A physiotherapist may also prescribe mobility aids such as a cane or a walker to increase the patients safety.Speech therapists may assist in assessing, treating and supporting speech (dysarthria) and swallowing difficulties (dysphagia). Speech changes mean that alternative communication may be needed, for example, communication aids or word charts.Early intervention of swallowing difficulties is particularly useful to allow for discussion around tube feeding further in the disease progression. At some point in the progression of the disease, fluid and food modification may be implemented. Avoidance of postural hypotension
One particularly serious problem, the drop in blood pressure upon standing up (with risk of fainting and thus injury from falling), often responds to fludrocortisone, a synthetic mineralocorticoid. Another common drug treatment is the alpha-agonist midodrine.Non-drug treatments include "head-up tilt" (elevating the head of the whole bed by about 10 degrees), salt tablets or increasing salt in the diet, generous intake of fluids, and pressure (elastic) stockings. Avoidance of triggers of low blood pressure, such as hot weather, alcohol, and dehydration, are crucial. The patient can be taught to move and transfer from sitting to standing slowly to decrease risk of falls and limit the effect of postural hypotension. Instruction in ankle pumping helps to return blood in the legs to the systemic circulation. Other preventative measures are raising the head of the bed by 8 in (20.3 cm), and the use of compression stockings and abdominal binders.
While its true that children diagnosed with PDD-NOS, as a whole, show fewer intellectual deficits and are higher-functioning than autistic children, many others who fit the criteria for PDD-NOS have some autistic features but also have intellectual deficits that are so severe that its difficult or impossible to tell whether some of the deficits come from the autism or from the severe to profound degree of intellectual disability itself. Furthermore, some others who fit the criteria for PDD-NOS come to professional attention at a later age, compared to those diagnosed with autism. Subgroups
Studies suggest that persons with PDD-NOS belong to one of three very different subgroups:
A high-functioning group (around 25 percent) whose symptoms more or less overlap with that of Asperger syndrome, while also not meeting the criteria for autistic disorder, but who completely differ from those with Asperger syndrome in terms of having a lag in language development and/or mild cognitive impairment. (The criteria for Asperger syndrome excludes a speech delay or a cognitive delay in early life.) Another group (around 25 percent) whose symptoms more closely resemble those of autism, but do not fully meet all its diagnostic signs and symptoms. This is because either the symptoms were recognized at a later age or because they were too young or have cognitive deficits that are too severe to properly identify all the symptoms of autism that they may have.