eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Pervasive Developmental Disorder: Follow-up

Author: Sufen Chiu, MD, PhD, Assistant Clinical Professor (Volunteer Faculty), University of California Davis Medical School; Consulting Staff, Child and Adolescent Psychiatry of Sacramento County; Consulting Staff, Sutter Center for Psychiatry; Consulting Staff, Transcultural Wellness Center
Coauthor(s): Randi Jenssen Hagerman, MD, FAAP, Professor of Pediatrics, Medical Director MIND Institute, Endowed Chair in Fragile X Research, Division of Developmental/Behavioral Pediatrics, University of California Davis Medical Center; Henrietta Leonard, MD, Program Director, Child and Adolescent Psychiatry, Professor of Psychiatry and Human Development, Division of Child and Adolescent Psychiatry, Rhode Island Hospital and Brown University
Contributor Information and Disclosures

Updated: Mar 26, 2008

Follow-up

Further Inpatient Care

  • Thorough medical evaluation is warranted before psychiatric hospitalization is considered.
  • Inpatient care is warranted to manage acute medical issues or for a workup of subclinical medical disorders.
  • Patients often present with medical problems that manifest as changes in behavior.
  • Psychiatric hospitalization is indicated whenever the safety of the patient cannot be maintained.

Further Outpatient Care

Outpatient management requires a multidisciplinary approach.

  • Comorbid medical problems, including seizures and constipation, are frequent.
  • Certain behaviors may require medication by a child and adolescent psychiatrist or behavioral-developmental pediatrician.
  • A speech pathologist's expertise is essential to develop a communication plan.
  • A special education professional may be needed to design a specific curriculum for each child with pervasive developmental disorder (PDD).
  • Occupational and physical therapists may be indicated for motor deficits and sensory processing deficits.
  • A social worker not only helps find financial, educational, and emotional resources but also provides important psychosocial support for the family.
  • Psychologists often develop behavioral plans and ongoing therapy to improve social relationships.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to conduct a thorough medical review: A thorough review is important because none of the pervasive developmental disorders (PDDs) has a medical cure. Treatable conditions may cause symptoms of PDD, or they may worsen behaviors associated with these disorders.
  • Failure to suggest legal consultation: Many parents of children with PDD need legal guidance to help them understand their legal rights to benefits and services for their children from public schools and from the medical system.
 
Acknowledgments

This article is dedicated to Henrietta Leonard, MD (program director of child and adolescent psychiatry and professor of psychiatry and human development in the division of child and adolescent psychiatry at Rhode Island Hospital and Brown University) who passed away in August 2007. Dr. Leonard will be missed by many for her passion for teaching, highest ethical standards, and dedication to children's mental health. Without her, this chapter would never have been realized.



More on Pervasive Developmental Disorder

Overview: Pervasive Developmental Disorder
Differential Diagnoses & Workup: Pervasive Developmental Disorder
Treatment & Medication: Pervasive Developmental Disorder
Follow-up: Pervasive Developmental Disorder
Multimedia: Pervasive Developmental Disorder
References

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Further Reading

Keywords

personality developmental disorder, PDD, autistic disorder, autism, Rett disorder, Rett syndrome, childhood disintegrative disorder, Asperger disorder, Asperger syndrome, pervasive developmental disorder not otherwise specified, childhood disintegration, obsessive compulsive disorder, OCD, attention deficit hyperactivity disorder, ADHD, schizophrenia, anxiety, regression, language delay, epilepsy, cerebral palsy, tuberous sclerosis, phenylketonuria, neurofibromatosis, Down syndrome, congenital rubella

Contributor Information and Disclosures

Author

Sufen Chiu, MD, PhD, Assistant Clinical Professor (Volunteer Faculty), University of California Davis Medical School; Consulting Staff, Child and Adolescent Psychiatry of Sacramento County; Consulting Staff, Sutter Center for Psychiatry; Consulting Staff, Transcultural Wellness Center
Sufen Chiu, MD, PhD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Psychiatric Association, California Medical Association, and Sierra Sacramento Valley Medical Society
Disclosure: Janssen Honoraria Speaking and teaching

Coauthor(s)

Randi Jenssen Hagerman, MD, FAAP, Professor of Pediatrics, Medical Director MIND Institute, Endowed Chair in Fragile X Research, Division of Developmental/Behavioral Pediatrics, University of California Davis Medical Center
Randi Jenssen Hagerman, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Society of Human Genetics, Society for Developmental and Behavioral Pediatrics, Society for Pediatric Research, and Western Society for Pediatric Research
Disclosure: Nothing to disclose.

Henrietta Leonard, MD, Program Director, Child and Adolescent Psychiatry, Professor of Psychiatry and Human Development, Division of Child and Adolescent Psychiatry, Rhode Island Hospital and Brown University
Henrietta Leonard, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

Medical Editor

Carol Diane Berkowitz, MD, Executive Vice Chair, Department of Pediatrics, Professor, Harbor-University of California at Los Angeles Medical Center
Carol Diane Berkowitz, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, American Pediatric Society, and North American Society for Pediatric and Adolescent Gynecology
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry, Department of Psychiatry and Biobehavioral Sciences, Division Chair of Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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