Expert: James Michael Roan - 1/5/2007

Question
Hi
I have a son that turned 3 in Nov.  He has a PDD dx from a development pediatrician that he got over the summer.  He is in special pre-school at the moment - primarily because of lack of focus issues when he was tested by the Dept. of Education during the summer.  He was in another pre-school before then and they expressed concerns about his running around, not paying attention, only playing with one other kid, etc.  This was his first experience with kids his own age.  A few months made a lot of difference because I see that he is now no longer afraid of other kids (he showed aversion to kids after twice being knocked down at the playground by peers when he was about 18 months old).  He approaches them and will try to play with other kids.  He has always responded to his name and when he is another room and I call him he will always answer by telling me what he is doing; he points to everything, asks tons of questions (no real why question yet though), is very verbal, asks for what he wants, shows us things of interest and things he makes, has a good imagination, does pretend play, likes to be involved in everything and wants to "help" with whatever is going on, is great in public, will eat anything, etc., etc.  He is receiving OT for low upper body muscle tone, speech therapy for a slight pragmatic problem and also physical therapy for minor issues.  He used to repeat things a lot but this has pretty much stopped.  He still has some pronoun reversal with "I" and "You" but just a look at him is good enough for him to repeat whatever he said using the correct pronoun.  He has no real tantrums and his only "odd" issue is that he doesn't like it when I have a shower and wash my hair.  I think he associates this with me going to work and he keeps saying he doesn't want me to go to work but unfortunately I have to.  He also likes to feel my hair and smell it especially when he is tired.  This replaced his "blankie".  He plays with a large variety of toys but at the moment prefers his busses and cars.  He likes opening their doors and usually puts in small things like cheerios, but he pretends the cheerios are people.  I am sorry this is so long but I think you get the gist.  My question is, can a PDD dx be reversed.  His dev. pedi. wasn't even totally sure but gave him the dx in case he needed services.  He is completely undistinguishable from the other kids at this stage (at least nobody has picked up on anything odd about him).  I now think he has ASD traits but not ASD.  Thanks for you input

Answer
Hi Sally;

Many children on the high functioning end of the autism spectrum (i.e., PDD-NOS/Asperger's Syndrome) can move even higher until they are virtually indistinguishable from other children by most of us but who will often retain some degree of social dysfluency or have low social competency around groups of their peers. Even this difficulty all but disappears in early adulthood.

I wish I could be more specific, but would need to observe him in a group of others his age.

Kind Regards,
James