Pervasive Developmental Disorder Differential Diagnoses

Updated: Oct 19, 2018
  • Author: Sufen Chiu, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Diagnostic Considerations

Psychosis is often the most difficult symptom to elicit and diagnose appropriately in children with pervasive developmental disorder (PDD/ASD). Not long ago, children with ASD were often identified as having childhood-onset schizophrenia. The DSM establishes criteria that clearly distinguish ASD from childhood-onset schizophrenia. The DSM recognizes that children with ASD may develop psychotic disorders if they present with clear evidence of auditory, visual, tactile, and/or olfactory hallucinations. Nevertheless, determining whether a child has ASD or psychosis may be difficult during the initial clinical evaluation. For example, individuals with intellectual disability may present with cognitive disorganization; they may link irrelevant thoughts together or have beliefs in magical beings, even as adults. These findings are considered normal in a person with intellectual disability.

Conditions to consider in the differential diagnosis of pervasive developmental disorder, along with those in the next section, include the following:

  • Reactive attachment disorder

  • Landau-Kleffner syndrome

  • Schizotypal personality disorder

  • Intellectual Disability (Mental retardation)

  • Selective Mutism

Differential Diagnoses