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Mixed Developmental Disorder - what exactly is it?

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My 9 year old son was diagnosed with Mixed Developmental Disorder just before Christmas. The psychaiatrist said that he 'clearly has aspects of mild (grrrr I hate the word mild - doesn't feel mild when he melts down or gets violent :angry: ) Autism and Dyspraxic traits' but that he doesn't feel that he has a diagnosis of an Autistic Spectrum Disorder. So now I'm a little confused... On a previous appointment he said that our son was just on the cut off point for where they would diagnose him with Aspergers, and he repeated this at the next appoinment - but then when we were sent the report if states that he has a Mixed Developmental Disorder - I've never heard of this and can't find anything if i Google it either - could anyone point me in the right direction to find some more information on this?

 

Maybe I'm being cynical, but I'm beginning to wonder if its a sort of 'catch all' diagnosis for those who don't quite tick all the right boxes for Aspergers and AHAD etc... :wallbash:

 

Has anyone else been recieved a diagnosis of this?

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No sorry, we have Global Developmental delay, perhaps the Paed is saying that he has areas of delay and areas which area age appropriate?

 

A x

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I was told that e had some autistic traits, then told by clinical psycoligist he was aspergers then got dx of hfa from paediatrician?!! I often wonder if it has to do with how much experience the proffesionals have with asd. I really understand how you feel. when I got the clinical pyscologist report it stated that he agreed with "me ?"that e was probably on the spectrum? during our appointment he clearly told me my son was aspergers? I had never even suggested my son was on the spectrum?I felt so upset and confussed. But then had appointment with paediatrician and he diagnosed my son with hfa?

I was advised to contact psycologist and ask him to amend his report ,I did not have the confidence to do this and as it worked out it did not matter as e got his dx but maybe you are braver than me and could chalenge what they have said in report as it was suggested your child was aspergers? Good luck

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Hi I have never come across this term either.Ben has a Dx of Developmental Coordination Disorder [Dyspraxia ]with Social Communication Difficulties though which sounds like a similar combination.Ben has DCD with some Asperger traits but Camhs have not been able to give a clear Asperger Diagnosis because agreement has not been reached regarding whether he fits the full criteria.

You could speak to the psychiatrist and ask for an explanation and then think about whether to ask for a review or second opinion.Karen.

Edited by Karen A

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I think when a child has a few traits of both ADHD DYSPRAXIA AS ASD then it can be difficult to tick every box in each sub diagnosis box, the three main areas for ASDs are the triads, also if he had already a diagnosis of ADHD, DYSPRAXIA then its more likely he could have more signs in other spectrum of the ASDs, PDDs.

 

I have not heard of your title but I have heard of multie complex developmental disorder where a child has traits from all the ADHD,ASDs ect...

 

I do think that it is however a complex disorder and I refer Js as complex needs, if you have any further concerns of the lack of diagnosis get the peadatrition to focus on your sons needs and what resources and services are going to be required diagnosis or not and if he doesnt diagnose today remember there is many young adults now been diagnosed and I bet there case notes would describe there recent diagnosis somewhere but only get it when a doctor really can understand exactly what it is under a diagnosed discription.

 

JsMum

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When my son was dx, his pead said he was very definitly asd but had so many other traits that she didn't think she would ever be able to fully dx him. She said he was obviously a very complex little boy - I could have told them that years ago!!!!! :lol:

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I haven't heard of that one either. DS2 has now been diagnosed with significant speech and language disorder, motor planning disorder(dyspraxia), attention disorder and mental processing disorder but still not enough for a diagnosis of ASD.

 

Again it is dependent on Paediatrician. With DS1, initially at 3 he wasn't autistic just speech and language disorder, at 4.5 years he was aspergers (despite clinical criteria which stated that early diagnosis of speech and language disorder meant autism) and at 6.5 years he was diagnosed as moderate autism - he was seen by 3 different paediatricians!

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Multiplex Developmental Disorder

 

 

Ever since autism was first recognized, its continuity with schizophrenia has been a matter of debate. In fact, until the late 1970s, children with autism were often labeled as having "childhood schizophrenia." In the last thirty years, however, the term "childhood schizophrenia" has been displaced. Diagnostic criteria for autism have been established that rely solely on social, communicative and sensorimotor symptoms, without reference to the thought disorders typical of schizophrenia.

 

 

Nevertheless, there are some children who display the severe, early-appearing social and communicative deficits characteristic of autism who ALSO display some of the emotional instability and disordered thought processes that resemble schizophrenic symptoms. Cohen, et al. (1986) coined the term Multiplex Developmental Disorder (MDD) to describe these children, although they are often given a diagnosis of PDD-NOS by clinicians who may be unfamiliar with this terminology. Unlike schizophrenia, MDD symptoms emerge in earliest childhood, often in the first years of life, and persist throughout development. Diagnostic criteria for MDD include:

 

 

Impaired social behavior/sensitivity, similar to that seen in autism, such as:

Social disinterest

Detachment, avoidance of others, or withdrawl

Impaired peer relations

Highly ambivalent attachments

Limited capacity for empathy or understanding what others are thinking or feeling

 

 

Affective symptoms, including:

Impaired regulation of feelings

Intense, inappropriate anxiety

Recurrent panic

Emotional lability, without obvious cause

 

 

Thought disorder symptoms, such as:

Sudden, irrational intrusions on normal thoughts

Magical thinking

Confusion between reality and fantasy

Delusions such as paranoid thoughts or fantasies of special powers

 

Children who show evidence of symptoms from ALL THREE of these categories may be classified as having MDD.

 

 

Currently, MDD is a research category, with no specific educational or treatment implications. Because we know so little about this disorder, it is premature to suggest special interventions. Children with MDD symptoms should be treated with individualized special educational programs developed in collaboration with parents, teachers, and a multidisciplinary team to address their unique strengths and needs. Parents should consult with a local child psychiatrist to determine whether medication may be useful in treating the accompanying affective and thought disorder symptoms.

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In a study of differential validity, three diagnostic groups based on ICD-10 criteria were compared, namely children with emotional disorders, children with conduct disorders, and children with mixed disorders of conduct and emotions. The patients were taken from a consecutive series of child and adolescent psychiatric service attenders from 1988 to 1992 and represented the total entire subgroups of patients with the respective diagnoses. Based on standardized item sheets that were filled out by the clinicians who were responsible for the respective cases, the groups were compared with regard to age, sex ratio, family background, premorbid behavioral abnormalities, abnormal psychosocial situations, and treatment. It was found that children with mixed disorders of conduct and emotions share many characteristics with pure conduct disordered children. It is concluded that the former group is a subgroup of the latter, and there is little evidence in this study supporting the validity of a separate category of mixed disorders of conduct and emotions

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Multiplex Developmental Disorder

Ever since autism was first recognized, its continuity with schizophrenia has been a matter of debate. In fact, until the late 1970s, children with autism were often labeled as having "childhood schizophrenia." In the last thirty years, however, the term "childhood schizophrenia" has been displaced. Diagnostic criteria for autism have been established that rely solely on social, communicative and sensorimotor symptoms, without reference to the thought disorders typical of schizophrenia.

Nevertheless, there are some children who display the severe, early-appearing social and communicative deficits characteristic of autism who ALSO display some of the emotional instability and disordered thought processes that resemble schizophrenic symptoms. Cohen, et al. (1986) coined the term Multiplex Developmental Disorder (MDD) to describe these children, although they are often given a diagnosis of PDD-NOS by clinicians who may be unfamiliar with this terminology. Unlike schizophrenia, MDD symptoms emerge in earliest childhood, often in the first years of life, and persist throughout development. Diagnostic criteria for MDD include:

Impaired social behavior/sensitivity, similar to that seen in autism, such as:

Social disinterest

Detachment, avoidance of others, or withdrawl

Impaired peer relations

Highly ambivalent attachments

Limited capacity for empathy or understanding what others are thinking or feeling

Affective symptoms, including:

Impaired regulation of feelings

Intense, inappropriate anxiety

Recurrent panic

Emotional lability, without obvious cause

Thought disorder symptoms, such as:

Sudden, irrational intrusions on normal thoughts

Magical thinking

Confusion between reality and fantasy

Delusions such as paranoid thoughts or fantasies of special powers

 

Children who show evidence of symptoms from ALL THREE of these categories may be classified as having MDD.

Currently, MDD is a research category, with no specific educational or treatment implications. Because we know so little about this disorder, it is premature to suggest special interventions. Children with MDD symptoms should be treated with individualized special educational programs developed in collaboration with parents, teachers, and a multidisciplinary team to address their unique strengths and needs. Parents should consult with a local child psychiatrist to determine whether medication may be useful in treating the accompanying affective and thought disorder symptoms.

 

 

Hi.I read through the above information and have had a look on the Web as I had not come across the label before.I think it is worth making a few observations.Although there are a few references to ''Multiple Complex Developmental Disorder'' it currently appears to be a description used in research rather than currently being a recognised diagnosis and the limited references I discovered appeared to come from America.NAS say that in Great Britain currently the diagnosis given for children with this pattern of difficulties is most likely to be Pervasive Developmental Disability Not Otherwise Specified.Karen.

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