3.
CONFUSION OF DIAGNOSTIC LABELS
The intent behind the DSM-IV is that the
diagnostic criteria not be used as a checklist but, rather,
as guidelines for diagnosing pervasive developmental disorders.
There are no clearly established guidelines for measuring
the severity of a person's symptoms. Therefore, the line
between autism and PDDNOS is blurry (Boyle, 1995).
As
discussed earlier, there is still some disagreement among
professionals concerning the PDDNOS label. Some professionals
consider "Autistic Disorder" appropriate only
for those who show extreme symptoms in every one of several
developmental areas related to autism. Other professionals
are more comfortable with the term Autistic Disorder and
use it to cover a broad range of symptoms connected with
language and social dysfunction. Therefore, an individual
may be diagnosed by one practitioner as having Autistic
Disorder and by another practitioner as having PDDNOS (or
PDD, if the practitioner is abbreviating for PDDNOS).
Generally,
an individual is diagnosed as having PDDNOS if he or she
has some behaviors that are seen in autism but does not
meet the full DSM-IV criteria for having Autistic Disorder.
Despite the DSM-IV concept of Autistic Disorder and PDDNOS
being two distinct types of PDD, there is clinical evidence
suggesting that Autistic Disorder and PDDNOS are on a continuum
(i.e., an individual with Autistic Disorder can improve
and be rediagnosed as having PDDNOS, or a young child can
begin with PDDNOS, develop more autistic features, and be
rediagnosed as having Autistic Disorder).
To
add to the list of labels that parents, teachers, and others
may encounter, a new classification system was recently
developed by ZERO TO THREE: National Center for Infants,
Toddlers, and Families (1994). Under this system, called
the Diagnostic Classification of Mental Health and Developmental
Disorders of Infancy and Early Childhood, the term Multisystem
Developmental Disorder, or MSDD, is used to describe pervasive
developmental disorders.
However,
amidst all this confusion, it is very important to remember
that, regardless of whether a child's diagnostic label is
autism, PDDNOS, or MSDD, his or her treatment is similar.
