Pervasive Developmental Disorder (PDD) not otherwise specified or bipolar not otherwise specified or both?

Discussion in 'General Parenting' started by crazymama30, Nov 27, 2011.

  1. crazymama30

    crazymama30 Active Member

    So difficult child now has both these diagnosis's. In reading about the Pervasive Developmental Disorder (PDD) not otherwise specified, he has almost all of those behaviors. He had problems with eye contact when he was younger (He is almost good with this now, but it took work), had problems with personal space when younger (would want to hug everyone. Once again, this is good now but it took alot of work), does not do well with complicated or lengthy directions (I simplify things and give them to him in steps), does not understand facial expressions or body language, has major problems with give and take in conversations (he thinks he should just talk and everyone should listen. lol), is very black and white and rigid with his thinking. I read a fact sheet on a website about how to make communication easier with a child on the spectrum, and I do all of them. I am going to print it out and take it to family therapy to give to the therapist so she will realize I DO know what I am doing and I have tried many interventions.

    He also has shown traits of bipolar disorder, the mood swings. He can be really manicky (extreme irritability, pressured speech, racing thoughts) and depressed (isolates himself, gets teary over little things, and once again the irritability).

    so I guess we treat each disorder? I will ask if he is doing speech therapy to help with communication at Residential Treatment Center (RTC) (I doubt it). I really wish they would do a medication wash so we could see which disorder was more pressing, needed more treatment. Would a medication wash even show that? I don't know.

    Any ideas? I am really concerned about how we will do having difficult child home. It has not been mentioned yet, but I know it will come within the next few weeks or month. I am probably getting ahead of myself here, but that thought has been most on my mind.
  2. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I know there have been several kids on the board who have flavors of both disorders, Fran is one who most comes to mind. It does sound to me like your son does have both issues going on. It wouldnt be odd for him considering his genetic history. Oddly enough though the whole personal space thing is something we had huge issues with concerning Cory and I dont think he has any Autism Spectrum Disorders (ASD) traits though reading other peoples emotions may not have been his strongest skill when he was younger...or even now. Cory was very touchy feely and the little boy who wanted to hug everyone long after it was appropriate for little boys to do so. We worked on the "bubble" that surrounds everyone and you dont go inside anyones bubble unless the invite you. The bubble was arms reach.

    However, I also have a very black and white I lucky or what to have so many kids so I get tons of examples of Billy is my rigid thinker. He is the one who has rules and theories and those are set in stone and you simply cannot shake them. It makes things interesting. For example. I had him drive me somewhere the other day and we had to merge onto a highway. He had to come to a dead stop when attempting to merge because there was a car in the right hand lane that was in the blind spot that was attempting to slow down for us to get on the road but he was only using the mirrors and he couldnt see them clearly and he wouldnt turn his head to look. He just complained that they wouldnt get out of HIS blind I took my car back at the next rest area. lol. He thinks he should be able to drive using the mirrors alone because that is the way it is taught in the drivers manual. Where I dont know but he has that in his head.
  3. buddy

    buddy New Member

    You are the one who lives this so I am not doubting you for a second. Please know that! I am just going to share what you have probably heard a million times here.... The behaviors you describe, the mood swings, the teary stuff, the "pressured speech" all are similar to the dozens of kids I have taught with autism over the years. I have worked with kids with bi-polar as a stand alone diagnosis, but not nearly the number of kids I have worked with on the spectrum so my knowledge is lopsided. The manicky and depressed symptoms do happen in autism, but caused by a different reason. The quality of them may be different? as I said, I do not have enough experience to compare so I would think once you start working with autism professionals you may get more information as to whether or not his behaviors look like autism symptoms to them. You have not spent time in programs with people who have worked on his autism yet right? So, if the medications are helping, great. I certainly use them. Many people do. And then now that you have the autism diagnosis (PDDnos) then you can get services for that and little by little you will sort out what looks more like autism vs. what looks more bi-polar.

    Unfortunately, so many kids with autism were misdiagnosed as another disorder and it certainly could be that this is the situation with you. People do not like to drop a diagnosis once they are committed to it and they will be looking for bipolar symptoms because that is what he came in with. It is just human nature. It will be interesting to see what they say and do.

    Not much help, sorry.....

    Can you have an IEP meeting and discuss getting into autism programming ?
  4. crazymama30

    crazymama30 Active Member

    I cannot help but wonder if he is more Pervasive Developmental Disorder (PDD) not otherwise specified than bipolar disorder not otherwise specified? that could just be me, as I think that overall an autism like diagnosis would carry less negative impact from society than a bipolar diagnosis. I can see he has traits of both, but really? The ones for the Pervasive Developmental Disorder (PDD) are the most disruptive. But then, how would I know? He has been on a stimulant since 2nd grade, a mood stabilizer since 3rd or 4th, and abilify since 5th grade?

    Buddy, we will definately have an IEP meeting when he gets back to his regular school, if he ends up there. He could end up at the special middle school for kids with behavior issues. I would like him to be able to finish 8th grade at his school, but it really is dependent upon where he needs to be. We actually were getting an IEP meeting set up before he left, as we need to do that to get him into the high school (one that is more theraputic in nature) that I want him to go to.
  5. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Autism Spectrum Disorders (ASD) kids have moodswings too, much due to their disorder. Please be careful. The drugs for bipolar are heavy duty and should not be taken unless you are sure he needs them. I wish my son had never been on them. Good luck :)
  6. crazymama30

    crazymama30 Active Member

    mwm, that is one of my concerns. However, he has done on the medications than off of them. My concern remains that he has been on them so long. I think that concern may remain un adressed, unless the Residential Treatment Center (RTC) will do a medication wash.
  7. pepperidge

    pepperidge New Member


    I think you really want a medication wash and won't be satisfied until you have really sorted that one out with the Residential Treatment Center (RTC). So you might want to make that your first priority in talking to them. He probably needs to be somewhere while they do that.

    I am not sure the diagnosis really makes all that much difference--the question is whether there are any medications that help him. That's what your gut is telling you about the medication wash.

    I hear you about the therapist. Perhaps they get kids there whose parents are clueless. So you can easily demonstrate you are not clueless. So I guess I would really emphasize that you have him there so they can observe him closely and try to figure out what kind of medications might help, if any.

    Second, they might teach him coping skills, but frankly, a couple of months probably isn't going to make too much difference. Given all the therapy that you have been through I doubt there is a whole lot they can tell you that you haven't already heard. Maybe the therapist needs to look at all the interventions you have tried.

    Third, having him there gives you a chance to regroup, probably not high on their list of reasons to have in the Residential Treatment Center (RTC).

    Fourth, they need to tell you what they think about his chances of being successful in a more normal school setting, and home. I know that you have some options, but do you think your HS can deal with him? If not, what then? Those are the questions the Residential Treatment Center (RTC) needs to be answering.

    If they are thinking about discharging him in a few weeks, ask them on what basis they are discharging him--what goals has he met.

    good luck. sounds like you need to keep warrioring on.
  8. crazymama30

    crazymama30 Active Member

    pepper, warrioring on is what I plan on doing. I plan on calling therapist on Tuesday, and I will either offer to fax a list of what we have done or go over it on the phone, as well as the pages I printed out about Pervasive Developmental Disorder (PDD) not otherwise specified interventions that we have already been doing.

    You are right, I won't be satisified untill we get a medication wash, unless seroquel turns out to be a miracle medication. I just don't see that happening.

    I don't think he would do ok in a normal high school setting, and I hope he will be able to finish middle school where he is. I have an IEP meeting planned at the current school so he can go to the more theraputic program, pm me if you are interested in knowing the name. It is in my town, so it would be a drive to your kiddos there. In fact, I know he would fail at a normal high school. Too many kids, too much activity, and not enough one on one with the teachers. The only reason he has made it at this middle school is that it is small, and the teachers take the time to get to know difficult child. It also helps that he is a likeable guy, and they truly like him and see that he struggles socially.
  9. buddy

    buddy New Member

    Is the therpeutic highschool an EBD school or an autism based program? OR both??? Just curious, I know you have heard my stories of Autism Spectrum Disorders (ASD) kids in EBD classes. But everyone is different.
  10. crazymama30

    crazymama30 Active Member

    Buddy, what is an EBD school? The school I want to him is meant for kids with behavioral challenges, and has therapists on staff and is based on the collaborative problem solving method.
  11. buddy

    buddy New Member

    sorry, Emotional/Behavior Disorders

    wow that is wonderful, what you are talking about could be good if he truly is dual diagnosis... and even if not then you may not have the pitfalls that other EBD classes have for kids with autism. I know you are checking it all out, so just make sure they add Autism Spectrum Disorders (ASD) on his IEP and have the Autism Spectrum Disorders (ASD) folks helping out. SOunds like it could be a good choice if they are used to working with kids with autism too... you are lucky if that is so!
  12. crazymama30

    crazymama30 Active Member

    buddy, then that is an ebd school.
  13. pepperidge

    pepperidge New Member

    CM--How much do you know about the therapeutic high school? Sometimes these things are better in name than practice. Have you ever had an autism consult with the regional resource group? They have some good specialists on their staff. PM me if you want to know more about that. If he has been reasonably successful at your specialized middle school then there is hope for the HS. One issue that you may have is that he will be hanging out with other kids with significant issues--hopefully not conduct disorder type issues--does the HS separate those out? I know you are worried about drugs and other things.

    Good luck with the therapist. What does your psychiatrist say about the medication wash?
  14. TerryJ2

    TerryJ2 Well-Known Member

    I agree, that a medwash is a good idea. I just don't see how anyone can tell when he's already on several medications.
    Other than that, I have no advice. In fact, I know a few people who are bipolar and have pressured speech, and I thought that was always bipolar. I thought those on the autism spectrum had speech that was more like shouting.
  15. crazymama30

    crazymama30 Active Member

    Well Terry, he shouts too. He speaks really really loud and has no idea he is doing so. It gets worse as he gets more agitated
  16. buddy

    buddy New Member

    I finally made them take all the voice modulation goals off the IEP...waste of time. Seems to be in part a sensory thing. WHen you look at non verbal kids they do it to get their voices above the perceived noise around them.... theory in part is that it is comforting to hear their own voices. Q started way back when he was very low verbal. Still is very very loud. Has lots of noise sensitivities though, has ear plugs all the time to help. Also is sensitive to smells, touch etc. but seeks touch in the extreme on his terms. yikes. can be complicated to sort thru, huh?

    crazymama, sounds like your gut is really wondering if this was it all along? if it is, that is ok. but as a mom of a kid with dual diagnosis,.... it can happen that they are just that lucky, to have more than one thing. I doubt it is super common though(I dont mean kids iwth Autism Spectrum Disorders (ASD) dont have other things, we know they get odd, anxiety, etc...labels that go under autism but explain better a symptom... I mean a true separate disorder) but it is common enough. Plenty of us here for sure. But I actually hope for you that it is mostly the Pervasive Developmental Disorder (PDD) stuff. I can hope right??
  17. Jules71

    Jules71 Warrior Mom since 2007

    I am interested in what you describe above. Do you have a link you can share? Thx.
  18. crazymama30

    crazymama30 Active Member

  19. Jules71

    Jules71 Warrior Mom since 2007

  20. TerryJ2

    TerryJ2 Well-Known Member

    Crazymama, interesting link. I could read all night. :)