionals blatant lies and deception.
So, have a good cry, pick yourself up, and get on the phone.
Find an advocacy service for parents/children who are on the autistic spectrum or at least who have experience of helping with educational needs.
I would go back to my GP and, as above, request that she is referred to a communication centre or clinic that deals specifically with autism/aspergers and I would make sure I kept that appointment no matter where it was in the USA.
If you can afford to get a private report do so.  But it would be worth asking a law firm to recommend an Educational Psychologist rather than just picking one out of the phone book.  You need someone experienced in autism and other childhood disorders and you need them to be independent and not tied to the Educational system in any way.
The most important reports are from an Educational Psychologist, Speech and Lanaguage Therapist and Occupational Therapist.
Can you clarify what they mean by a mood disorder?  I have heard of Oppositional Defiance Disorder, but that is different.
Regarding the speech delay.  Has a Speech Therapist given her that diagnosis?  There is a big difference between delay and disorder.  A delay implies that she will catch up, whereas a disorder is for life.
My school also told me that my son is interacting better with his peers.  Well, to some extent I would expect that as I am paying for private Play Therapy sessions.  But they don't seem to recognise that the 'quality' of his play is very poor, usually involving trying to repeat what he has seen on TV or involves chasing games.  He finds it hard to adapt his play to what the other children are doing which usually results in him or them getting angry/upset.  His attempts at play are becoming more and more age inappropriate and if something isn't done soon his peers will not accept him.
The reason I ask about the language delay diagnosis is that my understanding is that echolalia (although part of normal speech development up to a certain age, ie 2-3) is present only in autism.  I don't know of any other condition or disorder that has echolalia apart from autism.  I don't think someone with Aspergers would have echolalia.  And echolalia indicates a severe speech disorder for someone who is aged 8.  Bearing that in mind she is probably having huge difficulties understanding the spoken language in the classroom and will have problems with following instructions, sequencing tasks, planning etc.  She will also have problems with producing her own speech and although she well have selective mutism, it is also quite possible that she doesn't speak because she cannot find the words to express what she wants to say in the timeframe allowed for her to do so.
she does the echolalia usually when we say a number like if i say a number on a house she will repeat it 5 times more,she also does it with movies u know like if they say something funny she will repeat it 50 times more and sometimes she will say it for days later.also if me and my husband are havin a conversation she will out of nowhere talk about something else that has nothing to do with what weare talkin about and usually something that happened days earlier.the other thing u said about her ocupational therapist being hte one to say what she thinks about her dx well she already did she said definitly a PDD,as far as speech tharapist she has only been in the school one and well u know how they are everything is normal.she is going to a private speech tharapist this friday so we will have to see hopefully they are more intuned.
With the echolalia (which you must mention to the Speech Therapist) they tend to learn language in chunks rather than the meaning of individual words.  They can then use those phrases either correctly in their emotional context eg. if my son is really angry about something I have asked him to do (usually tidying up!), he will saying something like 'this place is a dumping ground'.  That is a phrase from a TV series about children in care.  Or he may say 'I'm going to send you to Timbuktu'.  That is a phrase from Walt Disney's The Aristocats.  They can also use echolalia to turn take, as in the example you gave ie. you ask her a question and she says something (to take her turn in the conversation), but it is totally unrelated to the question you asked.  This indicates an understanding of the turn taking part of conversation, but indicates that in the timeframe allowed to her she is unable to formulate a response to your question either because she didn't understand what you said or she couldn't put together her reply quick enough, so she uses an echolalic phrase to take her turn.  
They can be very good at understanding the background emotional context of a phrase they have heard on TV and will use that phrase appropriately.  So you have to analyse the bizzare reply you got to see what the emotional meaning behind it might be.
There can also be difficulties with associations for example if your daughter was bitten by a dog called Jack she might use the word 'Jack' to mean a 'dog', or to mean 'a bite' or to mean 'frightened or hurt'.  So, for example, she might be very upset and you ask her 'what's wrong' and she will reply 'Jack'.  If you know what has  happened previously with the dog called Jack you have got a better chance of interpreting what she means.
Good luck with the Speech Therapist.
thanku u are very helpful,and as far as her getting in my conversation  didnt ask her a question i was talkin to my husband and she yelled over me,she does that all the time.she can be extremly rude,she is always yellin over me even if im on the phone.
Don't be depressed... it sounds like you have a bad school system, and bad doctors to deal with.  I'm upset that they would blame you for not giving your daughter ample social interaction.  Which is BS because she has to socialize with 4 siblings!  She has 4 siblings to watch, to observe, to hear them talking, etc.  

If my daughter can get a diagnosis of PDD at not yet 3 (they will not specify which type, whether autism or PDD-NOS --aspergers is ruled out because of language delay and they ruled out fragile X as well by genetic testing-- since she is quite young), then I do not understand why they can't diagnose your daughter at age 8.  You need to get her in to see a top rated specialist.  We waited almost 5 months for our first visit to the developmental pediatrician (he was quite highly rated).  She has seen him 3 times since March, and he was well worth waiting to see.  Developmental pediatricians are great.  Some people see pediatric neurologists.  Her specialist was covered by our insurance (sometimes genetic testing is not, so before they draw any blood check to see what your benefits cover).  Also sometimes the therapist teams they use to do an assessment are not covered by insurance.  Again, you would want to check with your insurance and with the office.  Sometimes the doctor can get an assessment without his team of therapists doing the tests.  Our insurance didn't cover the therapist team that he had, but we found out what the cost would be and decided to go ahead and have his team do a complete evaluation.  Our daughter is in the process of qualifying for a developmental preschool through the public school system, and having a diagnosis helps going in because I don't trust the public school system to accurately diagnose or test my daughter.  They will of course do their evaluation and tests to see if she qualifies and where to place her, but they will also look at the doctor's evaluation and diagnosis and use that as a basis.  I guess it saves them work and time and hence money to have it already done.  

Anyways, I wish you luck trying to get your daughter diagnosed.  It is a very frustrating process.  I guess I can see what I have to look forward to with the school system with my daughter.
thanku for caring,the school actually had the nerve to say family dont count as social interaction,LMAO what the hell is the difference?interaction is interaction i guess the idiots think my family is all morons and we cant teach her how to do anything.she has had ample social experiances i always had her around people i would have 20 people over at a time for birthday paries and everything she just didnt know how to interact.
If that were the case then all your children would have these problems.  
But the important thing for you to do is to either get a referal through your GP to a multi-disciplinary specialist team that can diagnose autism.
If you can afford it pay for a private report.
Your daughter is now 8, and in the UK alot of the supports eg. Speech and Language Therapy stop in Secondary School (11 years onwards), unless your child goes to a Special School.
Although she is only 8, it could take a while for referals and reports etc.  But you need to have a definate diagnosis and reports for you to access the right kind of schooling for your daughter.  
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