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Clarification of Diagnosis
Before jumping to a PDD NOS prognosis discussion, it's important to understand what PDD NOS is, in terms of diagnostic criteria, to prevent confusion. Pervasive Developmental Delay, Not Otherwise Specified (PDD-NOS) is something of a catchall diagnosis. When a child does not fit a specific PDD or autism spectrum disorder, but presents with numerous symptoms, experts often reach for a PDD-NOS diagnosis. The “NOS" portion (not otherwise specified) indicates the child has symptoms, but not enough to meet diagnostic criteria of a specific disorder.
As a child matures, the signs and symptoms that fit the criteria for a PDD diagnosis may evolve and change. Some who are diagnosed with PDD-NOS, may no longer exhibit enough symptoms to qualify for a PDD-NOS diagnosis when they reach adulthood. They may present with symptoms closer to Nonverbal Learning Disorder. Alternatively, they may display symptoms and characteristics closer to an Asperger’s diagnosis.
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Differing Developmental Paths
Each person on the spectrum develops according to their own neurological path, with challenges and specific characteristics changing and evolving in severity over time, depending on interventions and the individual. Few children on the spectrum lose characteristic symptoms, but borderline behaviors and developmental delays may improve or worsen over time. This evolution, along with measuring educational progress, is at the heart of policies for regular re-evaluation of children on the spectrum with IEPs in educational settings.
Diagnosing developmental delays is not an exact science, so symptoms disregarded as borderline may appear more prominent as other developmental delays are addressed. Likewise, one evaluator may see more symptoms or characteristics than another. It is nearly impossible for evaluators to see every symptom and its severity during the course of a single evaluation. This also makes determining exact outcomes difficult for professionals, teachers, and parents.
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The Overall PDD-NOS Prognosis
Like all PDD and autism spectrum disorders, outcomes vary widely between patients. The PDD-NOS prognosis for most children, as is the case with any autism spectrum disorder, is impossible to accurately predict. However, statistically, adults with PDD-NOS and similar diagnoses lead closer to normal lives than their more severely affected counterparts. The severity of a person’s disability and how well they learn to function in mainstream environments determines their final outcome.
According to the National Institute of Neurological Disorders and Stroke (NINDS,) early intervention, appropriate support services, and IEPs or other customized educational programs are crucial to a more successful outcome. PDD-NOS does not affect life span expectations, but diagnosed adults often struggle with quality of life challenges including relationships, employment, and independent living capabilities in varying degrees. The outcome of a young child is hard to predict until they mature and their abilities and challenges can be more accurately assessed.
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References and Resources
Autism Help.org Long-term Outcome with Autism http://www.autism-help.org/autism-prognosis-long-term.htm
Autism Society of America Educational Evaluations http://www.autism-society.org/site/PageServer?pagename=life_edu_evaluation
National Institute of Neurological Disorders and Stroke, PDD Information Page http://www.ninds.nih.gov/disorders/pdd/pdd.htm#What_is_the_prognosis
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