d gets older. There may be a striking contrast between clearly enunciated echolalic speech and poorly pronounced spontaneous speech. Some children have a chanting or singsong speech, with odd prolongation of sounds, syllables, and words. A question-like intonation may be used for statements. Odd breathing rhythms may produce staccato speech in some children.Abnormal grammar is frequently present in the spontaneous speech of verbal children with PDDNOS. As a result:phrases may be telegraphic (brief and monotone) and distorted; words of similar sound or related meaning may be muddled; some objects may be labeled by their use;new words may be coined; andprepositions, conjunctions, and pronouns may be dropped from phrases or used incorrectly.When children with PDDNOS do develop functional speech, they may not use it in ordinary ways. Such children tend to rely on repetitive phrases. Their speech does not usually convey imagination, abstraction, or subtle emotion. They generally have difficulty talking about anything outside of the immediate context. They may talk excessively about their special interests, and they may talk about the same pieces of information whenever the same subject is raised. The most able persons can exchange concrete pieces of information that interest them, but once the conversation departs from this level, they can become lost and may withdraw from social contact. Ordinary to-and-fro conversational chatter is lacking. Thus, they give the impression of talking "at" someone, rather than "with" someone.Unusual Patterns of BehaviorThe unusual responses of children with PDDNOS to the environment take several forms. Resistance to changeMany children are upset by changes in the familiar environment. Even a minor change of everyday routine may lead to tantrums. Some children line up toys or objects and become very distressed if these are disturbed. Efforts to teach new activities may be resisted.Ritualistic or compulsive beh...
