Pervasive Developmental Disorder (PDD) and Disability Benefits

PDD-NOS, or pervasive developmental disorder - not otherwise specified, is a diagnosis applied to individuals who have many, but not all, of the symptoms of autism. The condition is characterized by:

• difficulty communicating
• problems interacting with others, and
• having a highly limited group of interests and activities.

Can You Get Disability Benefits for PDD-NOS?

Children and adults with PDD-NOS might qualify for disability benefits by meeting the criteria for autism spectrum disorder (ASD) found in the Social Security Administration's (SSA's) Listings of Impairments (more on this below).

But meeting the requirements of a "listing" isn't the only way to get benefits: Adults who don't meet the listing might instead receive a "medical-vocational allowance" if they can prove that their PDD-NOS prevents them from being able to work any type of job. And children who don't meet the listing might qualify for benefits if they have severe functional limitations. Here's what you need to know about getting disability benefits for PDD-NOS.

What Is Pervasive Developmental Disorder?

Pervasive development disorder - not otherwise specified used to be considered one of several subtypes of disorders on the autism spectrum. It's a sort of "residual" diagnosis that was used when someone's symptoms didn't quite meet the diagnostic criteria for autism, Asperger's syndrome, or other developmental disorders. Sometimes referred to as "atypical autism," PDD-NOS is often diagnosed in older subjects—sometimes teenagers and occasionally adults.

PDD-NOS is marked by severe deficits in social interaction and communication as well as limited or stereotyped behaviors and interests. The symptoms of PDD-NOS—particularly those involving social behavior—are frequently milder than those of autism, but not always.

In addition to social and communicative difficulties, a person diagnosed with PDD-NOS might have other issues like:

• impaired motor skills
• unusual or rigid routines
• repetitive behaviors and movements, and
• mild intellectual deficits.

It's important to remember that every case of PDD-NOS is different, and symptoms that are prominent in one person might be absent in another.

Is PDD-NOS a Development Disorder or a Social Communication Disorder?

In the past, "pervasive developmental disorder" was an umbrella term that included five diagnoses:

• autistic disorder
• Asperger's syndrome
• PDD-NOS
• Rett syndrome, and
• childhood disintegrative disorder.

Pervasive development disorders are now referred to as autism spectrum disorders. ASD is grouped into three different levels based on severity:

• high functioning (characterized by difficulty communicating verbally and social withdrawal)
• low functioning (characterized by having a very difficult time communicating verbally, having limited or no speech ability, and often having behavioral issues), and
• classic autism (characterized by severe communication problems, very limited speech, social isolation, and repetitive actions).

Today, PDD-NOS is generally considered on the autism spectrum, but the extent of impairment can vary widely from person to person. Someone with PDD-NOS might struggle with verbal communication and social behavior. Or a child or adult with PDD-NOS might exhibit most of the symptoms of classic autism but with stereotypical and repetitive behaviors that are noticeably mild.

PDD-NOS might now also be considered a neurodevelopmental disorder—specifically, a social (pragmatic) communication disorder (SCD). SCD is characterized by persistent difficulties with the use of verbal and nonverbal language for social purposes but, unlike ASD, with no restricted, repetitive behaviors.

For more information on obtaining disability benefits for other autism spectrum disorders, read our specific articles on autism and Asperger's syndrome.

PDD-NOS and Social Security's Blue Book Listings

Social Security evaluates PDD-NOS under the listing for autism spectrum disorder:

• listing 12.10 for adults, and
• listing 112.10 for children.

Many individuals with an ASD diagnosis will meet the criteria of the listing for autism spectrum disorder, but those with PDD-NOS will likely find it more difficult. To meet the ASD listing, Social Security requires that a child or adult with PDD-NOS demonstrate both of the following:

• deficits in social interaction and verbal and nonverbal communication skills, and
• significantly restricted, repetitive patterns of behavior, interests, or activities.

In addition, a child or adult with PDD-NOS must have symptoms that cause an extreme limitation in one—or a "marked" (severe) limitation in two—of the following areas:

• understanding, remembering, and using information (following instructions, learning new things, applying new knowledge to tasks)
• interacting with others using socially appropriate behaviors
• concentrating on and finishing tasks, or
• being able to self-manage (which differs somewhat for children and adults):
• for adults, it's things like knowing what's acceptable work performance, maintaining personal hygiene and attire appropriate to a work setting, being aware of normal hazards, and taking appropriate precautions, and
• for children, it's things like regulating emotions, controlling behavior, and adapting to changes in age-appropriate activities and settings compared to other children of the same age.

You'll need medical documentation to prove that you or your child meet the requirements of the listing, including documents such as:

• hospital records
• psychiatric records
• diagnostic tests, and
• notes from counseling or therapy, if applicable.

In addition, the opinion of your treating physician or mental health provider as to whether you or your child meets the above listing can be extremely important to your case. School records can also be helpful to show the extent of impairment. (Read more about the medical evidence needed for a mental disorder claim.)

A child who doesn't have "restricted, repetitive patterns in behaviors, activities, and interests" isn't likely to meet the criteria of the ASD listing, but might be found "functionally equivalent" to the listing (more on this below).

If you're an adult and Social Security determines that your PDD-NOS doesn't meet the criteria of the adult listing for autism, it's still possible to get disability benefits. But to do so, you'll need a medical-vocational allowance—the most common basis for receiving disability benefits.

Medical-Vocational Allowances for Pervasive Development Disorder

In determining whether you qualify for a medical-vocational allowance, Social Security considers not only the severity of your medical impairments but also various vocational factors, including your:

• age
• work history
• job skills, and
• education.

A medical consultant (generally a psychiatrist or psychologist) who works for Social Security will assign you a mental residual functional capacity (mental RFC) based on a mental consultative exam or a review of your medical records. (You can also ask your treating doctor, psychiatrist, or psychologist to complete a mental RFC form to send to Social Security.)

Your mental RFC is an assessment of your ability to perform mental and cognitive activities needed for employment, including your ability to:

• concentrate
• keep up with the pace
• get along with others, and
• communicate sufficiently to work.

Your mental RFC will assign you to unskilled work, semi-skilled work, or skilled work. If Social Security determines, based on all the evidence in your case and your RFC, that there are no jobs that someone with your skill level and limitations could do, you'll be found disabled under a medical-vocational allowance. (Read more about getting disability for a mental condition.)

SSI Benefits Available for Children With PDD-NOS

For your child to qualify for SSI disability benefits based on PDD-NOS, both of the following must be true:

• the child meets Social Security's medical requirements for disability, and
• your family meets the financial requirements of the SSI program.

Meeting Social Security's Medical Requirement for a Child with PDD-NOS

A child with PDD-NOS can receive Supplemental Security Income (SSI) disability benefits without meeting the requirements of the listing for autism spectrum disorder. But a child can't get an adult medical-vocational allowance—because children aren't expected to be able to work. Instead, a child's condition must be found "functionally equivalent" to the listing.

Instead of assessing a child's mental RFC, Social Security will look at how the child functions compared to children of the same age in six areas or domains of functioning. (20 C.F.R. § 416.926a(b)(1).) The six domains include:

• acquiring and using information
• attending and completing tasks
• interacting and relating with others
• moving about and manipulating objects
• self-care, and
• health and physical well-being.

Learn more about how Social Security evaluates a child's functioning.

Family Financial Requirements for a Child to Recieve SSI

SSI is a needs-based program. For a child to qualify for disability benefits through SSI, the child's family must meet certain financial criteria. The family must have both:

• a limited income, and
• few resources or assets.

(Learn more about meeting the financial criteria for a child's SSI.)

Children who qualify (both financially and medically) can collect SSI until they turn 18. Then, Social Security reevaluates them using the adult disability criteria. A child approved for SSI disability benefits can also receive health coverage through Medicaid.

Applying for Disability Benefits

Adult applications. An adult with PDD-NOS who has a sufficient work history can apply for Social Security disability insurance (SSDI) benefits by completing the online application.

If you don't meet the work requirement for SSDI, you can apply for SSI disability benefits. You can start your SSI application online, but you must speak with a Social Security representative to complete the process.

You can also apply for SSDI or SSI by contacting your local Social Security office or calling Social Security at 800-772-1213 (TTY 800-325-0778) to make an appointment to apply by phone or in person.

Child applications. You can make an appointment to file an SSI application for a child by contacting Social Security at the number above. Otherwise, applying for SSI disability benefits for a child is a two-step process:

1. Complete the online child disability report, and
2. Speak with a Social Security representative to complete the application.

Whether you're applying for disability benefits for yourself or a child with PPD-NOS, you'll be interviewed by a Social Security claims representative. The interview is a critical part of the claims process because it's your first chance to prove your (or your child's) PPD-NOS is disabling. Learn more about what to expect during the Social Security interview.