Potential PDD diagnosis

[Anonymous]

Anonymous wrote:Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

This describes a lot of special needs kids, not just those with Asperger's.

And you can get an IEP with all 13 different categories, including EDD, language and OHI.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

Is it really possible that a child with AS would present as totally NT one-on-one?

DS does with adults. He'll happily chatter and engage with them including strangers he's just met. His eye contact has always been good. Of course if the topic of conversation turns into one of his obsessive interests... one of his obsessive interests is cars so that can seem normal in a little boy, however, the elevators and subway/metro systems can get a bit weird.

We have many MDs and psychologists (even a teacher who works in Sp Ed) in our family and they never saw anything wrong. Parallel play is still considered pretty normal for three yr olds and he was never in group settings with same age peers until he turned four.

[Anonymous]

Anonymous wrote:Just so you know the PDD-NOS diagnosis is sometimes given to kids on the very high functioning end of the spectrum, kids who have above average intelligence so just b/c your son is bright does not mean he cannot have PDD-NOS. Also, b/c Aspergers can only be diagnosed when kids are older (i.e around 6 years old), a lot of dev. pediatricians will give the PDD-NOS diagnosis when the kid is younger than 6, but it is more of a PDD-NOS/Aspergers like diagnosis: meaning they think the kid actually has Aspergers but since the kid is too young to be able to say that, they give him the PDD-NOS diagnosis. Maybe that's the case with your toddler especially since you are saying his problem is mainly social skills.

PDD diagnosis by dev. ped. around age 2. We could not believe it and sought other counsel, who also just felt there were various non-ASD delays to tend to. We did recommended early interventions, pragmatic speech, private OT, play therapy, etc.

Fast forward to elementary school. A complete disaster. Switched schools in K and again in 2. Went for another evaluation (different place this time around) and got the AS diagnosis. Read up on it. It fit. DS now has an IEP, appropriate interventions and is in a special program.

World of difference. Looking back, first doctor was on to something and while we did the interventions, we should have been in a year or so sooner for a re-evaluation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

This describes a lot of special needs kids, not just those with Asperger's.

And you can get an IEP with all 13 different categories, including EDD, language and OHI.

It does? DS has no language delay except with pragmatics. He is highly, precociously verbal in English and in the immersion language. His main issues are with social interactions, repetitive behaviors and having obsessive interests - the definition of AS.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Our developmental pediatrician went to our son's school and observed him, prek, and spoke with his teachers. DS presents NT one-on-one with adults: good eye contact, very verbal, very engaging. It's only when you see DS in a classroom with peers that his deficits are apparent: not engaged, wanders aimlessly, does not play with other children. DS excels academically - attends an immersion school. We don't speak the language. No behavior issues.

I'm glad our developmental pediatrician DX our DS with Aspergers b/c it's clear that's what he has: DS has an IEP and it's made a world of difference and very quickly.

This describes a lot of special needs kids, not just those with Asperger's.

And you can get an IEP with all 13 different categories, including EDD, language and OHI.

It does? DS has no language delay except with pragmatics. He is highly, precociously verbal in English and in the immersion language. His main issues are with social interactions, repetitive behaviors and having obsessive interests - the definition of AS.

SN kids often have trouble with peer relationships. Children with language delays, for example, can't keep up with conversations, and get left behind enough that they just stop trying. They can't attend to circle times because they have no idea what is being said, so they wander around and do their own thing. They don't engage, again, because the language is such a barrier. These kids are misdiagnosed with autism in absolute droves.

The other issues you describe are classic AS. But even that's a matter of degree. I had repetitive behaviors and obsessive interests as a youngster, but no trouble with social interactions. Luckily, I grew up in a time before these labels.

[Anonymous]

But PP was referring to children without language delays (except for pragmatics). The point was that the child was verbal, and does well academically. Add in the social deficits, special interests and repetitive behaviors and you have classic AS, certainly not "a lot of special needs kids." If you are the poster who often posts about children being misdiagnosed, you are stretching your argument here.

[Anonymous]

The PP has a AS diagnosis she feels fits, so that's good. (However, in her descriptions, she describes the child as having perfectly normal relationships with adults, but not with kids. So that's a bit confusing. She didn't initially mention the repetitive behaviors and the obsessive interests, which are hallmark AS issues and absolutely do affect relationships with adults down the road.)

But the OP isn't sure PDD is right at all. There are many reasons a child might avoid eye contact, for example, or have trouble with social cues or be lagging with peers. So I encourage parents to get to the bottom of the issues, especially if the parents and others who work with the child think PDD isn't the answer.

[Anonymous]

The one diagnosis a child with language delays will NOT get is Aspergers/ASD which by definition rules out language delays (except pragmatics). DS has no language delay. In fact, language (except pragmatics) appears to be a strength and he excels in the language at his immersion school where preK is only in the target language.

And pp is correct. DS has been described by his developmental pediatrician as "classic" Aspergers.

[Anonymous]

Anonymous wrote:
The PP has a AS diagnosis she feels fits, so that's good. (However, in her descriptions, she describes the child as having perfectly normal relationships with adults, but not with kids. So that's a bit confusing. She didn't initially mention the repetitive behaviors and the obsessive interests, which are hallmark AS issues and absolutely do affect relationships with adults down the road.)

But the OP isn't sure PDD is right at all. There are many reasons a child might avoid eye contact, for example, or have trouble with social cues or be lagging with peers. So I encourage parents to get to the bottom of the issues, especially if the parents and others who work with the child think PDD isn't the answer.

You're right. I didn't mention these b/c they're a given with an AS diagnosis. You can't get an AS diagnosis without repetitive behaviors and special interests - they are equally important as the social deficits. Without all three components, one would get an PDD-NOS diagnosis or if not ASD, MERLD or some other language disorder.

[Anonymous]

Anonymous wrote:
The PP has a AS diagnosis she feels fits, so that's good. (However, in her descriptions, she describes the child as having perfectly normal relationships with adults, but not with kids. So that's a bit confusing. She didn't initially mention the repetitive behaviors and the obsessive interests, which are hallmark AS issues and absolutely do affect relationships with adults down the road.)

But the OP isn't sure PDD is right at all. There are many reasons a child might avoid eye contact, for example, or have trouble with social cues or be lagging with peers. So I encourage parents to get to the bottom of the issues, especially if the parents and others who work with the child think PDD isn't the answer.

She didn't say "perfectly normal relationships with adults," she said "presents as NT." There is a big difference. Its pretty common for kids with AS to relate better to adults than children. There's nothing confusing about it. My DS has a much easier time carrying on a conversation with an adult and they would never think he has AS. They would think he was awkward or shy, but awkward and shy come under the umbrella of NT.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
The PP has a AS diagnosis she feels fits, so that's good. (However, in her descriptions, she describes the child as having perfectly normal relationships with adults, but not with kids. So that's a bit confusing. She didn't initially mention the repetitive behaviors and the obsessive interests, which are hallmark AS issues and absolutely do affect relationships with adults down the road.)

But the OP isn't sure PDD is right at all. There are many reasons a child might avoid eye contact, for example, or have trouble with social cues or be lagging with peers. So I encourage parents to get to the bottom of the issues, especially if the parents and others who work with the child think PDD isn't the answer.

You're right. I didn't mention these b/c they're a given with an AS diagnosis. You can't get an AS diagnosis without repetitive behaviors and special interests - they are equally important as the social deficits. Without all three components, one would get an PDD-NOS diagnosis or if not ASD, MERLD or some other language disorder.

Aspergers isn't all about the social communication deficit. I should explain that my AS son's social communication is weak/borderline but on the normal side as explained by his neuropsych who evaluated him using ADOS. Weak but normal hence his eye contact, engagement with adults, etc appears NT. It's his repetitive behaviors and special interests much more than his social deficits that qualifies him for an AS diagnosis.

People seem to think AS is all about being socially inept and I wish it was that simple. It's actually the repetitive behaviors and obsessions that cause it to be a disability.

[Anonymous]

Can you elaborate on the repetitive behaviors? We are in the middle of a multi-faceted evalutation for my 5 year old, and I am anticipating a diagnosis of PDD NOS, because although he seems to have most characteristics of Asp., it's just not quite enough, I think. He has the obsessions, but I don't think he has the repetitive behaviors. He used spin things before he was 2 yrs old., but he has no "stim" behaviors now.

[Anonymous]

Anonymous wrote:
The PP has a AS diagnosis she feels fits, so that's good. (However, in her descriptions, she describes the child as having perfectly normal relationships with adults, but not with kids. So that's a bit confusing. She didn't initially mention the repetitive behaviors and the obsessive interests, which are hallmark AS issues and absolutely do affect relationships with adults down the road.)

Gifted kids -- especially as they get towards the higher end of the gifted scale -- can look exactly like this. They have good verbal skills, poor peer relationships, and good adult relationships. They can be obsessive. They're not necessarily suffering from an ASD. They're just gifted.

[Anonymous]

Anonymous wrote:Can you elaborate on the repetitive behaviors? We are in the middle of a multi-faceted evalutation for my 5 year old, and I am anticipating a diagnosis of PDD NOS, because although he seems to have most characteristics of Asp., it's just not quite enough, I think. He has the obsessions, but I don't think he has the repetitive behaviors. He used spin things before he was 2 yrs old., but he has no "stim" behaviors now.

Different poster here, but I can describe what my son's stims look like. He had no stims/repetitive behaviors after he was a small baby. He hand-flapped a lot when he was under 1 year, but he stopped doing that at a developmentally appropriate age. He had no stims/repetitive behaviors again until he was 6 or 7. Then he started pogo-jumping when he was excited. He jumps up and down with both feet like he is on a pogo stick. He does this when he's playing on the playground or playing a video game or watching a really good TV show. (American Ninja Warrior is a current favorite.)

He also finger postures. He touches his thumb to the tips of his fingers, over and over, when he is talking to people. Sometimes he snaps his fingers. It's not obnoxious, but it's definitely there.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
The PP has a AS diagnosis she feels fits, so that's good. (However, in her descriptions, she describes the child as having perfectly normal relationships with adults, but not with kids. So that's a bit confusing. She didn't initially mention the repetitive behaviors and the obsessive interests, which are hallmark AS issues and absolutely do affect relationships with adults down the road.)

Gifted kids -- especially as they get towards the higher end of the gifted scale -- can look exactly like this. They have good verbal skills, poor peer relationships, and good adult relationships. They can be obsessive. They're not necessarily suffering from an ASD. They're just gifted.

My 4 yr old ASD/Asperger's kid has an IQ of 145 which according to the psych who tested him (and diagnosed him for school) we should take with a grain of salt b/c his fine motor issues interfered with testing. His IQ is most likely higher. Being "gifted" and having Asperger's is not that uncommon. He has also been diagnosed with AS by Children's and a developmental pediatrician so we have no doubt about the DX.

If the "gifted" kid had similar issues with social relationships and repetitive behaviors/obsessions, he should get treatment and support b/c it'll make for a much better school experience. I don't see any negatives here. My DS is in a mainstream classroom with an IEP and he has friends and is happy. He also excels academically in the immersion language.