Pervasive developmental disorder not otherwise specified (PDD-NOS)—also known as atypical autism—is an outdated term used when a child has some symptoms of autism but does not meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4). We can explore more about how we understand and approach atypical autism today.
Understanding Autism: From Neuro-typical to Atypical
Autism Spectrum Disorder (ASD) spans a wide range of symptoms and severity, leading to the differentiation between ‘neuro-typical’ and ‘atypical’ autism. Neuro-typical refers to individuals whose development and behaviours are in line with what society considers ‘typical’ or ‘standard’. They typically exhibit social and cognitive behaviours expected for their age, without significant differences. On the other hand, atypical autism, also known as Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), represents a subtype of ASD where individuals display some, but not all, characteristics of ‘typical’ autism or exhibit them in a less severe or different pattern. This range of symptoms reflects the broad diversity in experiences and behaviours of those on the autism spectrum.
Diagnosis and Evaluation: Recognizing Atypical Autism
Diagnosing atypical autism can be a complex process due to the wide range of symptoms and their varying degrees of intensity. This form of autism often falls into the category of Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) because individuals may exhibit some signs of autism, but not to the extent defined by the full diagnostic criteria for Autism Spectrum Disorder (ASD). Common characteristics can include challenges with social interactions, communication difficulties, and restricted or repetitive behaviors, though these may be less pervasive or severe than those observed in ‘typical’ autism. It’s important to involve multidisciplinary teams consisting of psychologists, neurologists, psychiatrists, and speech therapists to ensure a comprehensive evaluation and accurate diagnosis. The process usually involves in-depth observation, interviews, and standardized testing to analyze behaviour, language, social interactions, and developmental history.
Comparing Atypical Autism and Classic Autism
Atypical autism and classic autism fall within the same umbrella of Autism Spectrum Disorders (ASD), but they differ in certain characteristics and severity of symptoms. Both share common hallmarks such as difficulties in social interaction and communication, along with restricted and repetitive behaviours. However, in classic childhood autism, also known as Kanner’s autism, these symptoms are generally more severe and become noticeable in early childhood, often before the age of three. Individuals with classic autism may also exhibit intellectual disability.
On the other hand, those with atypical autism, often classified as Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), may not meet all the diagnostic criteria for classic autism. Their symptoms might be milder, vary more widely, or may have become evident later in childhood. They may also be quite independent in various areas. While both forms of autism can greatly benefit from early intervention and therapy, understanding the differences between them is vital for tailoring effective treatment strategies and setting appropriate goals.
Treatment Approaches for Atypical Autism
The treatment for atypical autism, like all forms of autism, should be highly individualized to cater to the unique needs and challenges of each person. Although atypical autism manifests differently and often more mildly than classic autism, the core elements of treatment remain similar. They generally involve a combination of therapies aimed at enhancing social skills, communication, and adaptive behaviours while reducing problematic behaviours.
Applied Behavior Analysis (ABA) therapy is widely recognized as an effective approach, and can be tailored to the individual’s needs. Other interventions may include speech and language therapy, occupational therapy, social skills training, and possibly medication for co-occurring conditions such as ADHD or anxiety. Parent-mediated interventions also play a critical role in treatment, providing consistency and reinforcement of skills in the child’s everyday environment outside of intervention sessions. For children with milder symptoms or those diagnosed later, counselling or cognitive-behavioural therapy might be appropriate options. The goal of treatment is not to ‘cure’ autism, but to help the individual manage areas that are challenging and lead a fulfilling and meaningful life, maximizing their potential while respecting their unique neurodiversity.
Applied Behavior Analysis (ABA) Therapy in Managing Atypical Autism
Applied Behavior Analysis (ABA) therapy has shown considerable efficacy in managing atypical autism, just as it has with other forms of autism spectrum disorders. This behavioural therapy focuses on improving specific behaviours, including social skills, communication, and academics, and decreasing problematic behaviours. Given that atypical autism often presents with milder symptoms and higher functioning, ABA can be particularly effective, especially when customized to address the individual’s specific needs and capabilities. Its data-driven approach allows for regular adjustment of strategies based on progress, ensuring optimal efficacy. It can mainly focus on the areas that are challenging for atypical autistic individuals to help build those skills effectively.
By breaking down complex skills into smaller, teachable steps and reinforcing positive behaviours, ABA can foster significant improvement in children with atypical autism. The ultimate goal of ABA is not to alter the individual’s unique personality or interests, but to equip them with essential skills that enhance their independence and overall quality of life.
Incorporating Speech and Occupational Therapy: Collaborative Approach to Atypical Autism
In treating atypical autism, a multidisciplinary approach that incorporates both speech and occupational therapy has been proven beneficial. Speech therapy aims at improving communication skills, which may encompass verbal and non-verbal methods depending on the child’s needs. It can help individuals articulate their thoughts and feelings more effectively, understand social cues, and improve the overall quality of their social interactions. On the other hand, occupational therapy focuses on enhancing daily living skills. This may include refining motor skills for tasks like writing, improving sensory processing to better tolerate various environments, or teaching practical life skills such as dressing, eating, or maintaining personal hygiene. When combined, these therapies work in synergy, empowering the individual with a holistic set of skills for daily life and social engagement.
This collaborative approach is largely determined by the individualistic needs of an individual. For instance, if an individual’s main area of challenge is around verbal skills and speech but is fully independent in daily living skills. Then, occupational therapy might not be necessary at the time. There is no ‘correct’ order or group of treatments, it is most important to assess what the individual needs and build our support from there. This collaborative approach allows for a more personalized and comprehensive treatment plan, significantly improving the prognosis for children with atypical autism.
Parental and Community Support
Treatment and management of atypical autism extend far beyond therapy sessions—it encompasses the active involvement of parents and the wider community. For parents, it is essential to maintain an open dialogue with therapists, educators, and medical professionals to understand their child’s unique needs, progress, and strategies that can be reinforced at home. Supportive parenting includes fostering a safe and understanding environment that appreciates the child’s individuality while promoting consistent growth.
Similarly, community involvement is pivotal. This could mean fostering autism-friendly spaces, promoting awareness and inclusivity, or providing resources and support groups for families. With a supportive community, individuals with atypical autism can experience increased acceptance and understanding, which are key in enhancing their self-esteem and social interactions. In essence, the collaborative effort of parents and the community can significantly augment the effectiveness of professional treatments and ultimately improve the quality of life for those with atypical autism.
Living with Atypical Autism
Living with atypical autism presents unique challenges and opportunities that, while initially daunting, can unfold into inspiring narratives of resilience and triumph. Stories from individuals with atypical autism and their families often highlight their journey of navigating the intricacies of this condition, the trials they have faced, and the milestones they’ve achieved.
One common theme among these stories is the celebration of small victories, from mastering a new skill, improving in social interactions, or even having a good day at school or work. These accomplishments, though they may seem modest to some, often represent significant leaps for someone with atypical autism. Moreover, the ongoing commitment of families and therapists to nurture and maintain the individual’s potential, combined with the individual’s own fortitude, often result in awe-inspiring progress over time. These stories serve as a beacon of hope, encouraging others dealing with atypical autism and spreading awareness and understanding of this condition.
What is an example of atypical autism?
An example of atypical autism, also known as Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS) based on the DSM-4, could be a child who shows late-onset or milder symptoms compared to classical autism. For instance, they might have difficulties with social interactions and communication but not display restrictive or repetitive behaviours typically seen in classical autism.
At what age does atypical autism start?
The onset of atypical autism can vary widely between individuals. While symptoms of autism typically appear in early childhood, usually before age 3, atypical autism might not become apparent until later, sometimes even into adulthood, particularly if symptoms are milder or less typical.
What is the difference between autism and atypical autism?
The main difference between autism and atypical autism lies in the presentation and severity of symptoms. In atypical autism, the symptoms might be milder, fewer in number, or have a later onset compared to classical autism. This could mean that a person with atypical autism experiences difficulties in some areas such as social interactions but may not exhibit the full range of symptoms typical of autism spectrum disorder.
What is the test for atypical autism?
Diagnosis of atypical autism typically involves a comprehensive evaluation conducted by a multidisciplinary team of specialists, including psychologists, psychiatrists, and paediatricians. This assessment involves structured interviews and observational tools, such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview – Revised (ADI-R), and takes into account the individual’s developmental history, behaviour, and current functioning. However, the specific tests used may vary depending on the individual’s age and specific symptoms.
Janice is a Board Certified Behavior Analyst. She graduated from the University of British Columbia with a Bachelor of Arts in Psychology and Special Education. She also holds a Master of Science in Applied Behaviour Analysis (ABA) from Queen’s University, Belfast. She has worked with and case managed children and youth with autism and other intellectual and/or developmental disabilities in home and residential setting since 2013.