PDD or Asperger's?

[prncessme]

My almost 3 year old daughter (in less than a month) has been diagnoised with OCD and a generalized anxiety disorder by her neurologist. He has also said that he believes she suffers from PDD (didn't say NOS though) and wants us to see a group at the children's hospital to further diagnose the PDD. Since it takes so long to get into the place he also suggested a developmental pediatrician and a child psychiatrist that could prescribe her medication for her OCD/anxiety (this I am NOT comfortable with). When telling her speech therapist and Occupational therapist the diagnoses they agreed with them all BUT the PDD. They believe it's Asperger's and have for a long time (she has been in speech and OT for 2 years-same therapists). After asking the neurologist about Asperger's vs. PDD he said that he doesn't think it's Aspergers since she doesn't have a "scowling" face, that she is "sweet".
My question is this...is there any other autism's that look just like asperger's with the ocd tendiencies and anxiety that when faced with things that upset them that they withdraw instead of "voicing" their concerns and still can have good eye contact? By the way...she has no social skills at all.

[William L. Holcomb, Ph.D., BCBA-D]

I would definitely have your daughter seen by a team specializing in developmental disabilities in young children.  The diagnosis of OCD in a child who is not yet three years of age seems somewhat unusual to me (likewise, the suggestion for medication).  Other than saying your daughter has no social skills, you have not described much of her behavior.  You did mention that she has been receiving early intervention program (EIP) services since the age of less than one year, which leads me to believe that deficits (things like lack of communication, social relatedness) and excesses (preoccupation with objects, repetitive behavior) must have been pretty distinct at a very young age.  If she has been receiving EIP services, I recommend you work with her team there to come up with a plan for addressing your daughter’s development and challenging behaviors as soon as possible.  It is unfortunate that sometimes it does take a long time to get the appropriate assessments, but it is very important to obtaining the proper intervention for your daughter.  Below is a list of websites that you might find helpful in learning more about pervasive developmental disorders.  

About.com Pediatrics
http://pediatrics.about.com/od/weeklyquestion/a/04_signs_autism.htm
American Academy of Pediatrics
http://www.aap.org/healthtopics/Autism.cfm
First Signs
http://www.firstsigns.org/
Cambridge Center for Behavioral Studies
http://www.behavior.org/

[prncessme]

Thank you for answering my question, as far as being concerned with her development, we have been concerned since she was about 2 months old (10 weeks) when she slept for over an entire week and was hospitalized (later learning that she had a liver infection-whether it was from that or something else, they don't know). At the age of 6 months she still wasn't smiling or laughing and had generalized hypotonia. It took us until she was almost 1 before we could get some help for her, it orginally was for dysphia when her speech therapist noticed that she might have SPD. It was 2 weeks later an OT agreed and she started intense therapy for SPD. She is a very hypersensitive child with all 7 of her senses. She doesn't understand social cues from other people, when I am upset with her I have to show her my face and ask if I look happy at her-and tell her that I am not, doesn't have the traditional imaginative play others her age do. For example, she "plays" with her dolls but instead of talking to them and acting like a mom she would rather carry them around in their carrier or in the backpack, nothing more. She also has an adult like humor that other children don't seem to understand, not that she would talk to them. She doesn't like to spin, but she likes to watch other things spin. When she was a baby, it was the ceiling fan and now it's anything that spins from ice skating to chairs to car wheels. She has a fascination with red cars, no other type-just red. She does like to have her schedule the same as much as possible and when it's way off, she is not comfortable and will cry and refuse to do anything else but stay at home. She also likes to watch her movies over and over again and can recite one of them word for word -even before the character says it.

When it comes to the anxiety and OCD-she washes her hands for hours at a time if I let her. She has to get in the car a certain way, be buckled a certain way, go to bed a certain way, get dressed the same way, go up and down stairs a certain way, milk has to be made a certain way, scared to "go fast" in the car since she believes we are going to "run over a car", scared to sleep alone-afraid of the "niner" (a make believe character that comes at 9 o'clock) and of the dark because of it. Scared of "the guy"-any man besides her father. We have no idea why, she can't even explain it. Clothing has to match and knows when it's not and will undress herself and refuse to wear it until it matches -including her hairbows or even the rubber bands and her socks. Can only wear one brand of diapers (she is not even close to being potty trained as of yet).
I hope that gives you a little more insight to my daughter.