Monterey Bay Forum

written by Cameron Jackson DrCameronJackson@gmail.com

Does Peter — this is a hypothetical clinical case — suffer from NLD or Asperger’s Disorder or PDD-NOS? So some combination? What is the best fit? Many of the facts are true however names and identifying information has been changed to protect privacy.

Remember the children’s verse: “Peter, Peter, pumpkin eater… had a wife and couldn’t keep her… so he put her in a pumpkin shell… there he kept her very well… ”

It certainly was socially inept of Peter to keep his wife locked in a shell….Was that the best that Peter could do?

Non-verbal learning disability (NLD) was much talked about 10 years ago. Maybe because NLD never made it into in the Diagnostic and Statistical Manual (DSM-IV) it’s only known in certain circles.

In some ways NLD is similar to 298.0 Asperger’s Disorder — which is a diagnosis in the DSM-IV.

Many people somewhat approximate the diagnosis that are in the DSM-IV. The issue is to find the best fit.

Let’s see what is the best diagnosis for Peter. A number of facts are changed to protect privacy. Let’s see whether Nonverbal Learning Disability (NLD) or Asperger’s fit as a better fit for this young man.

Peter — not his real name — is in his middle 20′s. He went to private schools in Santa Cruz County and finished at an alternative high school. Both his parents finished college and work professionally. Peter is an only child.

From his father for years he heard, “Just step up to the plate… you can do it… Try harder…” Yes, Peter has low self esteem. (more…)

There is a saying, “the devil is in the details…” 

Assessment of autism with the ADOS is fraught with difficulties.  The ADOS per the Manual does not assess for Category 3 behaviors — repetitive, stereotypic behaviors. 

 There must be substantial Category 3 behaviors for a DSM-IV-TR diagnosis.  It sounds like, per Assessment of Autism Spectrum Disorders (2009) that a new algorithm published in 2007 takes care of the problem. But does it?  (more…)

This is a true story with some information changed to protect privacy.

The boy, I will call him Mark, is nearly seven years old. He was diagnosed with Autistic Disorder a year ago.

The diagnosis was given after a thorough assessment by a licensed California psychologist up in the Bay Area. Mark and his parents live in the Monterey Bay area. Mark goes to a public school kindergarten.

In the course of just one year, Mark’s functional abilities have improved considerably. He no longer meets criteria for a diagnosis of Autistic Disorder. (more…)

The next version of the Diagnostic and Statistical Manual (DSM-V) more than likely will collapse Asperger’s Disorder and PDD-NOS into “Autistic Spectrum Disorder” (ASD). If you want to comment go to the following web site.

I think the new definition of ASD is cleaner and well written. It still needs something in the diagnostic criteria that addresses how substantially handicapped the person is by his/her particular symptoms.

The flip side of diagnosis is treatment. A diangosis of “Autistic Spectrum Disorder” should include the specific deficits — and degree of deficit — so as to suggest appropriate, individual interventions.