Pervasic Developmental Disorder

[Lodo]

My six 1/2 year old son was diagnosed with Pervasive Developmental Disorder.  He is currently enrolled in an emotional support class where he can receive more individualized attention.  He is extremely bright and seems to be more advanced than even my 7 year old in his academic work.  The problem is his behavior.  Yesterday, his teacher called to say that he just refuses to do his work.  He just puts his head down and will not do anything.  I went to his school to talk with him and he found this very amusing.  His teacher then told me that she feels that she does not feel that this is autism, but just obstinance. She said if he were her child, when he refuses to work in school, she would make him sit at home and take away all privileges (TV, video games, computer, toys).  When he got home that day, he had a note saying that she took his arm to attempt to get him to do his work and he bit her.  After that he did complete his work. I told her I would try her suggestion.  I sat him in a chair facing the wall.  After he knocked the chair backwards twice, I took the chair away and made him stand.  Although I had to constantly tell him to turn around and face the wall, he did stay in the general area I put him in.  I guess it was a start.
I guess what is bothering me is the fact that now she feels that he is only being stubborn, while I still see that he is not a "normal" child emotionally.  ( I have four other children, ages 15, 7, 5 and 6 weeks).  The symptoms that originally lead to the diagnosis were:  late language development (around age 3); extreme reactions to loud noises (ie: school bells ringing, doorbells, screaming or yelling); compulsiveness and obsessions (if he is interested in something, that is all he thinks about or wants to do); does not interact with his peers or siblings, prefers to be by himself; he likes to wrap himself up in blankets or a towel and almost always strips down to his underwear as soon as he comes home.  When he was smaller he had an obsession with hair and fur and when he would rub his face in it, he would make a noise and keep repeating it.  He doesn't do this anymore with the fur, but he does like to repeat things over and over again.  Also, his frustration level is non-existent, usually screaming when someone anoys him or when he is unable to do something.  Any suggestions on what my next step should be would be appreciated.

[Kevin Kennedy, Ph.D.]

Dear Lodo,

Actually, the diagnosis seems pretty appropriate, as far as it goes. My sense is that your son also displays some sensory integration problems, and this should be explored if it already hasn't. The teacher's suggestion makes some sense, since you will likely be able to support better school performance by the collaborative behavior managemnt plan instituted between home and school. You'll have to figure out what might be appropriate rewards/punishments. It would also be sensible to schedule a consultation with a child psychiatrist, to consider any options re: medication. It may not be needed, but is worth checking out because it might be a tool that enhances his performance.