PDD-NOS

[Mom to Robbie]

Our DS Robbie at 37 months was just diagnosed with PDD-NOS. Brief med history- born full term but with under developed lungs,in NICU for 2 weeks, intubated for 3 days. He is in perfect health now. We noticed a delay in speech, so started Speach Therapy at 22 months. Since March he is repeating everything we say and putting some 2-3 words together.He is still not where he should be at 36 months,but there has been a big improvement. I noticed a lack of eye contact 6 months ago and finally getting an appointment last month with a very cold psychatrist,(not friendly at all!) he was diagnosed with PDD.One month after this dx his eye contact is getting so much better. He loves to be around other kids when we can find some(not many in our neighborhood)He's not afraid to go out to public places. He use to hit himself in the head whenever he was frustrated, and look at me to see if I was watching. Since I turn my head when he does this, it barely happens anymore.The only stimming he does is with a favorite stuffed frog where he pats his mouth or chin easily.Maybe 1-2 times daily, when he gets up and goes to bed. My husband will say" no stimming" and Robbie repeats "no stimming" and stops. Barely has tantrums. We use a 1-2-3magic approach where if we call him to do something if at first he doesn't come we say 1, then 2, he will do as asked before we get to 3. On the rare occasion he doesn't, he goes to his room for a time out.
My question is, could he really have PDD? I read so much where most kids regress.He seems to be improving.As stated before the psychatrist was not kid friendly, but he took so well to the developmental doctor, she actually wanted the psychatrist to  re-evaluate him, but they thought to give him the dx so he could get TSS services, they couldn't hurt.
My husband feels with his rough start in life that he is just developmentally behind, and once he gets around other kids his age and starts pre-school he is going to be fine.He plays with toys ok. The only issue is he seems to have an obsession with the pipe on our roof, or any roof . He will just point to them and say "Pipe!"This is not an all day occurance.
I would just like an opinion,could we be in denial, maybe he is high functioning, or maybe we should get a second opinion?
Appreciate any input!!
Thank you!
Robbie's mom

[Kevin Kennedy, Ph.D.]

It's certainly possible that your son displays PDD, but on the basis of what you have described it seems not very likely. Except in moderate-severe instances, it can be difficult to discern PDD in very young children, and it often does happen that development proceeds well after some initial problems. For your own reassurance you can always seek a second opinion, but at his young age I'm not so sure it will help. In other words, if there's nothing to be gained by way of treatment or intervention, it really isn't necessary to engage in additoinal diagnostic work at this point.