What does high functioning autism look like?

[Anonymous]

My kid is 6 years old. She is flexible, has friends and has no intense interests. On the other hand, her eye contact is inconsistent. When she tells stories, she always looks all around as if the story is playing out in front of her. We often have to remind her to look at people when she asks a question or says “thank you.” She loves make believe games with friends and is very creative, but if a friend loses interest, she’ll just keep the make believe game going on her own, talking to stuffed animals, narrating out loud, etc. She engages when she sees friends after school on the playground, but, at recess, she prefers to play alone (again, talking to herself as she engages in make believe).

Stixrud said we should “keep an eye on” things for a possible ASD diagnosis. Does this sound like ASD to you? What’s your ASD kid like? How did you know it was ASD?

[Anonymous]

Anonymous wrote:My kid is 6 years old. She is flexible, has friends and has no intense interests. On the other hand, her eye contact is inconsistent. When she tells stories, she always looks all around as if the story is playing out in front of her. We often have to remind her to look at people when she asks a question or says “thank you.” She loves make believe games with friends and is very creative, but if a friend loses interest, she’ll just keep the make believe game going on her own, talking to stuffed animals, narrating out loud, etc. She engages when she sees friends after school on the playground, but, at recess, she prefers to play alone (again, talking to herself as she engages in make believe).

Stixrud said we should “keep an eye on” things for a possible ASD diagnosis. Does this sound like ASD to you? What’s your ASD kid like? How did you know it was ASD?

This does not sound remotely like ASD to me. But i'm someone who thinks the diagnosis is thrown around so frequently as to be meaningless.

WHile ASD kids have a hard time with eye contact, so do lots of people including ADHD folks. I definitely do NOT have ASD, but i guess I could have some aspects of ADHD (my mind is extremely full of fast moving info relative to the general population, but I've never had a problem organizing my thoughts or activities), and I have severe issues keeping eye contact. I googled it a few years ago, and best article I saw was suggesting that some brains are so intensely full of some stimulants that adding BOTH verbal and audio inputs is too much. If I want to process the audio, I have to shut out the video.

I also think lots of 6 year olds are naturally socially loners, and for many kids at that age, meaningful friendships are a parent construct, and not naturally occurring.

But with all that said.... there must be something more going on than the above innocuous description if you took her to Stixrud?

[Anonymous]

No one knows what hfa is or looks like any more - as pp says it is so overdiagnosed in some populations (Altho autism is also under diagnosed in some other populations) as to be ridiculous and meaningless.

Our evaluator said the main reason she gave dc an asd dx when he was 7 was that she asked him about his family and he didn’t ask her about hers. I think that sums up where we’ve got to with diagnosing asd

Op all those things could just be her personality. Asd is only worth diagnosing if someone has significant challenges relating to others and those challenges are causing distress or avoidance

[Anonymous]

Anonymous wrote:No one knows what hfa is or looks like any more - as pp says it is so overdiagnosed in some populations (Altho autism is also under diagnosed in some other populations) as to be ridiculous and meaningless.

Our evaluator said the main reason she gave dc an asd dx when he was 7 was that she asked him about his family and he didn’t ask her about hers. I think that sums up where we’ve got to with diagnosing asd

Op all those things could just be her personality. Asd is only worth diagnosing if someone has significant challenges relating to others and those challenges are causing distress or avoidance

Are you serious? Should a 7 year old be expected to ask an adult about their family after a similar question? My kid would definitely not do that consistently. More so with a peer but she would feel like an adult is just collecting information.

[Anonymous]

I think it sounds not inconsistent with ASD, but it's not really enough on its own. Especially with kids' social skills generally being a bit behind due to Covid. Do you have anything else, like meltdowns, strong food or other sensory aversions, struggles to interpret the behavior of others, hard time reading faces, stimming or sensory seeking behavior like twirling or flapping? If you don't have much else, I'd say keep an eye on social skills and coach her, but it's not enough to support an ASD diagnosis.

[Anonymous]

Anonymous wrote:No one knows what hfa is or looks like any more - as pp says it is so overdiagnosed in some populations (Altho autism is also under diagnosed in some other populations) as to be ridiculous and meaningless.

Our evaluator said the main reason she gave dc an asd dx when he was 7 was that she asked him about his family and he didn’t ask her about hers. I think that sums up where we’ve got to with diagnosing asd

Op all those things could just be her personality. Asd is only worth diagnosing if someone has significant challenges relating to others and those challenges are causing distress or avoidance

+1

Also, "high functioning" isn't really a medical term, autism is properly classified as mild, moderate, severe, profound. Degree of functionality correlates with level of autism, but is not determinative.

[Anonymous]

Does not sound like ASD to me.

Signed,
Mom of child who is also on the border but seems to have much more classic autism symptoms than what you describe here

[Anonymous]

For a girl, it can be too early to tell.

[Anonymous]

Anonymous wrote:

Anonymous wrote:No one knows what hfa is or looks like any more - as pp says it is so overdiagnosed in some populations (Altho autism is also under diagnosed in some other populations) as to be ridiculous and meaningless.

Our evaluator said the main reason she gave dc an asd dx when he was 7 was that she asked him about his family and he didn’t ask her about hers. I think that sums up where we’ve got to with diagnosing asd

Op all those things could just be her personality. Asd is only worth diagnosing if someone has significant challenges relating to others and those challenges are causing distress or avoidance

Are you serious? Should a 7 year old be expected to ask an adult about their family after a similar question? My kid would definitely not do that consistently. More so with a peer but she would feel like an adult is just collecting information.

Deadly serious. Honestly I don’t think I have ever asked a dr about their family or themselves and plenty of times they ask me. That’s kind of the doctor patient dynamic. I sometimes wonder if the evaluator had an issue reading social cues.

That aside my experience taught me that there’s so much we don’t know and so much that’s subjective. A year after our asd dx I have a kid that def has adhd, and may be challenging and inflexible at times, but has the same social understanding as his nt brother - broadly speaking. It took me a long time to give myself permission to question the dx but I started to realize inwaS doing ds a disservice by not doing so, and I also realized that the blurriness of the dx helps no one

[Anonymous]

Anonymous wrote:For a girl, it can be too early to tell.

+1 My dd was diagnosed at age 10, and only borderline then. Her social skills weren’t far from the norm until she got older. I agree with Stixrud. Your dd could have ASD, but if so, she’s high enough functioning that it’s difficult to say. The good news is that she clearly doesn’t need serious interventions.

[Anonymous]

Anonymous wrote:

Anonymous wrote:For a girl, it can be too early to tell.

+1 My dd was diagnosed at age 10, and only borderline then. Her social skills weren’t far from the norm until she got older. I agree with Stixrud. Your dd could have ASD, but if so, she’s high enough functioning that it’s difficult to say. The good news is that she clearly doesn’t need serious interventions.

My DD is 10, and was diagnosed at 9, after previously being diagnosed with selective mutism and anxiety. At 6, she was a quiet kid who was very into make believe and acting out her favorite stories with her stuffies. She often ignored people speaking to her, but again, she was cautious and quiet. It didn't seem too far out of the ordinary. She didn't have "intense" interests but was, like a lot of 6yos, really "into" certain characters or activities. She had friends and knew all about the kids in her class, but didn't really play with them (no playdates, no birthday invites). We were concerned for her mental health, but as I said, we were told anxiety, and so we tried strategies related to that. In 2nd grade, things really came together (or fell apart, depending on how you look at it) and her behavior began circling further outside the norm. We began 3rd grade with pursuing testing and the ASD Level 1 (the current term for what was once called high functioning autism or Aspergers) diagnosis came that spring. Now at age 10, she has very obvious traits of autism and we are confident that the diagnosis is correct.

It's worth understanding that ASD looks different in girls than boys, and girls are generally underdiagnosed, and diagnosed much later. What prompted you to take her to Stixrud? If they determined it's too early to tell, it probably is. For girls, it's really not unusual.

[Anonymous]

Sounds like you could use an ADOS test

[Anonymous]

Anonymous wrote:For a girl, it can be too early to tell.

Never too early, I’ve worked with kids 16 months old

[Anonymous]

Anonymous wrote:

Anonymous wrote:For a girl, it can be too early to tell.

Never too early, I’ve worked with kids 16 months old

I know several girls who were diagnosed as young teens. Are you a psychologist?

[Anonymous]

Anonymous wrote:

Anonymous wrote:For a girl, it can be too early to tell.

Never too early, I’ve worked with kids 16 months old

So why not test at birth then, since it's never too early.

For some children, yes, 6 may be too early to tell.