Description
This articles describes a common problem in young children that is felt to be related to autistic disorders.
Multisystem Developmental Disorder (MSDD) is one of the newer terms to describe a group of children with communication, social, and sensory processing problems who do not fit into other categories such as autism. MSDD is usually diagnosed in early childhood.
What kind of problems do children with MSDD have?
- Abnormal reaction to sounds, smells, textures, movement, temperature, and other body sensations
- Disturbed behavior that seems more related to unpleasant experiences than lack of interest in participating
- Some impairment in communication development
- Relatively normal interest in communicating and interacting socially when they are not reacting to their environment
- Varying amounts of attention and organization problems
- Varying amounts of coordination problems or clumsiness
- Varying amounts of problems regulating sleep, activity, and appetite
These problems must interfere significantly with everyday life, and interfere with normal development to warrant a diagnosis.
Is it MSDD or Autism?
MSDD is thought to differ from autism in several ways. First, children with MSDD tend to respond to treatment better than children with autism. They are less likely to have severe delays in mental ability, and less likely to have severe rituals or repetitive behaviors. Still, these diagnoses are hard to tell apart in young children since children with both diagnoses, Autism and MSDD, may have similar behavior problems.
What behaviors are seen in MSDD?
- Emotional outbursts or "meltdowns"
- Refusal to eat certain foods
- Insistence on wearing certain clothing, or not liking clothing at all
- Extreme reactions to noise or movement
- Avoidance of sensory experiences or seeking out extreme sensory experience
- Abnormal reaction to pain
- Sleep disturbance
- Avoidance or lack of pleasure in being touched or cuddled in spite of interest in being with you socially
- Refusal to have hair washed, touched, combed, cut, etc.
- Toe walking. Refusal to walk on certain surfaces (such as walking on grass in bare feet)
How do we treat MSDD?
Like many childhood developmental problems, we have few specific treatments or cures. Most of our treatment is meant to help a child work around a problem, or to guide them into learning or discovering skills that they are not mastering on their own.
Sensory Integration therapy is often a mainstay of treatment. It tries to help a child overcome their extreme sensitivity and reaction to their sensory experiences. Sensory Integration therapy is targeted at problems related to sensation. These include problems with touch, body position, movement, sound, food textures, and so forth. Techniques may involve deep pressure, brushing, and swinging. We do not know how these treatments work but often they can be helpful.
Speech and Language therapy is also an important part of the equation. Sometimes, therapy has to be aimed at social and pragmatic problems. A home program is crucial, since children need to practice skills throughout the day. A therapist should be sharing goals and techniques with parents and teachers. There are many handouts on this website that can help.
Behavior specialists can also be helpful in helping parents choose goals and learn techniques to teach appropriate behaviors and eliminate problem behaviors. In general, psychotherapy for the child is not effective for MSDD.
Medications can help in certain cases, but medication is not curative Potential side effects and treatment benefit have to be weighed carefully.
Advocacy
It is important to be an advocate for your child. Make sure that you and the doctor are very clear about the goals of treatment, including when you are going to stop or change treatment.
Children often have to be given diagnoses to get services. Sometimes the diagnosis also helps guide treatment. It may predict how the child may do in the future. A diagnosis can also tell you what your child does not have.
The MSDD diagnosis is getting better known, and is now being taught in early childhood special education courses. Some clinicians will still diagnose autism, pervasive developmental disorder, developmental delay, and language impairment. Sensory integration disorder is also diagnosed.
The most important thing is to understand your child's needs and strengths, to set goals, monitor progress, and make changes when things are not working.
References
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Zero to Three Diagnostic Classification Task Force. (1994). Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3)™. Zero to Three. ISBN: 0943-657-32-6 [282]
Keywords: autism,autism spectrum,autistic spectrum,multisystem developmental disorder,PDD-NOS,pervasive developmental disorder,sensory integration disorder
Publication date: May 27, 2004
Revise date: Nov 1, 2007
TextID: 96
