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Jakob's PDD Characteristics

First, let's look at what it means to be autistic, and the characteristics of the disorder that Jakob used to display, and those he still displays today...

DSM-4 Criteria for Autistic Disorder

299.00 Autistic Disorder

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):

(1) qualitative impairment in social interaction, as manifested by at least two of the following:

(a) marked impairment in the use of multiple nonverbal behaviors, such as eye-to- eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) failure to develop peer relationships appropriate to developmental level
(c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
(d) lack of social or emotional reciprocity

(2) qualitative impairments in communication, as manifested by at least one of the following:

(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:

(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
(c) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex whole-body movements)
(d) persistent precoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:(1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.

Jakob @ 23 Months:

When Jakob was diagnosed at 23 months, he displayed the following characteristics from section A above:

(1) - (a) & (c), and borderline (b)

(2) - (a) & (d) (the others are non-applicable since he didn't really speak)

(3) - (a), (c), & (d)

He was definitely delayed in all three parts of section B, and there was no other "childhood disintegrative disorder" that better explained his condition.

Jakob Today:

Today, Jakob displays far fewer characteristics than he did at 23 months, perhaps due to his therapy and his time in preschool. He still has a significant impairment in his spoken language. Although his vocabulary is growing, he has trouble pronouncing most words, to the point that people other than his parents often have trouble understanding him. At times, he also seems to exhibit (3)-(b) - an inflexible adherence to certain routines, although he is not consistent in this characteristic.

If Jakob were to be "diagnosed" based on his characteristics today, he would not be considered autistic (he would just be considered to have a "pervasive developmental disorder - not otherwise specified"). But he had more than enough characteristics BEFORE THE AGE OF THREE to be diagnosed as autistic. He was also technically diagnosed with autism REGRESSION, based on the fact that he had developed some language skills by the age of one and then lost them. There is a fear, always present, in his parents' mind that he might regress again at some point, but so far, his future looks bright.