Diagnosed with PDD-NOS at 4, but questioning teh diagnosis

[Natta1980]

Just wondering if anyone had a similar experience

My son was diagnosed with mild PDD-NOS when he was 4. He is now almost 6.

Ever since "interventions" started at school, he seems to be more withdrawn

Before "interventions" he would participate in circle time, walk in line, play with children some, do some academic work. Basically now he needs MORE help than prior to interventions. And he lost all the interest in academic work and art, and really stays away from other children. It is almost like all the joy of learning was taken out of him - now when I ask him to draw - he draws something very quick, says "good job" and runs off. Interventions he receives now require him to be taken out of his "home" classrooom frequently.

From my own experience, it is ok to guide him, but when you prompt him - he will shut down.

He does not look "autistic" to start with and can be very related, funny, and friendly. He does flap his hands and makes noises at times - but that started after "interventions" - he was in mixed classrooom with neuro-typical children as well as other ASD children.

He has tonns of language, but rarely answers questions is they are not related to a subject he is interested in.

He has lots of imaginative play, he imitates well when it is something he is interested in imitating. He seems to absorb every negative behaviour he sees around him; he feels other's anxiety

He has trouble with auditory processing

Some professionals we are seeing (and they seem to have the most insight into him) question the whole diagnosis and think that his temperament (anxiety plus oppositional) makes his look "ASD" when he is faced with lots of auditory input and requests

None of the "autism treatments" - aside from OT and Floortime (that is what I was doing since his birth, apparently) - work with him

All of my family is in engineering/analystical/musical professions, my side is quite introverted and experienced various sensory issues at some point


Does anyone have a similar experience where "interventions" make child more agressive and more withdrawn than prior to them? This applies to school only, at home his behavior is much, much better now; we virtually have not trouble with him...His teacher saw him with me " in the community" and could not beleive how well-behaved and happy he was.....


Does it sound like inappropriate programming/school issue?

Thank you in advance

[Natta1980]

Thank you for all your input

[Sandman2]

   Natta, thanks for all of your answers.  That was a lot to put down, but it may also help you in meetings with teachers, etc.  I think that in getting these together, you may have come close to answering your origional question - "Does it sound like inappropriate programming/school issue?"
  I don't think it is so much inappropriate as much as trying to find the correct way to work with him.  "As with other conditions, it takes a village of doctors, psychologists, teachers, therapists, and family members to arrive at an action plan that would work best for someone with PDD-NOS. A "one-size-fits-all" approach usually doesn't work:"    from a good site  -  " http://www.autismspeaks.org/navigating/pdd_nos.php "
  Personally, I think he has too much movement in his day.  I think it would be better for him to stay in his classroom a bigger percent of the day.  By now, I would hope that his teacher knows him well enough to prevent "meltdowns" from happening.  I find it a bit hard to believe that they cannot prevent overloading.  This is something that a one on one aide is supposed to really help with.  If you haven't done so, I would talk to the one on one - if she doesn't mind.  Many times these aides have a really good idea of what is going on, and ways to avoid things.  Sometimes the aides don't want to voice these ideas to the teacher, but you can.  You also might want to try and observe him in the classroom to get a feeling for what is going on.  This gets a little tricky due to how he might react when he sees you.  Best bet is to quietly show up once he is into his daily routine.  Just watching him play at recess is also very instructive.
  The fact that the teachers are working to increase his classroom time and decrease breaks is good and shows that they are probably getting the same vibes you are.  The main thing is that it there really is a bit of trial and error approach as to what works - along with consistent modifications based on how he is doing.  Perhaps the best thing that you can do is to stay in really good communication with all involved (including his aide)
  Finally, if you have not had a meeting where all involved get together to just discuss how he is doing and ways to tweak things (not really an IEP), its time to do so.  It will be a bit tough to get all together (including his aide), but well worth the effort.  I would find the person you are the most comfortable talking to and say that you would like this type of meeting.  Let them know that you like all the effort they are putting into your child (keep saying that), but feel that some things could be adjusted - or something like that.  I would definitely mention your concern with the transitions.
  Hope some of this helps.

[Natta1980]

sorry- I was rambling, it was late

Pre-school was mixed class - 50% with "disabilities", 50% - "typical"
He had lots of prompting and ABA-type reinforcing - they used food/toys rewards and claimed it was working.

4 times a week, 3 hours a day

Interventions I've listed in my previous post are all for this year

Right now he is in Kindergarten, social group - 4 times a week, 1 hr, not sure what other children are doing while he is out....he goes out for "OT breaks"...He also goes out for morning writing work and sometimes afternoon math (children are doing the same while he is out). All in all, he is in "regular" classroom about 60% of the time - on a "good" day
He has full time aide, which I think may make him more dependent. He loves her very much. In general, he is always willing to go to school, can get anxious at times during drop-off, but nothing out of ordinary

Teachers reports as to "how much time he spends in regular ed classroom" tend to vary - they say that they adhere to the schedule. That is - regular ed. teacher reports that he spends about 40% of his time in her classroom while sp. ed teacher says that it is more (70%)....They are working to increase his time in the classroom and decrease "breaks"

My concern is that he has many transitions, they claim that he melts down when overloaded and they have to take him out for a break. I think that many times he manipulates them so he can leave the room.

Kindergarten - full day, 8:30 till 3:30, I entertained the idea of part-time but they insisted on full day; plus he will be missing all the "specials" = music, art, PE if he goes part-time

There is no part-time program in our school district...


I hope it helps - thank you again for all of your feedback

[Sandman2]

Sorry, kinda confused here.  You said "interventions" in pre-school? So he has the same interventions in K?  Some of what you listed was last year?  Or were they all for this year.
  How long is his K day?  Does he go out everyday to social group and how long is he out of the room.  Any idea what the other kids are doing while he is out of the room?
   Sorry for all the questions.

[Natta1980]

He is in Kindergarten, public school, 17 children in his class

We do have IEP and have had multiple IEP meetings

"Interventions" in pre-school were based on discreet trial techniques (althought they said that they minimized them)- that seemed to irritate him great deal - first draw, then you get a "carrot", first play with friends - the same.

Then your good old "visual schedule" - I do not mind this one actually, I think it helps

"Auditory timers" - again his main objective becomes watching the timer/getting out

He goes to "social group" to work on his "social skills" - but if I had to guess, other children are way more severe than he is....

They pull him out in the morning for "writing" - as he concentrates more....Personally I do not think his fine motor skills are there yet, he is a perfectionist by nature, and will not do certain things if he is not sure how to do them perfectly

He gets "OT breaks" - outside of classroom

Generally, he seems to be doing better when there is no "contingency" hanging over his head - be it timer, rewards, etc....

That is all, in a nutshell

Let me know what you think

[Sandman2]

     Hi Natta,  specialmom asked me to take a look at your post and I can understand your concern.
     Couple of thoughts - kids seem to very quickly figure out when they are having trouble doing something.  The harder they try, the more frustrated they get and eventually (if they are smart), they seek the easier path which is avoidance.  I have always been amazed at how quickly some kids can pick this up.  I don't know how long the interventions have been going on, but subject matter does build from the first day.  So its always possible he has hit his limit and is seeking other paths.  If this is so, then the school should be doing something to help him be more successful.  
  Your main concern was the interventions.  There are all kind of interventions.  And yes, the wrong ones could hurt rather than help.
So a few questions.  
    What grade is he in.  What time of day does the school get out?  Are the interventions done by his classroom teacher - or by somebody else, somewhere else?
How does his teacher feel about the interventions?  Are the interventions a part of a BIP, an IEP, or a 504?  Was the school psychologist involved in the planning or just the teachers/principal.  Oh, how experienced does his teacher seem?
   Finally, I really need a feeling for what some of the interventions are.
You don't have to answer all at once - just do a couple at a time - of course, you don't have to answer at all.
   I do agree with specialmom about setting up a meeting.  That is one reason why I had the questions about how the interventions were set up.  There is a lot to be said about having children in the "least restrictive environment".  In other words, lots of things work better if they can be done in the classroom.

[specialmom]

Natta, I would be concerned.  I think there is something to be said for a child to start to feel different.  The preschool we went to made a very big deal about that.  They always paired my child up with one or two kids for sensory activities (they didn't know it was for MY son or that it was a sensory activity to get him regulated) or the whole class did it.  My son's teacher now has the whole class doing certain sensory things that are really for my son.  I told her about the "how does your engine run" program out occupational therapist uses and she used it for the whole class so if my son said to her that his engine was running too fast, that it would be something no one would think odd.  (not to mention it is awesome for all kids).  

I would set up a meeting and voice your concerns.  And I definatley think that in those early years, it can be very hard to diagnose these disorders that have so much overlap.  I've always read about all issues such as add/adhd, autism, odd, etc. to get ideas to deal with my child.  

I have a friend that I will ask about this as well as he is very well versed in school issues.