Yes it is confusing isn't it.
Firstly global developmental delay means that he is behind in all aspects of development. Even the fact that it is called a global 'delay' may be inaccurate, as some give this diagnosis even when there is no chance of catching up. A delay means just that. That in time that child has the possibility to catch up. Some children do. Some children don't.
The difference with a PDD NOS diagnosis is that you are not looking at a typical development to begin with. If you imagine it like the electrical wiring in your house. The GDD child is wired the same as everyone else, but for some unknown reason is not at the same level as their peers. The PDD NOS or spectrum child is wired up differently. They too can have learning difficulties, or they may have none at all. Even Einstein is thought to have had autistic traits.
This is just my opinion, but the fact that there is dyspraxia as well would appear to point to different wiring up of the brain.
Children on the spectrum can appear to have learning difficulties because they cannot access learning in the same way as other children. For example I had my son assessed by a private Educational Psychologist because I wanted a good idea of his cognitive ability to help me decide what type of school would best suit him. She found that on non-verbal assessments he scored higher than average intelligence. When tested using verbal assessments he scored way below average intelligence. So my son is cognitively above average, however due to his speech and communication problems he needs alot of support in those areas to make sure he can understand what the lesson is about. So he would not be suited for a school that was aimed at children with a lower than average IQ. He would also not be suited in a mainstream only school because of his language and social communication issues.
It is also possible that he has both. There are alot of children on the spectrum who are classed as having delays or learning difficulties.
What I did with my son was look at each thing he had difficulty with and traced it back to the core developmental ability needed to complete that task. And then identified whether it was an autistic based one, a sensory based one, a language based one, an auditory processing one etc.
However, to complicate matters further, those on the spectrum are as unique as you or I. So eventhough the child needs to have difficulties with social interaction, every child will be different. One child might be totally unaware of other children in its environment. Another child may respond to play when approached by other children but not initiate play themselves. Another child might be too controlling and try to always play in the way they want and get distressed when other children will not comply to their requests. So an autistic child could come across as delayed because they do have some skills, but not at the same level as their peers and not to a degree that they can function in those areas without support. However, a delayed child might catch up. An autistic spectrum child will have lifelong difficulties.
What part of the diagnostic criteria for being on the spectrum was he too good at, which left them to give a diagnosis of PDD NOS?
I would also question the SALT as to their speech and social communication issues, as they should be able to tell you whether those types of difficulties are consistant with a diagnosis of an ASD or GDD.
As he has both diagnosis, I would probably go with a school that has experience of teaching children on the autistic spectrum. An Educational Psychologist should be able to tell you whether a mixed school (mainstream and special needs) or a special needs only environment would be best.
Can you post back saying which country you are in so that you can get more specific advice.
My daughter was diagnosed with PDD (the doc felt it was PDD-NOS but would not make the specific diangosis between NOS or autism at her age of 3).
Things that my daughter will probably have as she grows into an adult are some of her "ritualistic" behaviors. It's kind of like OCD. Sort of. Her world is like totally turned upside down if you don't follow her rules on things. I don't know if kids with GDD have ritualistic behaviors or not.
My daughter also has a ton of sensory issues. I don't know if GDD has that or not. I don't know if the sensory issues will go away as she becomes an adult. I'm certainly dealing with several I had since being a baby that I still have as an adult. I'm sure she'll have many of these issues too, but maybe she'll be better off because of sensory integration therapy.
Another thing is that my daughter is ahead in certain areas while being behind in others. At age 3 she was tested by the public school system and her spoken language at that point was 23 months and her receptive language was estimated at 21 months of age. Her motor skills were all uneven, so she tested slightly below age level on those, but some skills she had were those an older child would have and others she lacked most kids had months earlier. They tested her on numbers and alphabet, and she tested at age 4 1/2 approximately with letters and spelling and at age 4 for numbers. My daughter has also been doing puzzles way ahead of schedule too. She's up to 60 piece puzzles at age 3 1/2. And was doing 20 piece puzzles at age 2 1/2. So, although she has a delay in the language area and the social communication area and a very minor delay in some of the motor skills... and a huge delay in the adaptive skills (self-feeding and toileting and that sort of thing)... she is hugely ahead in other areas.
I really don't know too much about GDD but I think the developmental pediatrician ruled that out because it wasn't delays in everything, just certain areas that are more typically on the autistic spectrum.
Hi my daughter hasn't a diagnosis but she is behind in a lot of things she has been seen by a speech therapist, who said she is behind by 2 years in a lot of things, but will not assess her at school as the teacher said she was only a little behind so she hasn't been assessed for her understanding, she is now about a year and half behind all her peers but they are still letting her plod on, she does get more one to one which has helped her.
I think pdd is something that will be there all their lives, don't think gdd will be and you don't get sensory issues with it. Good luck. Sharon x
Hi. I was just wondering about your daughter's "rituals" My son is almost 3 1/2 and this is one of my biggest struggles with him. He has alot of other things as well but this one is really getting to me. He had alot of OCD tendencies and become so angry and uncontrolable when anything is out of order or not the way he wants it. How do you deal with this when it happens with your daughter. He is still in the process of being diagnosed, they are starting to point to PDD-NOS.
My 4 yr old daughter also has an undiagnosed delay condition (no formal PDD or GDD yet). Speech, numbers, reading (not yet), fine motor skills, and more are far behind. She can't draw except for short lines on a page. She has always been good with puzzles (doing 60 piece ones as well) and has heavy OCD tendencies. We can't run the bathwater with her nearby, lights off, doors closed and everything sitting up if that's the way it's supposed to be. However, we've slowly gotten her comfortable with doors open upon our request. Her tantrums and outbursts have been very challenging, making going out in public with her a bit of a wildcard, severely limiting our time out in public with her. She has focus issues as well, making handwashing (if possible from a gross motor standpoint), impossible/difficult. She isn't potty trained yet - but we're making progress. She picks her bug bites and cuts to the point of bleeding and we have to put on waterproof bandaids to ensure they are covered.
We are doing speech therapy, occupational therapy, work with a behavioral therapist (instituting more consistent discipline, etc), and are next going to a psychiatrist (we do so reluctantly). We believe the psychiatrist may offer some insights and some low-impact medication for consideration. We've gotten my daughter off gluten and dairy with no effect.
My heart goes out to all on this message board - hard to watch (and live through) the challenges that await us afresh each day sometimes. However, we know that this is a marathon. Give yourself room to breathe and love on the kiddos!
Saw 2 comments directed to me... one from quite awhile back and one from recently...
As for the rituals, we generally let her do anything that she can do by herself or will eventually do by herself (like dressing and putting on shoes and the carseat). We do not allow her to establish any rituals that involve other people or how she interacts or plays with other people. As she becomes more verbal, I am learning that some rituals can even be negotiated out. She was trying to establish this count to 20 ritual before snapping her car seat last winter when it was way too cold for me to be standing outside waiting for her to get to 20. She wanted to count, so I told her she got to 5 and that was it for the counting. I was amazed the negotiation tactic worked. We eventually negotiated the counting out of the routine. Some routines and rituals have disappeared. Some new ones have appeared and some of those are gone andsome are still around. At least with her talking more, we can at least know when she wants to do something a particular way. We also make her talk to us and tell us if she wants something a certain way. We just figure, learning to communicate... well, if she has a desire for something so bad, if she can tell us, that's a bonus thing. There are lots of OCD tendencies on both mine and my husband's side of teh family and a bit in ourselves as well, that the OCD thing is not as much a problem for us... just so long as we know what the *bleep* our daughter is throwing a fit over. When she was younger we would have to figure it out on our own.
We also tried the gluten dairy free thing with no effect or if anything worse affect. Her behavior has never really been an issue so all these things about how gluten and dairy free will help the behavioral issues doesn't really apply to our daughter. Though she is going through the terrible twos a year later... her speech is about a year behind, and her behavior is consistent with a 2 1/2 year olds which is consistent with her verbal ability and I guess emotional age. We don't cave in to her terrible twos tantrums. It's a bit hard since she's going on 4 and is very tall and strong for her age... but hey, better going through it now than a couple years from now. And I guess we should be happy that her behavior is normal in that regard, even if it is not pleasant. Her health is amazingly great and she rarely gets sick. And I mean rarely. She doesn't fit the stereotypical sick all the time, tons of ear infections and colds and allergies that Jenny McCarthy and the DAN doctors say kids with autism have. Honestly I wouldn't take my daughter to a DAN doctor ever, but they seemed to help a lot of kids. I just wonder if there are different causes sometimes. And some parents have kids that were "normal" and then regressed in their development. My daughter was behind the whole time. I think there must be a huge difference between regressive autism, typical autism, aspergers, and PDD-NOS.
I never had problems with my daughter in public because I figured out pretty quickly what her limitations were, mostly sensory related. And also the OCD type rituals with going out. I am a bit of a ritualistic type of person myself, so when I shop, I usually have to go down the aisles in a certain order. And I like the routines of like having a drink at the coffee shop before shopping. And then shopping at smaller stores and keeping the shopping trip shorter help too. Shopping in smaller stores makes things a lot easier. Trying to pick stores that are well layed out, not noisy (picking times of the day they are less crowded), and not cluttered. Smaller stores with lower ceillings and shelves not as tall means less visual clutter and less visual processing. Of course, that means avoiding stores that are generally cheaper. Though we do find Target very easy to shop during the middle of the week during the day when there are not many peopel in the store. Target much nicer than Walmart. Walmart has aisles that are too close together. The lighting is never quite right. The floor smells like cheapo floor cleaner. The scanners at the checkouts are way too loud. There are too many people no matter what time of day you are in there, and it's just too much clutter... both visually and audibly and smelly. I hate Walmart. My daughter hates Walmart. I'm guessing she hates it for the same reasons. Or at least some of them and maybe a few more than I listed. KMart is pretty dismal too, though much better than Walmart. I guess not all Targets are great and not all Walmarts are bad, but that's just how it is where I live. I like smaller stores like Trader Joes. Aldi you would think would be good because they are smaller... but they stock canned goods and stuff way too high up it just is a bit intimidating to walk down the aisles. I like Aldi but my daughter has some severe problems with that store that I can not take her in no matter what. We have slighly different sensory perception problems.
Our daughter bites her nails way down. Or well, she used to. She has actually gotten over that one for the most part. She doesn't pick her bug bites and scabs, but I do. And my scars don't heal. Never really have ever since I was little. Partly because I pick them over and over and partly because I have an autoimmune disease with circulation issues (circulation does help scar healing). I know it's hard to teach your child not to do something when you do it yourself. I think my daughter is learning when I say "mommy really shouldn't do this, and mommy is trying not to." When I adopted that tactic on some issues, she has amazingly been a lot better. I guess she feels, hey, mommy isn't perfect, but she's trying so I guess she feels she can try too. So she's stopped biting her nails mostly... though I do catch her on occasion. Plus she likes to get "manicures" when she's good and doesn't bite them. A couple months ago she did chew the inside of her mouth repeatedly. I found out what the stress trigger for that was. Once we could eventually talk about it... though most of the talking was my end, well, she hasn't done that again. It was some boy in her class who was screaming way loudly and she hates the loud noises. Teacher addressed the situation when I informed her what my daughter was doing. Is amazing what things will set off certain behaviors.
Anywyas, I guess I'm rambling on a bit. I'm still not sure what diff between GDD and PDD-NOS is. I don't know if my daughter will outgrow everything by the time she's an adult. Maybe she will with therapy. I sure didn't outgrow my sensory issues, though I never had therapy. I didn't have the speech/language delay issues. Or the social communication problems, though my daughter with therapy has overcome a lot of those. i still see her struggle with some of it, and the way she interacts with kids is usually scripted and has become a ritual almost... so does that make her normal now because she's able to do all that after therapy and after learning techniques and scripted things that are more like routines? So a doc could say, hey, she's cured or oh it was only a delay that is now gone. I still see it as a difference. Not like it's a bad difference, but it is still a difference. A difference in how she learns and processes things in life. but hey, who cares what people want to call what, my daughter is who she is, and will be who she will be. And she is getting amazing speech therapy and other types of therapies that are helping her grow up to be an amazing little girl... so does it matter what label they slap on her?
Um, sorry went off on another digression... it's late, i prob shoudl go bed.
My little boy was diagnosed with gdd today he also has asd adhd spd and anxiety seperation he also has the mental age of 4 xx