Pervasive developmental disorder

Short description: Developmental disorder; related to autism

"PDD" redirects here. For dementia associated with Parkinson's disease, see Parkinson's disease dementia. For other uses, see PDD (disambiguation).

Not to be confused with PDD-NOS or Developmental disorder.

Pervasive developmental disorder

Specialty| Psychiatry, pediatrics

The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), was a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. It was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) (from 1980 to 2013), and the International Classification of Diseases (ICD) (until 2025).

The pervasive developmental disorders included autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), childhood disintegrative disorder (CDD), overactive disorder associated with intellectual disability and stereotyped movements, and Rett syndrome.[1] As of the publication of the DSM-5 in 2013, the first four of these disorders are now known collectively as autism spectrum disorder; the last disorder is much rarer, and is sometimes placed on the autism spectrum and sometimes not.[2][3]

The onset of pervasive developmental disorders occurs during infancy, but a specific condition is usually not identified until the child is around three years old. Parents may begin to question the health of their child when developmental milestones are not met, including age appropriate motor movement and speech production.[4]

There is a division among doctors on the use of the term PDD.[5] Many use the term PDD as a short way of saying PDD-NOS.[5] Others diagnose the general category label of PDD because they are hesitant to diagnose very young children with a specific type of PDD, such as autism.[5] Both approaches contribute to confusion about the term, because the term PDD is intended by its coiners and major bodies to refer to a category of disorders and not be used as a diagnostic label.[5] The fifth edition of the DSM removed PDD as a category of diagnoses, and largely replaced it with ASD and a measure of the relative severity of the condition.[6][7] The eleventh edition of the ICD also removed the category.

## Contents

* 1 Signs and symptoms
* 1.1 Degrees
* 2 Diagnosis
* 2.1 Classification
* 2.2 PDD and PDD-NOS
* 3 Treatment
* 4 See also
* 5 References
* 6 External links

## Signs and symptoms

Symptoms of PDD may include behavioral and communication problems such as:

* Difficulty using and understanding language[8]
* Difficulty relating to people, objects, and events;[8] for example, lack of eye contact, pointing behavior, and lack of facial responses
* Unusual play with toys and other objects.[8]
* Paranoia, a characteristic form of social anxiety, derealization, transient psychosis, and unconventional beliefs if environment or routine are changed without notice[8]
* Repetitive body movements or behavior patterns,[8] such as hand flapping, hair twirling, foot tapping, or more complex movements[9]
* Difficulty regulating behaviors and emotions, which may result in temper tantrums, anxiety, and aggression[9]

### Degrees

Children with PDD vary widely in abilities, intelligence, and behaviors. Some children do not speak at all, others speak in limited phrases or conversations, and some have relatively normal language development. Repetitive play skills and limited social skills are generally evident. Unusual responses to sensory information—loud noises, lights—are common.[8]

## Diagnosis

Diagnosis is usually made during early childhood. Individuals who received diagnoses based on the DSM-IV maintain their diagnosis under the autism spectrum disorders. However, an editorial published in the October 2012 issue of American Journal of Psychiatry notes that, while some doctors argue that there is insufficient evidence to support the diagnostic distinction between ASD and PDD, multiple literature reviews found that studies showing significant differences between the two disorders significantly outnumbered those that found no difference.[10]

The World Health Organization's International Classification of Diseases, 10th edition (ICD-10) categorized PDD into five distinct subtypes, each with their own diagnostic criteria.[1] The five subtypes, childhood autism, atypical autism, Rett syndrome, Asperger syndrome and childhood disintegrative disorder, are characterized by abnormalities in social interactions and communication.[1]

The disorders were primarily diagnosed based on behavioral features, although the presence of any other medical conditions is important, it is not taken into account when making a diagnosis.

Before the release of the DSM-5, some clinicians used PDD-NOS as a "temporary" diagnosis for children under the age of five when, for whatever reason, they are reluctant to diagnose autism. There are several justifications for this. Very young children have limited social interaction and communication skills to begin with, so it can be difficult to correctly diagnose milder cases of autism in toddlers. The unspoken assumption is that by the age of five, unusual behaviors will either resolve or develop into diagnosable autism. However, some parents view the PDD label as no more than a euphemism for autism spectrum disorders, while the PDD label makes it more difficult to receive aid for early childhood intervention.

### Classification

The pervasive developmental disorders were:[5]

* Pervasive developmental disorder not otherwise specified (PDD-NOS), which includes atypical autism, and is the most common (47% of autism diagnoses);[11]
* Typical autism, the best-known;
* Asperger syndrome (9% of autism diagnoses);
* Rett syndrome; and
* Childhood disintegrative disorder (CDD).

The first three of these disorders are commonly called the autism spectrum disorders; the last two disorders are much rarer, and are sometimes placed in the autism spectrum and sometimes not.[2][3]

In May 2013, the Diagnostic and Statistical Manual–5th Edition (DSM-5) was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperger syndrome, Rett syndrome, and CDD, has been removed and replaced with the general term of autism spectrum disorders (ASDs). The American Psychiatric Association has concluded that using the general diagnosis of ASD supports more accurate diagnoses. The grouping of these disorders into ASD also reflects that autism is characterized by common symptoms and should therefore bear a single diagnostic term. In order to distinguish between the different disorders, the DSM-5 employs severity levels. The severity levels take into account required support, restricted interests and repetitive behaviors, and deficits in social communication.[12]

### PDD and PDD-NOS

There is a division among doctors on the use of the term PDD.[5] Many use the term PDD as a short way of saying PDD-NOS.[5] Others use the general category because the term PDD actually refers to a category of disorders and is not a diagnostic label.[5]

## Treatment

Medications are used to address certain behavioral problems; therapy for children with PDD should be specialized according to the child's specific needs.[8]

Some children with PDD benefit from specialized classrooms in which the class size is small and instruction is given on a one-to-one basis. Others function well in standard special education classes or regular classes with support. Early intervention, including appropriate and specialized educational programs and support services, play a critical role in improving the outcome of individuals with PDD.[8]

## See also

* Infantile neuroaxonal dystrophy
* Multiple complex developmental disorder
* Multisystem developmental disorder

## References

1. ↑ 1.0 1.1 1.2 World Health Organization (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization. ISBN 92-4-154422-8. OCLC 28294867.
2. ↑ 2.0 2.1 "Autism spectrum disorders". Neuron 28 (2): 355–63. 2000. doi:10.1016/S0896-6273(00)00115-X. PMID 11144346.
3. ↑ 3.0 3.1 "Identification and evaluation of children with autism spectrum disorders". Pediatrics 120 (5): 1183–215. 2007. doi:10.1542/peds.2007-2361. PMID 17967920. Bibcode: 2007Pedia.120.1183J.
4. ↑ Autism Health Center. "Pervasive Developmental Disorders (PDDs)". WebMD. http://www.webmd.com/brain/autism/development-disorder.
5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 "Disability Info: Pervasive Developmental Disorders (FS20)". http://www.nichcy.org/pubs/factshe/fs20txt.htm.
6. ↑ Posar, Annio; Resca, Federica; Visconti, Paola (2015). "Autism according to diagnostic and statistical manual of mental disorders 5(th) edition: The need for further improvements". Journal of Pediatric Neurosciences 10 (2): 146–148. doi:10.4103/1817-1745.159195. ISSN 1817-1745. PMID 26167220.
7. ↑ Mihalcea, D; Iordache, M P; Angelescu, C (December 11, 2025). "Neurodegeneration Within the Spectrum of Pervasive Developmental Disorders". Cureus 17 (12). doi:10.7759/cureus.99010. https://www.cureus.com/articles/446927-neurodegeneration-within-the-spectrum-of-pervasive-developmental-disorders#!/.
8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 This article incorporates public domain material from the National Institutes of Health document "NINDS Pervasive Developmental Disorders Information Page".
9. ↑ 9.0 9.1 Baird, G.; Douglas, H. R.; director, a.; Murphy, M. S. (2011-10-21). "Recognising and diagnosing autism in children and young people: summary of NICE guidance" (in en). BMJ 343 (oct21 1). doi:10.1136/bmj.d6360. ISSN 0959-8138. PMID 22021468. https://www.bmj.com/lookup/doi/10.1136/bmj.d6360.
10. ↑ American Psychiatric Publishing. "Autism Spectrum Disorder". American Psychiatric Association. http://www.dsm5.org/Documents/Autism Spectrum Disorder Fact Sheet.pdf.
11. ↑ ((Jon Baio, EdS, National Center on Birth Defects and Developmental Disabilities, CDC)) (2012). "Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008". https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm.
12. ↑ Autism Research Institute. "DSM-V: What Changes May Mean". http://www.autism.com/index.php/news_dsmV.

## External links

| Wikimedia Commons has media related to Pervasive developmental disorder.

|

* CDC's "Learn the Signs. Act Early." campaign \- Information for parents on early childhood development and developmental disabilities
* NINFS Pervasive Developmental Disorders Information Page

Classification|

* ICD-11: 6A02.Z
* ICD-10: F84
* ICD-9-CM: 299
* MeSH: D002659
* DiseasesDB: 33524

|

External resources|

* eMedicine: ped/1780

* v
* t
* e

Pervasive developmental disorders and autism spectrum (F84, 299)

Main|

* Causes
* Comorbid conditions
* Epidemiology
* Heritability
* Societal and cultural aspects
* Medical model
* Therapies

Diagnoses|

* Autism spectrum (High-functioning autism
* Classic Autism
* Asperger syndrome
* Pervasive developmental disorder not otherwise specified
* Childhood disintegrative disorder
* Rett syndrome)

Related conditions|

* Alexithymia
* Attention deficit hyperactivity disorder
* Anxiety disorder (obsessive–compulsive disorder)
* Late talker
* Epilepsy
* Fragile X syndrome
* Hyperlexia
* Savant syndrome
* Sensory processing disorder
* Intellectual disability
* Developmental coordination disorder
* Multiple complex developmental disorder

Controversies|

* Autism rights movement
* Autistic enterocolitis
* Facilitated communication
* MMR vaccine
* Rapid prompting method
* Thiomersal (Chelation)

Diagnostic scales|

* Gilliam Asperger's disorder scale
* Autism Diagnostic Observation Schedule
* Autism Diagnostic Interview
* Autism-spectrum quotient
* Childhood Autism Rating Scale

Lists|

* Autism-related topics
* Fictional characters
* Schools

* v
* t
* e

Mental and behavioral disorders (F00–F99 & 290–319)

Adult personality and behavior

| Gender dysphoria|

* Ego-dystonic sexual orientation
* Paraphilia
* Fetishism
* Voyeurism
* Sexual maturation disorder
* Sexual relationship disorder

|

Other|

* Factitious disorder
* Munchausen syndrome
* Impulse control disorder
* Dermatillomania
* Kleptomania
* Pyromania
* Trichotillomania
* Personality disorder

Childhood and learning

| Emotional and behavioral|

* ADHD
* Conduct disorder
* ODD
* Emotional and behavioral disorders
* Separation anxiety disorder
* Movement disorders
* Stereotypic
* Social functioning
* DAD
* RAD
* Selective mutism
* Speech
* Stuttering
* Cluttering
* Tic disorder
* Tourette syndrome

|

Intellectual disability|

* X-linked intellectual disability
* Lujan–Fryns syndrome

Psychological development
(developmental disabilities)|

* Pervasive
* Specific

Mood (affective)

* Bipolar
* Bipolar I
* Bipolar II
* Bipolar NOS
* Cyclothymia
* Depression
* Atypical depression
* Dysthymia
* Major depressive disorder
* Melancholic depression
* Seasonal affective disorder
* Mania

Neurological and symptomatic

| Autism spectrum|

* Autism
* Asperger syndrome
* High-functioning autism
* PDD-NOS
* Savant syndrome

|

Dementia|

* AIDS dementia complex
* Alzheimer's disease
* Creutzfeldt–Jakob disease
* Frontotemporal dementia
* Huntington's disease
* Mild cognitive impairment
* Parkinson's disease
* Pick's disease
* Sundowning
* Vascular dementia
* Wandering

Other|

* Delirium
* Organic brain syndrome
* Post-concussion syndrome

Neurotic, stress-related and somatoform

| Adjustment|

* Adjustment disorder with depressed mood

|

Anxiety|

| Phobia|

* Agoraphobia
* Social anxiety
* Social phobia
* Anthropophobia
* Specific social phobia
* Specific phobia
* Claustrophobia

|

Other|

* Generalized anxiety disorder
* OCD
* Panic attack
* Panic disorder
* Stress
* Acute stress reaction
* PTSD

Dissociative|

* Depersonalization disorder
* Dissociative identity disorder
* Fugue state
* Psychogenic amnesia

Somatic symptom|

* Body dysmorphic disorder
* Conversion disorder
* Ganser syndrome
* Globus pharyngis
* Da Costa's syndrome
* Hypochondriasis
* Mass psychogenic illness
* Neurasthenia
* Nosophobia
* Psychalgia
* Somatization disorder

Physiological and physical behavior

| Eating|

* Anorexia nervosa
* Bulimia nervosa
* Rumination syndrome
* Other specified feeding or eating disorder

|

Nonorganic
sleep|

* Hypersomnia
* Insomnia
* Parasomnia
* Night terror
* Nightmare
* REM sleep behavior disorder

Postnatal|

* Postpartum depression
* Postpartum psychosis

Sexual dysfunction|

| Arousal|

* Erectile dysfunction
* Female sexual arousal disorder

|

Desire|

* Hypersexuality
* Hypoactive sexual desire disorder

Orgasm|

* Anorgasmia
* Delayed ejaculation
* Premature ejaculation
* Sexual anhedonia

Pain|

* Nonorganic dyspareunia
* Nonorganic vaginismus

Psychoactive substances, substance abuse and substance-related

* Drug overdose
* Intoxication
* Physical dependence
* Rebound effect
* Stimulant psychosis
* Substance dependence
* Withdrawal

Schizophrenia, schizotypal and delusional

| Delusional|

* Delusional disorder
* Folie à deux

|

Psychosis and
schizophrenia-like|

* Brief reactive psychosis
* Schizoaffective disorder
* Schizophreniform disorder

Schizophrenia|

* Childhood schizophrenia
* Disorganized (hebephrenic) schizophrenia
* Paranoid schizophrenia
* Pseudoneurotic schizophrenia
* Simple-type schizophrenia

Symptoms and uncategorized

* Catatonia
* False pregnancy
* Intermittent explosive disorder
* Klüver–Bucy syndrome
* Psychogenic non-epileptic seizures
* Psychomotor agitation
* Stereotypy

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