Expert: James Michael Roan - 9/26/2006

Question
I am concerned with the way my nephew behaves. He is three years old.  He has always had difficulty speaking.  I thought at first he may have hearing problems, his grandmother is deaf. If he is in a setting with one on one he has a great personality.  Otherwise very bad and disruptive.  His teacher (day care provider) suggested that my in-laws have his IQ tested, and the Pediatrician suggested testing him for PDD.  I am unclear what that is.  I have four children and my nephew is their first cousin.  None of my children have ever acted out like he does.  When his older sister was little, the pediatrician also wanted to have her tested, mostly because she would repeat everything you said and then do what you asked.  She would also act out, badly.  I don't know if this is a failing of my sister-in-law and her husband or if he has autism.  I just want to see my nephew happy and stress free.  Last year (age 2) he had a series of tests due to the fact he kept holding his head and saying it hurt.  Nothing showed up.  They changed his diet, no refined sugars and only organic foods.  He seemed to get better for awhile, but the behavior has resurfaced.  Please give me the systems.
Thanks
Bridget  

Answer
Hi Bridget;

There are many causes of this sort of behavior. PDD stands for PDD-NOS (Pervasive Developmental Disorder-Not Otherwise Specified). It is virtually synonymous with Asperger's Syndrome (AS) and high functioning autism (HFA).

In autism, we are most concerned about social awareness, social development, and social interactions. I suggest you download off the internet the Modified Checklist for Autism in Toddlers (M-CHAT) http://www.firstsigns.org/downloads/m-chat.PDF It was normed on 1,293 children in the U.S. and provides a risk estimate for autism. Also download the scoring instructions at http://www.firstsigns.org/downloads/m-chat_scoring.PDF If there is any risk noted then do two things:

1. If you live in the U.S., make a special education referral to the school district in which your nephew lives. They are responsible for the assessment of children 0-21 years of age, and if they qualify for special education, responsible for education and related therapies.

2. In addition to the special education referral, take the M-CHAT to the child's pediatrician and ask for a referral to a multidisciplinary team expert in this area. Again, if you live in the U.S., you can go to the autism unit at a university near you, or a Children's Hospital.

It's absolutely essential to get the right diagnosis and appropriate services going right away. I am happy to review the results of the M-CAT with you and/or his mother.

Kind Regards,
James