Differential diagnosis and treatment of obsessive-compulsive, inattentive, and sleep symptoms in a 7-year-old with PDD-NOS

The overlap in symptoms among autism spectrum disorders (ASDs), anxiety disorders, and attention-deficit/hyperactivity disorder (ADHD) in youth can present diagnostic challenges for clinicians and researchers. Accurate diagnosis and comprehensive treatment can be facilitated by ongoing assessment and close collaboration among members of a multidisciplinary team. Specific treatment guidelines for reducing anxiety and/or inattentive behaviors in children with a primary ASD diagnosis are currently lacking. This case provides an example of how an empirically supported treatment for anxiety, exposure with response prevention (E/RP), in conjunction with pharmacotherapy, can be effective in reducing anxiety and ritualistic/compulsive behaviors in ASDs. This case also exemplifies how attention to and treatment of sleep problems can improve inattentive symptoms and overall functioning.