Do you have an Asperger's child without major social skills deficits?

[Anonymous]

My DH and I are arguing about whether to get our child assessed. We agree that 5 year old DC is 'quirky' and can be obsessional (lights, fans, electronic devices). But can be redirected now that he is older. Still tends to play with the same items repetitively, for example, 5 matchbox cars out of a large bin full of cars. Can play with these 5 cars for hours at a stretch and for months at a time. Very bright. Does not get into dramatic play or phantasy very much but will do some. Does not get excited about playdates but will have them. Here is the clincher for DH: DC has never had major social skills issues with peers. Not a single teacher in preschool noted any problems. DC can take a little while to get warmed up but not unusually so. I think DC could still be on the spectrum given all the other things we've noticed. DH thinks from reading websites that the lack of major social skills issues means that DC might have Asperger's tendencies but isn't diagnosable. What do parents of Asperger's think of this description?

[Anonymous]

What is he like in school? Have any issues come up that make it difficult for him to function there? What is he like with other children? Does he actively play with them?

[Anonymous]

One of the reasons that Asperger's is often diagnosed later (say around 10) is that it's hard to differentiate major and minor social skills deficits in a younger child. In five-year-olds, the range of normal variation is huge. In ten-year-olds the range is smaller and the expectations are higher, so the kids with real deficits really stand out.

For you DC, it sounds too early to tell. I would find ways to address whatever deficits you do see, but I'm not sure a label right now would be helpful: you're likely to spend time and money, only to hear "DC has traits which are not inconsistent with a diagnosis on the spectrum but does not fully meet the criteria for diagnosis. Keep an open eye/mind as he develops".

[Anonymous]

Anonymous wrote:One of the reasons that Asperger's is often diagnosed later (say around 10) is that it's hard to differentiate major and minor social skills deficits in a younger child. In five-year-olds, the range of normal variation is huge. In ten-year-olds the range is smaller and the expectations are higher, so the kids with real deficits really stand out.

For you DC, it sounds too early to tell. I would find ways to address whatever deficits you do see, but I'm not sure a label right now would be helpful: you're likely to spend time and money, only to hear "DC has traits which are not inconsistent with a diagnosis on the spectrum but does not fully meet the criteria for diagnosis. Keep an open eye/mind as he develops".

I totally agree that kids frequently aren't diagnosed (Asperger's or other challenge) until our expectations of them increase and the kids are unable to meet them in an age appropriate manner. I that's all the more reason to have your child evaluated now. It may not be Asperger's and social skills may not turn out to be your child's biggest challenge. Until you have an evaluation to better understand what's going on and why, you really can't know if you should be seeking services for your child. My oldest would have remained undiagnosed if our youngest child hadn't required services. What we learned about our youngest, made us look a little differently at our oldest. We had him evaluated at age 5 and our recent concerns were confirmed. With early intervention, his prognisis is fantastic. He'll probably always be quirky but it's much easier to train them and their brains when they're young. They're also less likely to encounter social stigma and isolation at the younger ages. That's going to change when they hit about 4th grade. IMHO, you should get him evaluated. If it comes back that he's just quirky, then you're only out some money. But, if you wait until he's having problems, how are you going to feel if you're told you should have begun much earlier?

[Anonymous]

Anonymous wrote:What is he like in school? Have any issues come up that make it difficult for him to function there? What is he like with other children? Does he actively play with them?

OP here: He is a happy little kid in school. No issues. He actively plays with other kids. Teachers have noted that he has occasionally shown a preference to play on his own but will go and join a group when asked to. He has friends in school.

[Anonymous]

Anonymous wrote:

Anonymous wrote:One of the reasons that Asperger's is often diagnosed later (say around 10) is that it's hard to differentiate major and minor social skills deficits in a younger child. In five-year-olds, the range of normal variation is huge. In ten-year-olds the range is smaller and the expectations are higher, so the kids with real deficits really stand out.

For you DC, it sounds too early to tell. I would find ways to address whatever deficits you do see, but I'm not sure a label right now would be helpful: you're likely to spend time and money, only to hear "DC has traits which are not inconsistent with a diagnosis on the spectrum but does not fully meet the criteria for diagnosis. Keep an open eye/mind as he develops".

I totally agree that kids frequently aren't diagnosed (Asperger's or other challenge) until our expectations of them increase and the kids are unable to meet them in an age appropriate manner. I that's all the more reason to have your child evaluated now. It may not be Asperger's and social skills may not turn out to be your child's biggest challenge. Until you have an evaluation to better understand what's going on and why, you really can't know if you should be seeking services for your child. My oldest would have remained undiagnosed if our youngest child hadn't required services. What we learned about our youngest, made us look a little differently at our oldest. We had him evaluated at age 5 and our recent concerns were confirmed. With early intervention, his prognisis is fantastic. He'll probably always be quirky but it's much easier to train them and their brains when they're young. They're also less likely to encounter social stigma and isolation at the younger ages. That's going to change when they hit about 4th grade. IMHO, you should get him evaluated. If it comes back that he's just quirky, then you're only out some money. But, if you wait until he's having problems, how are you going to feel if you're told you should have begun much earlier?

OP here: What kind of specialist should evaluate him? Where does one take a kid for "quirkiness"? Thank you for the advice to those who are responding.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What is he like in school? Have any issues come up that make it difficult for him to function there? What is he like with other children? Does he actively play with them?

OP here: He is a happy little kid in school. No issues. He actively plays with other kids. Teachers have noted that he has occasionally shown a preference to play on his own but will go and join a group when asked to. He has friends in school.

You shod get him evaluated regardless of what we think, simply for your piece of mind and for the most intervention possible if it is needed. From this post it sounds like may not need any intervention and it does not sound like he has Aspergers or is even on the spectrum. I have a son with Autism and a brother with Aspergers and both my son and my brother had definite differences in their behavior compared to non-autistic people. Their behavioral differences were definitely pervasive. Does he have any unusual speech patterns or delays? Does he have fine or gross motor delays? Any sensory integration issues? And his obsessions, are you able to distract him?

You said that you see other things that point toward him being on the spectrum, can you give a few more examples?

The important thing to know about spectrum disorders is that they have to be pervasive to be diagnosed. If his quirks do not interfere with his ability to function on a daily basis in various different settings, he likely will not get diagnosed with anything. (and rightfully so, there is no need to slap a label on if it doesn't fit) How was he as a baby and a toddler? These are all important things to consider when trying to find a conclusion.

[Anonymous]

OP: DC was quite speech delayed as a baby, no words until 22 months. Somewhat delayed gross motor skills, but completely caught up with some PT. His speech and language caught up rapidly as well and he is now highly verbal for his age. No sensory things that we have ever noticed. As a baby, he seemed to love people and interacting. He also loved lights, light switches, and eventually fans! This stuff really bothered us. There was a point at age 2, when it seemed really bad. He behaved fairly obsessively when in new situations, running to lamps and flicking them on and off. Every door of the hallway had to be shut before he would leave. Lining up of trucks. All of this eventually faded away, and now at age 5, he doesn't really look at fans and lights any more or flick switches. When he does seem "stuck" on something, he can be redirected. What really remains of the obsessiveness is how he can play with 5 cars for hours and hours and months and months. He washes his hands the exactly the same way every time. He is not terribly into dramatic play. At the same time, he remains social and has always loved people. That has always been the reason we have not known how to proceed.

[Anonymous]

Anonymous wrote:OP: DC was quite speech delayed as a baby, no words until 22 months. Somewhat delayed gross motor skills, but completely caught up with some PT. His speech and language caught up rapidly as well and he is now highly verbal for his age. No sensory things that we have ever noticed. As a baby, he seemed to love people and interacting. He also loved lights, light switches, and eventually fans! This stuff really bothered us. There was a point at age 2, when it seemed really bad. He behaved fairly obsessively when in new situations, running to lamps and flicking them on and off. Every door of the hallway had to be shut before he would leave. Lining up of trucks. All of this eventually faded away, and now at age 5, he doesn't really look at fans and lights any more or flick switches. When he does seem "stuck" on something, he can be redirected. What really remains of the obsessiveness is how he can play with 5 cars for hours and hours and months and months. He washes his hands the exactly the same way every time. He is not terribly into dramatic play. At the same time, he remains social and has always loved people. That has always been the reason we have not known how to proceed.

I agree that it can't hurt to have him evaluated, if only for your peace of mind. But the way you describe him, his issues don't seem to impede his ability to function, at home, school, or out and about--which is very significant. His quirks seem pretty mild. And at age two, the hallway door thing and lining up trucks isn't unusual. Does he play with any other toys besides these five cars? Is he able to be redirected when playing with them? Is he playing with them appropriately? Honestly, if he has no problems at school, socializes well and has no sensory issues that you can detect, what are you hoping to achieve by having him assessed? Any treatment would be focused on achieving the goals he has already met...socializing appropriately with peers, functioning well at school, motor skills, etc.

[Anonymous]

btw, what makes you think it's asperger's? is it because your son is highly verbal but has these other quirks that seem like potential autistic traits? the way you describe him, i would be surprised if he has asperger's (unless he's using language in odd, idiosyncratic ways and his social interactions themselves seem quirky).

[Anonymous]

Anonymous wrote:btw, what makes you think it's asperger's? is it because your son is highly verbal but has these other quirks that seem like potential autistic traits? the way you describe him, i would be surprised if he has asperger's (unless he's using language in odd, idiosyncratic ways and his social interactions themselves seem quirky).

We don't know what to make of the quirks and the obsessive aspects that remain. Yes, some of these traits seem autistic. Whats up with the interest in lights and fans and electronic doors?! He is an unusually bright child. Our extended family members all noted the obsessive traits around the time he was two. They were really quite marked at that point. They have also noted that they seem diminished or even entirely gone. But we were freaked out when he was two, and still see the oddities. We wonder whether these mean anything. These responses are very helpful. Thank you for those who are thinking through this with me.

[Anonymous]

In our area, any kid that has any of the autistic-like traits can eventually be given an ASD or PDD or Aspergers-type diagnosis. Sometimes it's sensory integration or anxiety, plain in simple. I hate that the ASD keeps getting wider and wider. Think about it, it's the ADHD of the 80's and early 90's.

I like how Dr. Greenspan advises that parents stop focusing on labels, and start focusing on the 'symptoms' and treating them. And this is coming from a parent of a kid who has ONLY the social component, but none of the other traits. So, is my kid ASD too?

[Anonymous]

Anonymous wrote:In our area, any kid that has any of the autistic-like traits can eventually be given an ASD or PDD or Aspergers-type diagnosis. Sometimes it's sensory integration or anxiety, plain in simple. I hate that the ASD keeps getting wider and wider. Think about it, it's the ADHD of the 80's and early 90's.

I like how Dr. Greenspan advises that parents stop focusing on labels, and start focusing on the 'symptoms' and treating them. And this is coming from a parent of a kid who has ONLY the social component, but none of the other traits. So, is my kid ASD too?

PP: Do you think our DC might just be showing anxiety symptoms? I understand what you are getting at and am not interested in labels as much as getting help for him if it seems necessary.

[Anonymous]

I think if you want to get him evaluated that I'd take him to Jake Greenspan at DIRSS in Bethesda. He will really zero in on how he interacts and may have some good ideas for addressing anxiety and broadening his play and emotional ranges. I think it was something like $700, so much cheaper than a dev ped's eval. I think he'd put a finer point on the issues that you are concerned about. We were able to get an appointment in a month or two a year ago. He also gives a very detailed report of things you can do to follow up at home which we have found very useful.

[Anonymous]

Anonymous wrote:OP here: What kind of specialist should evaluate him? Where does one take a kid for "quirkiness"? Thank you for the advice to those who are responding.

Our oldest was evaluated by Dr. Chuck Conlon and we were very happy with him. He's in Bethesda and we're in Alexandria so it was a haul but worth it. He's also been allowing our regular pediatrician to consult with him so we don't have to make the haul up there so often. He also worked with our education consultant as we were fighting to get DS qualified for special services. He's a kid that doesn't stand out in a crowd and would have fallen through the educational cracks without intervention. We're having our youngest child evaluated by him next month. He doesn't take insurance and his fee was in teh $800 range for the evaluation and followup.