Pervasive Developmental Disorder

What is pervasive developmental disorder (PDD)?

Pervasive developmental disorder was once a term used to describe a group of developmental delays that affect social and communication skills. But now healthcare providers call it autism spectrum disorder (ASD). This name change occurred in 2013, when the American Psychiatric Association reclassified the four following conditions into one umbrella diagnosis in the DSM-5:

• Autistic disorder.
• Asperger’s syndrome.
• Childhood disintegrative disorder.
• Pervasive developmental disorder not otherwise specified (PDD-NOS).

Note: “Autism spectrum disorder” is the correct, updated term for “pervasive developmental disorder.” But for this article, we’ll use both terms.

People with pervasive developmental disorder may experience a range of challenges, including:

• Delays in language or communication.
• Trouble adjusting to changes in their routines or surroundings.
• Difficulty relating to others.

How common is pervasive developmental disorder?

Pervasive developmental disorder is the most common subtype of autism spectrum disorder, making up about 47% of all ASD diagnoses.

What are the symptoms of pervasive developmental disorder?

The most common pervasive developmental disorder symptoms include difficulty with communication and social interactions. Children with PDD may also:

• Engage in repetitive behaviors like rocking or hand flapping.
• Have difficulty expressing their thoughts through language.
• Have a hard time with routine changes.
• Avoid eye contact.
• Have trouble engaging in conversation.
• Have difficulty controlling their emotions.
• Speak with a flat or high-pitched voice.

No two people with pervasive developmental disorder are the same. Symptoms can range from mild to severe — and most people fall somewhere between the two ends of the spectrum.

What causes pervasive developmental disorder?

Researchers are still working to find a specific cause for pervasive development disorder. But it’s likely there’s a combination of genetic and environmental factors rather than a single cause. Possible factors include:

• Genetics. Plenty of experts believe that genetics plays a major role in PDD. But they’re still learning exactly how. Many people with pervasive developmental disorder have gene mutations (changes). In fact, scientists have found more than 100 genes on different chromosomes that contribute to autism spectrum disorder in some way. But it’s complex. Not everyone with PDD has the same mutations in every gene. And some of these same mutations appear in people without PDD. Currently, most researchers agree that specific genetic mutations likely cause specific symptoms — or control how severe those symptoms become. At the very least, these genetic mutations can increase your risk for PDD.
• Environment. If you’re more prone to PDD because of a genetic mutation, then certain situations or environments can further increase your chances of developing it. For instance, if you have a specific genetic mutation, then getting an infection or coming into contact with a certain toxin can cause PDD.
• Biology. Researchers continue to examine biological factors that may increase your risk of PDD. This includes conditions that affect your metabolism, immune system or certain areas of your brain.

Pervasive developmental disorder risk factors

A risk factor is something that increases your chances of getting a certain condition. Experts have identified some risk factors for PDD, including:

• Having a sibling with PDD or another type of ASD.
• Some genetic conditions like fragile X syndrome or Down syndrome.
• Having biological parents who were at least 35 when you were born (advanced maternal age).
• Low birth weight.

What are the complications of pervasive developmental disorder?

While every person with PDD has their own challenges, the severity of symptoms can vary widely. Some children with PDD have typical language skills, while others may not speak at all. Your healthcare provider can help determine what types of resources your child might need. Early diagnosis and treatment can often reduce your child’s symptoms.

How do healthcare providers diagnose pervasive developmental disorder?

There’s no lab test or medical exam that can diagnose pervasive developmental disorder. Instead, healthcare providers observe a person’s behavior and look at their developmental history.

The American Academy of Pediatrics recommends that all children have screenings for autism spectrum disorder when they’re 18 to 24 months of age. Most healthcare providers screen children during routine developmental and wellness checkups. During these checkups, your provider will talk and interact with your child. They’ll also ask you questions about how your child moves, behaves and communicates at home.

While most diagnoses occur in early childhood, providers can also diagnose PDD and other types of ASD in older children, teens and adults. If you think you or your child could have pervasive developmental disorder or a related condition, talk to your healthcare provider. They can do an evaluation or refer you to someone who specializes in ASD.

How do healthcare providers treat pervasive developmental disorder?

Healthcare providers use a variety of treatments to manage PDD, including:

• Supportive therapies.
• Medications.
• Complementary medicine.

No two people are the same. What works for one may not work for another because each person has specific and unique needs. Your healthcare provider will design a personalized approach to give help and support where it’s needed most.

Supportive therapies

Supportive therapy is the mainstay treatment for pervasive developmental disorder. This can include things like:

• Speech therapy to help build communication and comprehension skills.
• Occupational therapy to strengthen coordination and help you learn routine tasks like bathing, getting dressed and brushing your teeth.
• Physical therapy to develop motor skills and learn ways to exercise and increase stamina.
• Applied behavioral analysis (ABA), a type of behavior therapy that aims to increase positive behaviors and decrease negative ones.

Medications

There are no medications that treat PDD directly. But many people with pervasive developmental disorder have attention-deficit/hyperactivity disorder (ADHD), anxiety, depression or other similar conditions. In these cases, medications can help improve your overall quality of life.

Complementary medicine

Complementary medicine involves combining nontraditional approaches with traditional treatments. This can include a wide range of things like:

• Art therapy.
• Music therapy.
• Massage.
• Acupuncture.
• Yoga.
• Meditation.

Your provider can help you find complementary therapies to enhance your overall health and wellness.

Can I prevent pervasive developmental disorder?

No, there’s nothing you can do to prevent PDD or other types of ASD. If you or your child has this condition, it doesn’t mean you’ve done something wrong. There are many reasons why people develop PDD, and none of them are under your control. There’s also no scientific evidence suggesting that childhood vaccinations cause PDD or ASD.

Early diagnosis and intervention are the best ways to manage pervasive developmental disorder. But it’s never too late to begin treatment, as it’s beneficial at any age.

When should I see my healthcare provider?

If you think your child might have PDD or a similar condition, talk to your healthcare provider about developmental screenings. They can tell you if your child’s screenings are up to date and whether they should see a specialist for further testing.

If you’re an adult who thinks you might have PDD or another type of ASD, ask your primary care physician for support. Due to the growing awareness around autism spectrum disorder, there are plenty of resources available today that weren’t available several years ago. It’s never too late to seek the support you deserve.

A note from Cleveland Clinic

Whether it’s you or your child, getting a developmental disorder diagnosis can feel scary — like you’re traveling in uncharted territory. Or you might feel a sense of relief to finally get some answers. Either way, your healthcare provider is here for you. Experts know significantly more today about autism spectrum disorder than they did just a decade or two ago.

People with ASD view the world differently — but that’s not a bad thing. Incorporating structure into your daily life is a great way to offer yourself support, and a great way to show your child you love them just the way they are. If you think you or your child might have PDD, talk to your healthcare provider about support and resources.