Can you tell me about the differences, or the links, between GDD and Autism?

[helpfulornot]

Hi,

DS2 is 22 months, and he has a "diagnosis" of GDD. He also has had hearing difficulties, and fairly early on was diagnosed with Delayed Visual Maturation.

He was late sitting, crawling, and has recently taken his first independent steps. His fine motor skills are delayed, he really likes toys and objects that spin, pop up toys. He doesn't "construct" at all.

His eye contact is poor but improving, he sometimes says a word approximating "more", but has never really babbbled. He has had several hearing tests but the audiologist told me on Thursday that she doesn't think the level of his hearing loss would solely explain his lack of speaking.

He has never pointed, nor does he copy.

He had a combined OT and SALT session today, and the SALT thinks he is exhibiting signs of autism, but she says that he is very young, and that it is a "spectrum".

Drs, including neruolgists, have commented more than once that he is a "very social little boy".

What do you think, I was not aware of a "link" between GDD and autism, this is the first time it's been suggested he's autistic (we have also had it suggested to us that he's got non-typical Angelmans, muscular dystrophy, and a diskinetic movement disorder (which his local neurologist negated by saying she has seen no signs of it).

Thx

[mumgoingcrazy]

Hi helpfulornot. I don't think I can be of help but the way you explain your DS is like your explaining my DD2. She is 15mo and have often wondered the same thing. Her eye contact is poor and is only sitting, not even close to moving. She has GDD but autism is always at the back of my mind. There are so many autistic traits that she shows. Would love to see the comments on this thread.

[Bumblelion]

Before my DD2 got a diagnosis of Sotos syndrome (overgrowth with delayed development, although growth now slowed down and development caught up), she was diagnosed with GDD (failed all fine and gross motor skill development tests).

As far as I am aware there is no connection between GDD and autism because, although my DD was first diagnosed with GDD, autism was never mentioned.

[jimjamshaslefttheyurt]

A lot of children with delays will have social communication delays as well. Sometimes these can mean the child meets the criteria (triad of impairments) and so can be diagnosed with autism as well. So for example some people with Down Syndrome can end up with an autism dx as well.

[misscutandstick]

i always assumed that global developement delay was just a statement of general being - like being short sighted, or tall. As far as i can tell the actual diagnosis comes later... but i may be wrong.

DS5 has GDD (or is??) but he is absolutely autistic (no Dx as yet - the paeds in denial!). but as for the original question - no, i dont think autism and GDD are always connection.

... that said....

children with autism generally have GDD, but NOT ALL children with GDD have autism. IYSWIM. HTH XXX

[CaptainPlump]

I don't know if there's a particular link beyond the fact that a lot of children with autism will also have a GDD. My DS certainly does! I suppose they're just trying to find a reason for the GDD by suggesting all of these other things.

According to some definitions the "spectrum" seems to encompass things like GDD (or PDD-NOS as it's otherwise known), but that isn't strictly autism.

It sounds to me like perhaps your SALT and OT are concerned by the lack of pointing or copying. Those are the strongest indicators or autism that you mention. Good luck!

[Peachy]

My friends DS has a dx of GDD, ASD and VI

The ASd dx didn't come until he was 13 but is now classed as primary DX as it is those trats that are now the most challenging

FWIW DS3 is spectrum (not exactly sure where yet, moderate - severe but poss dx of PDD-NOS). If he had walked a little later (2 weeks pmsl) Paed would have been prepared to make a GDD dx too- it can be that close

PDD_NOS isn't the ame thing from what I can see- it requires the triad of impairments, whereas GDD doesn't, that requires a failure to meet a set of goals by certain dates.

having said that, all PAeds seem to have their variations (and they shouldn't) and PDD-NOS is a new dx here. In our case its being considered as DS3 is clearly spectrum but has a sense of humour, which only goes to show the extent of the lack of standardisation as yet......

[Peachy]

Oh and ds1 (As/ HFA dx) has no delays, quite the opposite, bar those caused by severe dyslexia

[helpfulornot]

(should have said before, mm22bys here, named changed for another thread and didn't change back).

I was very surprised by what the SALT said, because I didn't think that it was a SALT's "place" to diagnose a child....Dh was there too though and did ask a rather leading question....

They stressed the spectrum bit, stressed the bit he is still so young.

There are many other communication "disorders" too aren't there?

While he is very much delayed, particularly with communication, we do think that because his sensory input for a year or so was so bad then of course other things will be delayed.

Anyway, thanks for your responses, I think it's as clear as mud but the best thing we can do at the moment is to try to work as best we can to improve his skills, whether he has a label or not, and regardless of that label....

[TotalChaos]

although SALT can't diagnose, I think they can often have suspicions and would recommend a joint clinic/paediatrican referral. I honestly don't know how far other delays would impact on language/communication. A language delay can have an impact on social skills/social communication. Have you looked into any alternative forms of communication such as PECs with SALT at all?

[helpfulornot]

He's had all sorts of assesments - he was first seen at CDC last September and so was referred to physio, OT, SALT, Portage. Drs have said he's "complex", an "anomaly".

This was actually at Bobath, they normally see children with CP.

He doesn't like changes, eg if he's playing and I think he needs a nappy change, he will scream, cry, carry on etc, but I always thought that was normal?

The SALT yesterday was talking about using objects to prepare him for a change eg before a bath giving him a rubber duck, a spoon before feeding, etc.

[TotalChaos]

I think completely normal for a near 2 year old to not like any change that takes them away from a fun activity to a not so boring activity. is that the main sort of change that upsets him?

I think the objects idea is very sensible - as giving a visual cue helps kids who have problems understanding language. You could also try photographs of people/places/objects too.

[cyberseraphim]

I think you would need a developmental expert to comment on a crossover between GDD and ASD not a SALT. The current diagnostic criteria for ASD mention 'qualitative' and 'marked' impairments in the key areas, language,communication, imagination so in theory, almost any child with developmental problems in those areas could technically fit the ASD criteria. A developmental expert should be able to separate out the issues - as well as anyone can that is.. I don't think you should place much importance on the SALT's opinion.

[helpfulornot]

Yep, he is less likely to object if we tell him what's about to happen to him.

Haven't gone down the photo route at all, it was vaguely brought up at Bobath about a month ago, we didn't go back though between then and yesterday so it didn't get off the ground. The OT asked about it (using photos) and the SALT thought it might be better to use objects.

We are going back to tomorrow so hope for some more ideas then.

Thx

[hecate]

Probably if they can't diagnose asd because not all the required boxes are ticked, but some are, then they call it GDD-NOS or whatever.

I think it's all the same thing really. It's a spectrum. Everyone on it is an individual but they (the 'experts') do like to lump them into neat little groups.

[anonandlikeit]

My purely non technical amateur take on it, is that the two DX while not linked do often exist together.
DS2 was always very delayed (prem birth) & when he did not met the milestones even with adjusted age he was dx with GDD, this was explained to me as being delayed across all areas of development, including social development.
DS2 was later dx'd with ASD & although in the system since birth he was 4.5 before getting this dx.
His paed explained that they had to be sure that his development was Disordered rather than just delayed & it met the triad of impairment. A very different assessment process to that of the standard developmental assessment.

DS2 is also very complex as he also has CP, it was a case of picking him to bits to see which boxes he ticked.

If your ds has sensory impairement & GDD i am sure it would be very hard at such a young age to dx ASD.