Asperger's vs PDD NOS

[George-Enfield]

  I am asking for a group of clinicians a question concerning Asperger's and PDD NOS.
  We are working with a child who presents with all of the features of a child with Asperger's
  save one.  He has a significant speech delay.  In compliance with the DSM-IV, this individual
  was diagnosed with PDD NOS. The team does not feel that this is an accurate discription of this client
  Is there any discussion about Asperger's children with speech problems.  This client does not
  meet enough of the criteria for Autisum, and PDD NOS apears to unclear.  We would like to be
  accurate and consise when working with families and schools.  Are there any documented cases
  with similar histories, or are we simply stuck with an inconciss dianosis for the time being.
  Do you have any suggestions on were to explore this topic further?
Dear George:
The difficulties associated with PDDs have been recognized for decades although there has been disagreement regarding wcactly what lavel best fits the specific constellation of symptoms.  Some specialists view children diagnosed with PDD-Not Otherwise Specified or Asperger's Disorder as having a milder form of Autistic Disorder, sometimes called high-functioning autism.  Other argue that it is helpful to distnguish the non-autistic forms of PDD from Autistic Disorder.  Hence your confusion (as well as most of us).  Here is our classification of Asperger's Disorder at the CCF, it is used to describe children with relatively normal intellectual and language development but with marked deficits in social and interpersonal areas.  There has been little research in the US regarding this dianosis but the newley revised diagnostic manual for mental disorders outlines the diagnositic features of Asperberger's Disorder.  In general, persons with Asperger's disorder show severe dificits in social interaction and display repetitive/stereotyped behaviors without global delays in the acuisition of language or in cognitive functioning.  The majority of persons with Asperger's have some degree of language disorder although their language difficulties may be mild and related only to the use of language for socialization.  There is some subjective defining of terms here, meaning of the use of language for socialization.  However, if the language delay is global, then I would use PDD-NOS.  I am sorry that this doesn't help as much as you probably wanted.  As you and I know, strict criteria for diagnosis is usually for the literature game, if it looks like a duck, quacks like a duck, walks like a duck but does not have the feather texture of a duck, it is still a duck (albeit atypical).
Let me know if you need some further information.
Sincerely,
CCF Neuro:Pediatrics MD, RPS