A Typical Children Followed-Up in Adolescence

Abstract

Five pre-school children with variability in the quality of their social relationships, unusual or abnormal speech and/or expressive language, and ritualistic or manneristic behaviors, were diagnosed as having an atypical pervasive developmental disorder. In order to study the natural history of this disorder these children were followed-up 10 years later. Four of the adolescents showed evidence of the persistence of social and communicative disorders consistent with a diagnosis of a pervasive developmental disorder (PDDNOS), while one was found to have a social phobia and the residual state of the PDDNOS. One of the PDD adolescents was actively psychotic. We find that young children diagnosed as having a pervasive developmental disorder with atypical features can have thinking disorders and/or poor reality testing which persists into adolescence, and can develop symptoms of childhood and adolescent schizophrenia. The overall cognitive functioning of young children diagnosed as having a pervasive developmental disorder with atypical features tends to be stable or perhaps even improve somewhat as they grow into adolescence. Parents are aware of, and can report, the presence of severe emotional and/or behavioral disturbance in such adolescents. The marked similarities in symptomatology, clinical course, and treatment histories, between this group and a group of adolescents who were not diagnosed as having a PDD until adolescence, suggests that there may be an underreporting or underdiagnosis of young children with pervasive developmental disorders.