PDD, and headaches

  Thank you for your time. My son was dianosed with PDD and has been in special services since 2nd grade, he is now in the 5th grade. The school has helped to start a Circle of Friends program to help him make friends but he still has a hard time. Some are nice to him but do not really include him in overnights and parties. He notices and says nobody likes him not even the girls. I try to say as little as possible and be a caring listener but it is difficult. Lately he has been complaining of headaches when he has a problem with someone at school, I don't know if it is physical or emotional. He is a very warm person that has a bad ability to socialise, does this improve with age? Is suicide a concern with people like this? He has been through a lot including a Neo Nazi with an AK47 rifle shooting at and around him at Synagogue yelling die Jew die. He has had some councling but it is very hard to convince him that the world is a pleasant place when he faces so much hostility. I try to keep him around people that love him and support him but I think he is getting more and more depressed. Thank you again  

[HVM Ph.D. - KDK]

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Dear Nancy,
As you probably already know, one of several distinguishing features of Pervasive Developmental Disorder is an impaired ability to interact with others, to maintain reciprocal social interactions. Because of their idiocyncracies or peculiarities, children with PDD are often shunned by their peers - they are seen as "different", and peers often do not readily relate to them. At the same time, many children who display PDD are not unaware of the reaction of others - they feel left out. This can be quite disheartening and lead them to develop negative self-perceptions.
Stress is frequently a contributing factor, and sometimes even the main cause, of headaches. Persistent, recurrent headaches certainly warrant evaluation. If the pattern to the headaches indicates that they are associated with unsatisfactory interactions with peers, the headaches may well be due to the stressful nature of your son's peer relationships.
Children with PDD, depending  on the severity of the condition (and there is a wide range of variation), improvements in relational ability can be achieved, but such improvements do not, generally, occur spontaneously. They occur when children participate in therapeutic groups, which have as their goal enhancement of social skills/social problem-solving skills. The more cognizant the child is about the nature of the peer-related difficulties, the more optimistic the prognosis for improvement.
As a parent, you are absolutely correct to engage in sensitive listening when your son speaks with you about his worries. You can't be his therapist, but you can try to locate help for him, such as the type of group therapy I mentioned above.
Relative to possible depression, it is not a condition which is necessarily associated with PDD, but children who display PDD may well display a depressive disorder as well. It would be wise to have your son evaluated by a child mental health clinician - part of the evaluation could also address his PDD-related needs, and the clinician could be helpful in locating a social skills or social problem-solving group.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
*Keyword: Pervasive Developmental Disorder