Borderline ASD: How to get services (DCPS)

[Anonymous]

There is no such thing as a "borderline" diagnosis in terms of an IEP. In a pre-k 3 they may accept this is she has significant behavioral challenges, but going forward into elementary they will need to code her properly. She either is or is not ASD. Though your report may have a great deal of descriptive elements which make it seem thorough, unless your child is evaluated with a standardized tool you're missing the whole picture (unless you suspect she will not make the criteria and you want to keep it vague for now).

[Anonymous]

What makes you think OP did not have ADOS done?

OP, my sympathies. Since your daughter is 3.5 you should be able to qualify her under develoopmental delay. Good luck!

[Anonymous]

Because an ADOS will say "Yes, meets diagnostic criteria" or "No, does not meet diagnostic criteria"

[Anonymous]

Shapiro does not refer out for ADOS. We got it on our own at Children's in Rockville. Fully covered by insurance and it added a lot to our understanding of DS who is very high functioning ASD in addition to Shapiro's report and evaluation.

I am surprised that a dev ped at Children's did not send you for ADOS however.

[Anonymous]

OP- do you mind sharing who is still using Asperger's as a diagnostic term?

[Anonymous]

OP here. Nobody diagnosed my child with Aspergers. But a doctor did use the term to describe some of her HFA traits.

Anyway, I posted to ask about people's experiences accessing public school services for a child with many ASD type social impairments, not to get all of DCUM to weigh in on her diagnosis or lack thereof.

I do have another child with a formal diagnosis, so I know what that looks like. I also have a NT child, so I know what that looks like, too.

My youngest, frankly, is in between. She may not have enough impairments in different areas to I warrant an official diagnosis, but I as her parent -- and, most certainly her teachers -- can see that she has a range of ASD-type issues that pose a range of developmental challenges.

She may not warrant an official diagnosis.

But most competent professionals would also see that she has a range of social and gross motor delays that warrant extensive early intervention, and that these traits are similar to some of the issues her older HFA sister has.

But sorry if the term "borderline" troubles some. It doesn't trouble me.

[Anonymous]

P.S.: it's probably accurate and simpler to say she has some social and gross motor delays. Nobody would dispute that.

[Anonymous]

I think the point that is being made is that you might be able to get services now with a "soft" diagnosis like this, but going forward you will need a real diagnosis of the actual impairments. Those diagnoses would be offered with suggested services/ treatments/ therapies.

[Anonymous]

Anonymous wrote:P.S.: it's probably accurate and simpler to say she has some social and gross motor delays. Nobody would dispute that.

She will get an IEP under "developmental delay" until she is in K when she'll needs a diagnosis code that is in one of the IDEA's categories. Even if she does not have a formal ASD diagsosis or stays "borderline", she may qualify for an "educational diagnosis" which will be "autism". Early stages and schools do not diagnose but they need to fit your child into a category under IDEA so that they get services. Even with Shapiro's report, it will be easier if you have the school evaluate your child including psychoeducational, OT, PT and Speech if you want these services.

I'm the poster who used Dr. Shapiro. Our charter does their own evaluations for an IEP. Shapiro's report has some weight (maybe not in your case bc he does not give a definitive diagnosis) but you need to let the school evaluate these areas if you want services under "developmental delay"

Depends on the school but in preK4 with IEP, we got OT (pencil grip, zippers, forks, buttons, etc), PT (stairs, climbing playground equipment, dribbling a ball, etc.), Speech (pragmatics) and a social skills group 4x a wk during nap time. The teacher also assigned "buddies" in the classroom. Since my child had a diagnosis, the school, teachers and admins, was very aware that he needs help and they look out for him. Still do.

[Anonymous]

Anonymous wrote:What do you mean by "borderline ASD/Asperger's"? Go get an ADOS or neuropsych eval. My kid got an Asperger's diagnosis by 1-2 puts on the ADOS, you either have ASD or not. There is no borderline.

If your child is having meltdowns with transitions are there other issues? Does he engage and play with other kids in the playground and classroom? Can he keep up with peers when the kids lineup and move as a group? Can he sit and pay attention during circle time? Does he have friends?

If he needs help in these things, you need a diagnosis and an IEP.

I agree with this because in my experience you will have a difficult time getting an IEP without the ASD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:P.S.: it's probably accurate and simpler to say she has some social and gross motor delays. Nobody would dispute that.

She will get an IEP under "developmental delay" until she is in K when she'll needs a diagnosis code that is in one of the IDEA's categories. Even if she does not have a formal ASD diagsosis or stays "borderline", she may qualify for an "educational diagnosis" which will be "autism". Early stages and schools do not diagnose but they need to fit your child into a category under IDEA so that they get services. Even with Shapiro's report, it will be easier if you have the school evaluate your child including psychoeducational, OT, PT and Speech if you want these services.

I'm the poster who used Dr. Shapiro. Our charter does their own evaluations for an IEP. Shapiro's report has some weight (maybe not in your case bc he does not give a definitive diagnosis) but you need to let the school evaluate these areas if you want services under "developmental delay"

Depends on the school but in preK4 with IEP, we got OT (pencil grip, zippers, forks, buttons, etc), PT (stairs, climbing playground equipment, dribbling a ball, etc.), Speech (pragmatics) and a social skills group 4x a wk during nap time. The teacher also assigned "buddies" in the classroom. Since my child had a diagnosis, the school, teachers and admins, was very aware that he needs help and they look out for him. Still do.

OT, PT and Speech were for 1 hr, 1x wk.

[Anonymous]

Anonymous wrote:OP here. Nobody diagnosed my child with Aspergers. But a doctor did use the term to describe some of her HFA traits.

Anyway, I posted to ask about people's experiences accessing public school services for a child with many ASD type social impairments, not to get all of DCUM to weigh in on her diagnosis or lack thereof.

I do have another child with a formal diagnosis, so I know what that looks like. I also have a NT child, so I know what that looks like, too.

My youngest, frankly, is in between. She may not have enough impairments in different areas to I warrant an official diagnosis, but I as her parent -- and, most certainly her teachers -- can see that she has a range of ASD-type issues that pose a range of developmental challenges.

She may not warrant an official diagnosis.

But most competent professionals would also see that she has a range of social and gross motor delays that warrant extensive early intervention, and that these traits are similar to some of the issues her older HFA sister has.

But sorry if the term "borderline" troubles some. It doesn't trouble me.

It should trouble you bc "borderline" isn't going to get your DD services, supports and/or an IEP. Do NOT show these reports to your school, they will not be helpful at best and may keep your DD from getting an IEP.

Like PP suggested, ask the school for an evaluation for psychoed testing, OT, PT, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP- take her in for the ADOS.

OP here. I should clarify: she's been evaluated twice -- first by Children's, then by Dr. Shapiro. Childrens (Dr. Mintz, who's quite good) said she had ASD traits that fell short of a diagnosis. And Shapiro diagnosed her with borderline HFA/Aspergers. We are satisfied with his report, which was a thorough as they get.

Anyway, we are pursuing an IEP.

Interesting that Dr. Shapiro, who is worshiped by many on these boards for his autism expertise, says your child is borderline ASD.

So, either Dr. Shapiro isn't as good as everyone says, or there is indeed a borderline ASD.

[Anonymous]

Well, OP's child is only 3.5yr old and a girl. Harder to diagnose Asperger's in girls and someone that young.

Asperger's is hard to diagnose definitively without an ADOS and even then the diagnosis may change or she may not have a diagnosis when she is older.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP- take her in for the ADOS.

OP here. I should clarify: she's been evaluated twice -- first by Children's, then by Dr. Shapiro. Childrens (Dr. Mintz, who's quite good) said she had ASD traits that fell short of a diagnosis. And Shapiro diagnosed her with borderline HFA/Aspergers. We are satisfied with his report, which was a thorough as they get.

Anyway, we are pursuing an IEP.

Interesting that Dr. Shapiro, who is worshiped by many on these boards for his autism expertise, says your child is borderline ASD.

So, either Dr. Shapiro isn't as good as everyone says, or there is indeed a borderline ASD.

Of course there are people on the borderline. A diagnosis is formed by evaluating people against a standard. There will always be people who fall just on either side of a standard.