PDD-NOS / Bat Crap Crazy Diagnosis Revealed

Kars 4 Kids $100 Million Dollar Charity Website. Oodles of parent-directed posts, services and programs for children. Anyone can donate $, but the services and programs are only for Jewish Children and Families. It might be worth converting if you can’t find services for your child’s needs.

“Your car donation will benefit Kars4Kids. Kars4Kids is a 501(c)(3), a national organization dedicated to addressing the educational, material, emotional and spiritual needs of Jewish children and their families.”

At least the posts are free!
If this post doesn’t convince people that the Psychiatry, Psychology, Psychotherapy industries; the Autism Industry; the Mental Health Industry and all the related “Helping Caring Fixing Industries” are a bat-crap crazy Socially, financially and Profit driven fraud” then I give up.

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PDD-NOS stands for Pervasive Developmental Disorder–Not Otherwise Specified. Once upon a time, doctors diagnosed PDD-NOS when symptoms didn’t quite fit the picture of plain old Pervasive Developmental Disorder (PDD), itself, something of a wastebasket term. Now, neither term is in use.

Back in the day, PDD served as an umbrella for five disorders: Autism, Asperger’s syndrome, Childhood Disintegration Disorder (CDD), and Rett’s syndrome. But the authors of the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) decided to broaden the wastebasket and do away with most of these terms and their subcategories. Going forward, doctors will no longer diagnose “Asperger’s syndrome” for instance, but simply say someone has an Autism Spectrum Disorder (ASD).

When the DSM V came out and even in the lead-up to its publication, a lot of people were upset. All of a sudden, people who had Asperger’s no longer had it. Instead, they simply had plain old autism. And people with PDD-NOS either had autism or something new called Social Communication Disorder (SCD).

Most people, when they think of autism, think of a syndrome that is severe. Asperger’s syndrome, on the other hand, has been thought of as being “almost normal” and maybe even quirky, cute, and interesting, in a geeky sort of way. If you’ve ever watched Criminal Minds on television, Dr. Spencer Reid is the perfect example of how people like to see Asperger’s. He’s loveable because he’s so awkward with people and yet so wide open and real. He’s a genius nerd. He’s interesting, upper class, a kind of savant.

Or perhaps when you think of Asperger’s, you think of something that causes mildly embarrassing confrontations in the supermarket, like the sort of thing that happens with Max Braverman in Parenthood. There’s angst, but also joy, and perhaps even social justice to the act of parenting a child like Max.

So if you’re a (white and wealthy) parent of a child with High-Functioning Autism (HFA), you’d probably much rather hear a diagnosis of Asperger’s than HFA, or at least your doctor would assume so and perhaps respond accordingly. You’d rather parent Max than Dustin Hoffman’s Raymond in Rainman.

By the same token, if you’re poor and black and your child had exactly those same symptoms, it’s likely the doctor, prior to 2013, would have simply said your child had autism or perhaps even PDD-NOS. There’s a problem here of consistency. There’s also a problem of mixing diagnostic boxes. HFA was interchangeable with Asperger’s and PDD-NOS could be interchangeable with autism, depending on a doctor’s cultural biases or upon how sure he was about that diagnosis—is it really “bad enough” to be autism? You have a problem here of sacrificing specificity for sensitivity’s sake so you keep it vague to prevent anyone from feeling too bad. You avoid the stigma of calling someone “autistic” if you think they might get upset.

PDD-NOS “Less Severe”

But since Asperger’s and PDD-NOS were deemed syndromes “less severe” than autism, 14 states didn’t offer people with these diagnoses access to services. While Asperger’s was the cute and quirky white person’s autism, PDD-NOS covered anything that didn’t quite fit the autism diagnosis, for instance Asperger’s. PDD-NOS could, for instance, be very mild autism. What the DSM V attempted to do, in eliminating so many terms and in making the listing for autism more broadly inclusive, was to address the bias, and make it possible for more people to receive much needed services.

But what happens to someone who has always thought of himself as having Asperger’s? It’s his identity. Suddenly you take it away and he’s now “autistic?” Ow. That bites.

Except it doesn’t. According to the Autism Speaks website, (OUCH! A notoriously disliked and suspect organization! Is K4Kids connected?) people can still call themselves what they always did. In fact, psychologists are allowed to designate “Asperger’s” as the type of autism a person has when writing up an evaluation or diagnosis, alongside the new diagnostic term autism spectrum disorder:

Many individuals may wish to retain their previous diagnosis as the label is considered part of their identity or may reflect a peer group with whom they identify. This is perfectly acceptable. A clinician can indicate both the DSM-5 diagnosis as well as the previous diagnosis, such as Asperger syndrome, in an individual’s clinical record.

The DSM-5 text states “Individuals with a well-established DSM-IV diagnoses of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of “autism spectrum disorder”.

The bottom line is that nothing really changed except for the fact that more people on the autism spectrum can get the services they deserve. Meantime, there’s the hope that bias and stigma can be excluded from the diagnostic process for autism spectrum disorders. It’s time to stop worrying so much how things look and instead to put that energy toward helping people with the challenges they face.

Hopefully, we’re all evolved enough to see that autism can happen to anyone and it has nothing to do with what color you are or how much money you have. And if this is the case, we can shove all that to the side and concentrate on early diagnosis and creating more treatment options. Because that is how it should be in an ideal world.

 

 

 

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