The Evaluation of Pervasive Developmental Disorders and Developmental Delay In Infants and Toddlers Based on DC:0-3 R

Background: The diagnosis of PDD or DD in infants and toddlers should be based on multiaxial classification systems which equally emphasize all axes. Because, when evaluating PDD or DD, in addition to reliable diagnosis, the assessment of other clinical variables is also important in early childhood. 

Objectives:  The present study was designed to investigate sociodemographic, clinical and parental characteristics of infants and toddlers with pervasive developmental  disorders (PDD) and developmental delay (DD) by using the Diagnostic Classification: 0-3 Revised (DC:0-3 R) and to determine the similar and different features of these two conditions.

Methods:  The sample consisted of 35 PDD and 29 DD cases aged 17 to 45 months and of their parents. Cognitive and emotional development of infants and toddlers were assessed using the Vineland Adaptive Behavior Scales and the Ankara Development Screening Inventory. Mother-infant interactional patterns were assessed by the Clinical Problem-Solving Procedure. The Diagnostic Classification: 0-3 Revised was used for multiaxial diagnostic classifications. The Mc Master Family Assessment Device (FAD) and the General Health Questionnaire (GHQ) were also administered to parents.

Results:  The age at initial evaluation was lower in children with PDD than those with DD. The proportion of single parent families in the DD group was higher than the PDD group. “Speech delay” was the foremost complaint regarding children with both disorders. Children with DD had more comorbid diagnoses than those with PDD. Families with psychosocial stress factors  were 69% in the PDD group and 76% in the MR group. There were no significant differences in mothers and fathers GHQ ratings between the two groups.  FAD ratings showed that  mothers’ and fathers’ affective responsiveness ratings and mothers’ communication ratings were significantly higher in the DD group. Children with DD had better scores than children with PDD in all of the emotional and social functioning (ESF) subscales. In the DD group, a significant negative correlation was detected between mothers’ GHQ ratings and ESF scores.

Conclusions:  

The present study considered that DD determined in infancy and early childhood may frequently be based on environmental factors which cause emotional deprivation. Similar to other childhood mental disorders, the diagnosis and treatment processes of infants and toddlers with PDD and DD should completed in parent-infant relationship context.