Stability of initial autism spectrum disorder diagnoses in community settings.
Community-assigned PDD-NOS labels flip more often than Autistic Disorder, so flag these cases for early re-evaluation.
01Research in Context
What this study did
The team tracked the kids who got an autism label in regular clinics. They asked: did the label stay the same two years later?
Records came from doctors, schools, and state lists across four US regions.
What they found
Autistic Disorder stuck a large share of the time. PDD-NOS stuck only a large share of the time.
Kids in the South kept their label more often. Kids seen by a neurologist kept it less.
How this fits with other research
Moore et al. (2003) saw high stability in a tiny university clinic. Amore et al. (2011) show the same idea breaks down in the messy real world.
Ekas et al. (2011) add that parents report almost no behavior gap between PDD-NOS and Autistic Disorder. Together the papers explain why the PDD-NOS label slips off so easily.
Huang et al. (2022) pick up the story in adults: shaky childhood labels lead to costly, confusing re-diagnosis later.
Why it matters
When a family hears PDD-NOS, tell them upfront that this label is twice as likely to change. Schedule a re-check in 12 months and keep data sheets handy. Document why you agree or disagree with the outside report so the next clinician has a clear trail.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a red PDD-NOS note to the file and book a six-month skills reassessment.
02At a glance
03Original abstract
The study's objectives were to assess diagnostic stability of initial autism spectrum disorder (ASD) diagnoses in community settings and identify factors associated with diagnostic instability using data from a national Web-based autism registry. A Cox proportional hazards model was used to assess the relative risk of change in initial ASD diagnosis as a function of demographic characteristics, diagnostic subtype, environmental factors and natural history. Autistic disorder was the most stable initial diagnosis; pervasive developmental disorder-not otherwise specified was the least stable. Additional factors such as diagnosing clinician, region, when in time a child was initially diagnosed, and history of autistic regression also were significantly associated with diagnostic stability in community settings. Findings suggest that the present classification system and other secular factors may be contributing to increasing instability of community-assigned labels of ASD.
Journal of autism and developmental disorders, 2011 · doi:10.1007/s10803-010-1031-x