Is there a way to eliminate the confusion between autism and pervasive developmental disorder not otherwise specified (PDD-NOS)? It is often more difficult to obtain services for children in inner-city settings and to get parents involved in treatment with a diagnosis of PDD-NOS. — SANDRA McTERNAN, MSN, CPNP, Summit, N.J.

The diagnostic criteria for autism are clearly defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. There are other neurodevelopmental disorders within the autistic spectrum (Rett’s disorder, Asperger’s disorder, childhood disintegrative disorder) that also have well-defined diagnostic criteria. The diagnosis of PDD-NOS is often used when a child has deficits in one or more of the three social-communicative areas (social interaction, language/communication, and imaginative play) but does not fully meet the criteria for one of the above diagnoses. Sometimes PDD-NOS is used in the initial evaluation of a child suspected of an autistic disorder before the specific disorder is defined. This does not mean that the child with a diagnosis of PDD-NOS does not require early intervention and educational services. These children qualify for the same mandated services as those with any disability. It is a challenge in many areas, however, to find accessible quality services and to motivate families to use them. This is a situation in which you or your office staff needs to become advocates for the patient, serving at the same time as a model for parents. — Julee B. Waldrop, MS, PNP (144-11)