Journal of Autism and Developmental Disorders

, Volume 43, Issue 6, pp 1491–1494 | Cite as

Brief Report: An Unusual Manifestation of Diagnostic Overshadowing of Pervasive Developmental Disorder—Not Otherwise Specified: A Five Year Longitudinal Case Study

  • S. S. Meera
  • Ramesh Kaipa
  • Jaslin Thomas
  • N. Shivashankar
Brief Report

Abstract

Children with communication disorders present with a range of comorbid conditions. Occasionally one of the comorbid conditions manifests so strongly that the primary condition goes unnoticed by the clinician. This tendency to overlook comorbid health problems in the presence of a disability is referred to as diagnostic overshadowing. This is a five-year follow up case study of a 9-year-old female child. The child was initially diagnosed to have Separation Anxiety Disorder (SAD), but during the course of follow up she began to exhibit features of pervasive developmental disorder-not otherwise specified (PDD-NOS). This case report throws light on the severity of SAD which overshadowed PDD-NOS. Importance of follow-up and the need for a multidisciplinary team to be sensitive to the phenomenon of diagnostic overshadowing is discussed.

Keywords

Diagnostic overshadowing Separation anxiety disorder Pervasive developmental disorder Speech language pathologist Follow-up 

References

  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
  2. Bhardwaj, A., Agarwal, V., & Sitholey, P. (2005). Asperger’s disorder with co-morbid separation anxiety disorder: A case report. Journal of Autism and Developmental Disorders, 35, 135–136.PubMedCrossRefGoogle Scholar
  3. Bieri, J., Atkins, A. L., Briar, S., Leaman, R. L., Miller, H., & Tripodi, T. (1966). Clinical and social judgment: The discrimination of behavioral information. New York: Wiley.Google Scholar
  4. Bzoch, K., & League, R. (1991). Receptive-expressive emergent language test: A method for assessing the language skills of infants (2nd ed.). Austin: Pro-Ed.Google Scholar
  5. Farrugia, S., & Hudson, J. (2006). Anxiety in adolescents with Asperger syndrome: Negative thoughts, behavioral problems, and life interference. Focus on Autism and Other Developmental Disabilities, 21, 25–35.CrossRefGoogle Scholar
  6. Gard, A., Gilman, L., & Gorman, J. (1993). Speech and language development chart (2nd ed.). Austin: Pro-Ed.Google Scholar
  7. Levitan, G., & Reiss, S. (1983). The generality of diagnostic overshadowing across disciplines. Applied Research in Mental Retardation, 4, 59–64.PubMedCrossRefGoogle Scholar
  8. MacNeil, B. M., Vicki, A. L., & Mines, P. M. (2009). Anxiety in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 3, 1–21.CrossRefGoogle Scholar
  9. Malin, A. J. (1972). Vineland Social Maturity Scale–Nagpur adaptation. Lucknow: Indian Psychological Corporation.Google Scholar
  10. Mason, J., & Scior, K. (2004). Diagnostic overshadowing amongst clinicians working with people with intellectual disabilities in the UK. Journal of Applied Research in Intellectual Disabilities, 17, 85–90.CrossRefGoogle Scholar
  11. Schopler, E., Reichler, R., & Rochen-Renner, B. (1988). The Childhood Autism Rating Scale (CARS). Los Angeles, CA: Western Psychological Services.Google Scholar
  12. World Health Organisation. (1992). ICD-10 classifications of mental and behavioral disorder: clinical descriptions and diagnostic guidelines. Geneva: Author.Google Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • S. S. Meera
    • 4
  • Ramesh Kaipa
    • 1
  • Jaslin Thomas
    • 2
  • N. Shivashankar
    • 3
  1. 1.Department of Communication Sciences and DisordersOklahoma State University StillwaterOklahoma
  2. 2.All India Institute of Speech and HearingUniversity of MysoreMysoreIndia
  3. 3.Department of Speech Pathology and AudiologyNational Institute of Mental Health and NeurosciencesBangaloreIndia
  4. 4.Department of Speech Pathology and AudiologyNational Institute of Mental Health and NeurosciencesBangaloreIndia

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