Does anyone get defensive when it is suggested SOME kids with language disorders MAY have ADHD too?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Just wondering. This is a spin off from another thread, but I didn't have room to put s/o in the title. I am always surprised about how upset people get when ASD comes up. I have met quite a few parents of kids with language disorders who freely admit they and/or their doctor suspect ADHD as well and time will tell, whereas I have also met parents of kids with language disorders who go out of their way to say "my child does not have autism" when the subject hasn't even come up. Sometimes it's people I have literally just met. I never asked if your child had autism. I didn't even ask if your child has a language disorder. It's none of my business. Yes of course there are kids who have language disorders who don't have autism, but why on earth are you going out of your way to say "my child doesn't have autism."

Yes. The first speech-language pathologist we saw flatly told us that our son has ADHD in addition to MERLD and that he needed meds for treatment to be effective. She also said that she didn't want to do therapy with him unless he was medicated We talked to our psychologist and our pediatrician who said they didn't agree. We said "Thanks very much" and found another SLP. After asking around we found that the first SLP said that every kid has ADHD and recommends medication. She is a quack.

Oh wow that's awful!!!! Did she work for a practice? If so, did you let them know. I wanted to puke when out 1st ST thru EI shared the "good news" with me that one of her other clients finally got on meds. We may well go that route one day, but I couldn't believe how flippant she was.

Oh, she put in her note that the parents were not receptive to the diagnosis and that we were not open to assistance for DC at this time. Which is code for "defensive" and "neglectful." Anything we had to say about her to her clinical supervisor was colored by those two phrases. It was pointless.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids with language disorders, e.g., receptive and/or expressive delays are more at risk for ADHD, however it doesn't automatically mean they have ADHD. They are also more at risk for learning disabilities, e.g., dyslexia. I'm not sure what there is to get defensive about. Parents usually learn these things if they get a comprehensive evaluation. However, OP, I don't think YOU should be suggesting these things to parents. Then yes, I could see where they would be defensive.

This thread is a spin off from the MERLD/ASD thread where a lot of people got defensive. Nobody said anybody's kid had ASD, but the implication that some kids with the mERLD presentation may have ASD set off a firestorm that likely would not have occured if you inserted ADHD for ASD.

Not true. Reread that thread. There are definitely people out there that think MERLD is an "autism light" or "soft landing" for autism Dx.

Frankly, people don't view ASD and ADHD equally. If you did a survey of which Dx they'd rather be dealing with, ASD or ADHD, which do you think a parent would choose? (Besides neither one, of course.)

I don't think it's so much that people view MERLD as an "autism light" as that there are quite a few private practitioners who give that diagnosis when there's more involved. It may help some parents feel better to not get the ASD diagnosis or have to share with school personnel; but a child will still present as he is, regardless of the diagnosis. Quite often, we see children in the schools whose parents are reluctant to share the ASD diagnosis; however, when there are attention issues, fine-motor weaknesses, language delays (especially in the area of pragmatics), anxiety/OCD behaviors, and concerns regarding social interactions, we can recognize that there's more going on than MERLD.

[Anonymous]

<<I don't think it's so much that people view MERLD as an "autism light" as that there are quite a few private practitioners who give that diagnosis when there's more involved.>>


This is the part of the debate i dont get. Why would a private practioner give that diagnosis if its not accurate and comprehensive? And if it is accurate and more incolvied, why not give that dx as well as others: as in merld, adhd (or asd), etc etc?

The point im making is this: its been suggested repeatedly that private practioners are giving diagnosises to make parents feel better. Do people really believe thats happening? Isnt it the responsbility of the practioner to say: look, this is the deal with you kid? It just seems like an awefully big conspiracy theory to think the private practitioners hare hiding the reality...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids with language disorders, e.g., receptive and/or expressive delays are more at risk for ADHD, however it doesn't automatically mean they have ADHD. They are also more at risk for learning disabilities, e.g., dyslexia. I'm not sure what there is to get defensive about. Parents usually learn these things if they get a comprehensive evaluation. However, OP, I don't think YOU should be suggesting these things to parents. Then yes, I could see where they would be defensive.

This thread is a spin off from the MERLD/ASD thread where a lot of people got defensive. Nobody said anybody's kid had ASD, but the implication that some kids with the mERLD presentation may have ASD set off a firestorm that likely would not have occured if you inserted ADHD for ASD.

Not true. Reread that thread. There are definitely people out there that think MERLD is an "autism light" or "soft landing" for autism Dx.

Frankly, people don't view ASD and ADHD equally. If you did a survey of which Dx they'd rather be dealing with, ASD or ADHD, which do you think a parent would choose? (Besides neither one, of course.)

I don't think it's so much that people view MERLD as an "autism light" as that there are quite a few private practitioners who give that diagnosis when there's more involved. It may help some parents feel better to not get the ASD diagnosis or have to share with school personnel; but a child will still present as he is, regardless of the diagnosis. Quite often, we see children in the schools whose parents are reluctant to share the ASD diagnosis; however, when there are attention issues, fine-motor weaknesses, language delays (especially in the area of pragmatics), anxiety/OCD behaviors, and concerns regarding social interactions, we can recognize that there's more going on than MERLD.

Again, MERLD often presents with several issues that make it seem like ASD, including fine motor weakness (they are located in the same area of the brain) and of course anxiety, social issues and attention issues. Anyone giving a moment's thought to how a young child might react when they can't understand what's being said -- while all their peers can -- should be able to see this clearly.. This is the dangerous "checklist" mentality that causes so many children to be mislabeled.

Once a MERLD child's language starts to catch up, these symptoms start to fade out. The problem if you've tagged a MERLD child with ASD is that the language treatments are NOT the same for them, and the approach tends to be all wrong. BEEN THERE, DONE THAT!

[Anonymous]

Anonymous wrote:
however, when there are attention issues, fine-motor weaknesses, language delays (especially in the area of pragmatics), anxiety/OCD behaviors, and concerns regarding social interactions, we can recognize that there's more going on than MERLD.

Except for the fine-motor weakness, all of these are related to MERLD and are not necessarily indications that there's "more going on."

Language delays are the definition of MERLD. Attention issues are caused by poor ability to listen and follow written instruction. Anxiety/OCD like behaviors are caused by an inability to understand what is going on or follow directions. Social interactions are hampered by the inability to listen or express yourself. Learning pragmatics is impaired by the lack of receptive language. When the language improves, these symptoms improve.

The PP's comment is why parents of MERLD kids are defensive, folks. Educators and general by-standers generally have a poor understanding of what MERLD looks like, and lots of people are generally ready to rediagnose our kids with ASD, even if they're not qualified to so and haven't done the *#(&*$&*( assessment or talked to the people who have. It's unbelievably frustrating to see your child struggle, go through the wringer to have the child dx'd (we saw 4 separate professionals in different fields), do the research to figure out what MERLD is (most people have never heard of it), battle with insurance companies and school districts to get the therapy your child needs, and then be told by by-standers that you are "in denial" about your child's problem. When it's another SN parent, it's crazy making, because if anyone should have sympathy for the challenges of dealing with a SN child, it's another SN parent.

[Anonymous]

PP -- what you describe below sounds just like us. Four different assessments, only to be dismissed by school

[Anonymous]

what i want to know is why educators and other professionals have such a poor understanding of merld?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids with language disorders, e.g., receptive and/or expressive delays are more at risk for ADHD, however it doesn't automatically mean they have ADHD. They are also more at risk for learning disabilities, e.g., dyslexia. I'm not sure what there is to get defensive about. Parents usually learn these things if they get a comprehensive evaluation. However, OP, I don't think YOU should be suggesting these things to parents. Then yes, I could see where they would be defensive.

This thread is a spin off from the MERLD/ASD thread where a lot of people got defensive. Nobody said anybody's kid had ASD, but the implication that some kids with the mERLD presentation may have ASD set off a firestorm that likely would not have occured if you inserted ADHD for ASD.

Not true. Reread that thread. There are definitely people out there that think MERLD is an "autism light" or "soft landing" for autism Dx.

Frankly, people don't view ASD and ADHD equally. If you did a survey of which Dx they'd rather be dealing with, ASD or ADHD, which do you think a parent would choose? (Besides neither one, of course.)

I don't think it's so much that people view MERLD as an "autism light" as that there are quite a few private practitioners who give that diagnosis when there's more involved. It may help some parents feel better to not get the ASD diagnosis or have to share with school personnel; but a child will still present as he is, regardless of the diagnosis. Quite often, we see children in the schools whose parents are reluctant to share the ASD diagnosis; however, when there are attention issues, fine-motor weaknesses, language delays (especially in the area of pragmatics), anxiety/OCD behaviors, and concerns regarding social interactions, we can recognize that there's more going on than MERLD.

Again, MERLD often presents with several issues that make it seem like ASD, including fine motor weakness (they are located in the same area of the brain) and of course anxiety, social issues and attention issues. Anyone giving a moment's thought to how a young child might react when they can't understand what's being said -- while all their peers can -- should be able to see this clearly.. This is the dangerous "checklist" mentality that causes so many children to be mislabeled.

Once a MERLD child's language starts to catch up, these symptoms start to fade out. The problem if you've tagged a MERLD child with ASD is that the language treatments are NOT the same for them, and the approach tends to be all wrong. BEEN THERE, DONE THAT!

I'm the PP. I've been in the special ed field for years and would never knowingly make a diagnosis prematurely. I should have been more clear, but I was thinking of older children--around 11 and older. When I see these same characteristics in a middle schooler, yet they're carrying only a speech/lang eligibility, I often think there's "more going on. I share my concerns with parents and try to get more services for these students.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
however, when there are attention issues, fine-motor weaknesses, language delays (especially in the area of pragmatics), anxiety/OCD behaviors, and concerns regarding social interactions, we can recognize that there's more going on than MERLD.

Except for the fine-motor weakness, all of these are related to MERLD and are not necessarily indications that there's "more going on."

Language delays are the definition of MERLD. Attention issues are caused by poor ability to listen and follow written instruction. Anxiety/OCD like behaviors are caused by an inability to understand what is going on or follow directions. Social interactions are hampered by the inability to listen or express yourself. Learning pragmatics is impaired by the lack of receptive language. When the language improves, these symptoms improve.

The PP's comment is why parents of MERLD kids are defensive, folks. Educators and general by-standers generally have a poor understanding of what MERLD looks like, and lots of people are generally ready to rediagnose our kids with ASD, even if they're not qualified to so and haven't done the *#(&*$&*( assessment or talked to the people who have. It's unbelievably frustrating to see your child struggle, go through the wringer to have the child dx'd (we saw 4 separate professionals in different fields), do the research to figure out what MERLD is (most people have never heard of it), battle with insurance companies and school districts to get the therapy your child needs, and then be told by by-standers that you are "in denial" about your child's problem. When it's another SN parent, it's crazy making, because if anyone should have sympathy for the challenges of dealing with a SN child, it's another SN parent.

I'm the PP and can appreciate your frustration, but I'm not just "an educator or general by-stander with a poor understanding of what MERLD looks like." There can always be differing opinions, even among medical professionals, neuropsychologists, etc. I care deeply about children with special needs and have been evaluating them for years.

[Anonymous]

Anonymous wrote:<<I don't think it's so much that people view MERLD as an "autism light" as that there are quite a few private practitioners who give that diagnosis when there's more involved.>>


This is the part of the debate i dont get. Why would a private practioner give that diagnosis if its not accurate and comprehensive? And if it is accurate and more incolvied, why not give that dx as well as others: as in merld, adhd (or asd), etc etc?

The point im making is this: its been suggested repeatedly that private practioners are giving diagnosises to make parents feel better. Do people really believe thats happening? Isnt it the responsbility of the practioner to say: look, this is the deal with you kid? It just seems like an awefully big conspiracy theory to think the private practitioners hare hiding the reality...

Yes, some do. They view school systems as giving labels prematurely and try to help parents avoid that situation by providing a more limited diagnosis to younger children. They're aware that, if it's really ASD, it's "not going away."

[Anonymous]

Anonymous wrote:

Anonymous wrote:
however, when there are attention issues, fine-motor weaknesses, language delays (especially in the area of pragmatics), anxiety/OCD behaviors, and concerns regarding social interactions, we can recognize that there's more going on than MERLD.

Except for the fine-motor weakness, all of these are related to MERLD and are not necessarily indications that there's "more going on."

Language delays are the definition of MERLD. Attention issues are caused by poor ability to listen and follow written instruction. Anxiety/OCD like behaviors are caused by an inability to understand what is going on or follow directions. Social interactions are hampered by the inability to listen or express yourself. Learning pragmatics is impaired by the lack of receptive language. When the language improves, these symptoms improve.
The PP's comment is why parents of MERLD kids are defensive, folks. Educators and general by-standers generally have a poor understanding of what MERLD looks like, and lots of people are generally ready to rediagnose our kids with ASD, even if they're not qualified to so and haven't done the *#(&*$&*( assessment or talked to the people who have. It's unbelievably frustrating to see your child struggle, go through the wringer to have the child dx'd (we saw 4 separate professionals in different fields), do the research to figure out what MERLD is (most people have never heard of it), battle with insurance companies and school districts to get the therapy your child needs, and then be told by by-standers that you are "in denial" about your child's problem. When it's another SN parent, it's crazy making, because if anyone should have sympathy for the challenges of dealing with a SN child, it's another SN parent.

So what would cause you to consider the possibility of ASD?

[Anonymous]

I'm the PP and can appreciate your frustration, but I'm not just "an educator or general by-stander with a poor understanding of what MERLD looks like." There can always be differing opinions, even among medical professionals, neuropsychologists, etc. I care deeply about children with special needs and have been evaluating them for years.

What's your point? It's one thing to bring up concerns about a child's behavior, it's very different to question a diagnosis. Even if you are in the business of evaluating children, if you've not been asked to provide an opinion, you shouldn't offer one. I also don't know how you could even offer an opinion if you haven't conducted a formal evaluation.

I'm not the poster you're responding to but I have a child with MERLD and apraxia of speech. Like many of the others on this and other threads, I'm incredibly annoyed by others suggesting we are trying to avoid an ASD diagnosis, that my child hasn't been correctly diagnosed or that they know better than the specialists we consult and who have been involved with our kids for years. I don't care who you are or what you think you know.

[Anonymous]

Anonymous wrote:

I'm the PP and can appreciate your frustration, but I'm not just "an educator or general by-stander with a poor understanding of what MERLD looks like." There can always be differing opinions, even among medical professionals, neuropsychologists, etc. I care deeply about children with special needs and have been evaluating them for years.

What's your point? It's one thing to bring up concerns about a child's behavior, it's very different to question a diagnosis. Even if you are in the business of evaluating children, if you've not been asked to provide an opinion, you shouldn't offer one. I also don't know how you could even offer an opinion if you haven't conducted a formal evaluation.

I'm not the poster you're responding to but I have a child with MERLD and apraxia of speech. Like many of the others on this and other threads, I'm incredibly annoyed by others suggesting we are trying to avoid an ASD diagnosis, that my child hasn't been correctly diagnosed or that they know better than the specialists we consult and who have been involved with our kids for years. I don't care who you are or what you think you know.

I have not and would not offer an opinion about a specific child unless I conducted a formal evaluation. I am not trying to evaluate your child. Just as all the other posters, including you, I do have every right to offer an opinion about DCUM thread topics, such as ASD characteristics.

[Anonymous]

Educators work hard to accomodate the needs of the child that affect his/her functioning in the classroom. If a MERLD child has many ASD like characteristics but isn't on the spectrum, it doesn't matter. If those autism like symptoms are impairing the child, they will be addressed in the same ways those symptoms are addressed for a child on the spectrum so I don't see the need to differentiate until the child presents with only language issues.

It was mentioned that MERLD kids outgrow these autism like symptoms. Many kids on the spectrum "lose" some promounced autism symptoms as well or they diminish substantially either on their own or through intervention. Most experts agree that one of the most important keys to unlocking a child on the spectrum's potential is speech and language therapy-the more the better. So, yes with intensive ST both those with MERLD and those with ASD can often improve substantially.

I think if you stop focusing on the labels and pay attention to the presentation many kids with MERLD label are getting the same accomodations and intervention as those with ASD labels and yes the prognosis can be quite good for both groups.

[Anonymous]

Anonymous wrote:
Educators work hard to accomodate the needs of the child that affect his/her functioning in the classroom. If a MERLD child has many ASD like characteristics but isn't on the spectrum, it doesn't matter. If those autism like symptoms are impairing the child, they will be addressed in the same ways those symptoms are addressed for a child on the spectrum so I don't see the need to differentiate until the child presents with only language issues.

It was mentioned that MERLD kids outgrow these autism like symptoms. Many kids on the spectrum "lose" some promounced autism symptoms as well or they diminish substantially either on their own or through intervention. Most experts agree that one of the most important keys to unlocking a child on the spectrum's potential is speech and language therapy-the more the better. So, yes with intensive ST both those with MERLD and those with ASD can often improve substantially.

I think if you stop focusing on the labels and pay attention to the presentation many kids with MERLD label are getting the same accomodations and intervention as those with ASD labels and yes the prognosis can be quite good for both groups.

I agree with all that you've said. In many school systems, however, it can be extremely difficult to provide some of the assistance, accommodations, and services (especially a paraprofessional) that parents and educators think would be appropriate/beneficial, unless the child has the AU eligibility. In systems that have a procedure in place for the review of all eligibilities and IEPs by administrators, the eligibilty areas are often read very carefully.