Abstract
This study aimed to explore the boundaries between PDD and related disorders and to develop classificatory algorithms for what is currently called Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). Data collected by means of a standard coding system for the DSM-IV field trial for autistic disorder were used. Information on diagnostic criteria for autistic disorder as listed in ICD-10 and DSM-IV was compared between subjects functioning at least in the mildly retarded range and clinically classified as autistic disorder (n = 205), PDDNOS (n = 80) and other non-PDD disorders (n = 174). Only a limited number of items from the ICD-10 and DSM-IV systems for autistic disorder significantly discriminated the PDDNOS group from other disorders. A scoring rule based on a short set of 7 ICD-10/DSM-IV criteria with a cutoff of 3 items and 1 social interaction item set as mandatory had the best balance between high sensitivity and high specificity in discriminating PDDNOS from non-PDD disorders. These rules yielded a somewhat better prediction than most effective rules based on the full set of 12 criteria for autistic disorder with a cutoff of 4 items and 1 social item as mandatory. Generally accepted and well-validated criteria to identify individuals with PDDNOS should facilitate both research and clinical services.
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REFERENCES
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: Author.
Bishop, D. V. M. (1989). Autism, Asperger's syndrome and semantic-pragmatic disorder: Where are the boundaries? British Journal of Disorders of Communications, 24, 107–121.
Bolton, P., Macdonald, H., Pickles, A., Rios, P., Goode, S., Crowson, M., Bailey, A., & Rutter, M. (1994). A case-control family history study of autism. Journal of Child Psychology and Psychiatry, 35, 877–900.
Buitelaar, J. K., & Van der Gaag, R. J. (1998). Diagnostic rules for children with PDD-NOS and multiple complex developmental disorder. Journal of Child Psychology and Psychiatry 139, 911–919.
Cohen, D. J., Paul, R., & Volkmar, F. R. (1986). Issues in the classification of pervasive and other developmental disorders: Toward DSM-IV. Journal of the American Academy of Child Psychiatry, 25, 213–220.
Cohen, D. J., Towbin, K. E., Mayes, L., & Volkmar, F. R. (1994). Developmental psychopathology of multiplex developmental disorder. In S. L. Friedman & H. C. Haywood (Eds.), Developmental follow-up: Concepts, genres, domains and methods (pp. 155–179). New York: Academic Press.
Klin, A., Mayes, L. C., Volkmar, F. R., & Cohen, D. J. (1995). Multiplex developmental disorder. Journal of Developmental and Behavioral Pediatrics, 16, S7–S11.
Kraemer, H. C. (1988), Assessment of 2 × 2 associations: Generalization of signal-detection methodology. American Statistician, 42, 37–49.
Le Couteur, A., Bailey, A., Goode, S., Pickles, A., Robertson, S., Gottesman, I., & Rutter, M. (1996). A broader phenotype of autism: The clinical spectrum in twins. Journal of Child Psychology and Psychiatry, 37, 785–801.
Lord, C., & Rutter, M. (1995). Autism and pervasive developmental disorders. In M. Rutter, E. Taylor, & L. Hersov (Eds.), Child and adolescent psychiatry, modern approaches (pp. 569–593). Oxford: Blackwell.
Mayes, L., Volkmar, F., Hooks, M., & Cicchetti, D. (1993). Differentiating pervasive developmental disorder not otherwise specified from autism and language disorders. Journal of Autism and Developmental Disorders, 23, 79–90.
Rescorla, L. A. (1986). Preschool psychiatric disorders: Diagnostic classification and symptom patterns. Journal of the American Academy of Child and Adolescent Psychiatry, 25, 162–169.
Siegel, S., & Castellan, N. I. Jr. (1988). Nonparametric statistics for the behavioral sciences. New York: McGraw-Hill.
Sparrow, S. A., Rescorla, L. A., Provence, S., Condon, S. O., Goudreau, D., & Cicchetti, D. V. (1986). Follow-up of “atypical” children—-a brief report. Journal of the American Academy of Child and Adolescent Psychiatry, 25, 181–185.
Szatmari, P. (1992), The validity of autistic spectrum disorders: A literature review. Journal of Autism and Developmental Disorders, 22, 583–599.
Van der Gaag, R. J., Buitelaar, J. K., Van den Ban, E., Bezemer, M., & Van Engeland, H. (1995). A controlled multivariate chart review of multiple complex developmental disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1096–1106.
Volkmar, F. R., Klin, A., Siegel, B., Szatmari, P., Lord, C., Campbell, M., Freeman, B. J., Cicchetti, D. V., Rutter, M., Kline, W., Buitelaar, J., Hattab, Y., Fombonne, E., Fuentes, J., Werry, J., Stone, W., Kerbeshian, J., Hoshino, Y., Bregman, J., Loveland, K., Szymanski, L., & Towbin, K. (1994). Field trial for autistic disorder in DSM-IV. American Journal of Psychiatry, 151, 1361–1367.
Wing, L. (1988). The continuum of autistic characteristics. In E. Schopler & G. B. Mesibov (Eds.), Diagnosis and assessment in autism (pp. 91–110). New York: Plenum Press.
World Health Organization. (1992). The International classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines (10th ed.). Geneva: Author.
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Buitelaar, J.K., Van der Gaag, R., Klin, A. et al. Exploring the Boundaries of Pervasive Developmental Disorder Not Otherwise Specified: Analyses of Data from the DSM-IV Autistic Disorder Field Trial. J Autism Dev Disord 29, 33–43 (1999). https://doi.org/10.1023/A:1025966532041
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DOI: https://doi.org/10.1023/A:1025966532041