Can a child have ASD and be "very social"?

[Anonymous]

My son is 16 months old- doesn't walk (but close), no words, doesn't really point, obsessed with doors, light switches, DVD buttons, etc., BUT, he waves and plays peek-a-boo with everyone and has a huge smile for everyone he sees, is very engaging, great eye contact, gives hugs both on his own initiative or upon request. My ped says he can't have an ASD because he is "very social" but there seem to be so many other signs. FWIW, I think my DH could have some type of high functioning autism ...

[Anonymous]

A kid can be a true extrovert and also have an ASD. What you would most likely see is the social intent - trying to engage - but problems in the execution - indiscriminate hugs, not differentiating between different people. For kids on the higher functioning end of the spectrum this is what makes diagnosis difficult - it isn't until social interactions become more nuanced that the deficits become more obvious.

[Anonymous]

Anonymous wrote:A kid can be a true extrovert and also have an ASD. What you would most likely see is the social intent - trying to engage - but problems in the execution - indiscriminate hugs, not differentiating between different people. For kids on the higher functioning end of the spectrum this is what makes diagnosis difficult - it isn't until social interactions become more nuanced that the deficits become more obvious.

Thanks. That's kinda what I was thinking. So if we do end up with an ASD diagnosis, it probably won't be until on the late side. Which is fine, but I keep reading about how important early intervention is. We are going to seek help for the language delay if things don't change soon, he is close to walking and we are waiting to see if the language takes off once he masters walking, but other than that, I guess we just take a wait and see approach.

[Anonymous]

Early intervention is extremely important. Find a speech therapist who uses floortime (many in the area do) and who can work on abstract language as well as expressive. Honestly, if he's nonverbal at 16 months I don't know what you are waiting for.

My DS was also obsessed with light switches and doors and has an ASD. Our pediatrician also told us everything was fine. The general pediatricians don't really get it. I think you should see a developmental pediatrician, even as early as this.

[Anonymous]

Anonymous wrote:Early intervention is extremely important. Find a speech therapist who uses floortime (many in the area do) and who can work on abstract language as well as expressive. Honestly, if he's nonverbal at 16 months I don't know what you are waiting for.
My DS was also obsessed with light switches and doors and has an ASD. Our pediatrician also told us everything was fine. The general pediatricians don't really get it. I think you should see a developmental pediatrician, even as early as this.

I know, you're right. His babbling seems to be increasing in range a lot lately though and it sometimes seems like he is using mama and dada appropriately and he is really focused on walking. But I guess it can't hurt to be more proactive.

[Anonymous]

Both my boys were obsessed with doors, light switches, buttons, wheels, you name it. Neither is on the spectrum. Neither had more than a couple of words at 16 months. (Both were walking).

[Anonymous]

My son (6) has an educational diagnosis of autism from an evaluation by the school system. He was evaluated when he was 2 1/2, when he showed a lot of delay in speech, repetitive behaviors, rigidity, etc. He has always been very social though, but in an awkward and often inappropriate way. He loves people and gravitates to other kids, but often gets overly excited and blurts out things without thinking. It's quite likely that he has Asperger's syndrome, as he is very smart and has social interest, but severe difficulty with execution. So, yes - it's possible for kids to be very social and still be on the spectrum.

[Anonymous]

Except for the pointing this could be my DS. ASD is not the only developmental delay this could be; our diagnosis is global dev delays. You should see a dev ped.

[Anonymous]

I wonder about this too. My DD is highly social and interactive, yet has traits of an ASD as well. No dx yet.

[Anonymous]

Anonymous wrote:A kid can be a true extrovert and also have an ASD. What you would most likely see is the social intent - trying to engage - but problems in the execution - indiscriminate hugs, not differentiating between different people. For kids on the higher functioning end of the spectrum this is what makes diagnosis difficult - it isn't until social interactions become more nuanced that the deficits become more obvious.

I remember reading in a book on Asperger's Syndrome that AS comes in a few diagnostically recognized forms and one is kids with "social intent" but poor execution. However, most people (teachers and regular doctors) are more familiar with the social avoidant type--which is the common stereotype of Asperger's Syndrome. After reading this book, I had a better sense of my son and he definitely fits the social intent type. I have found that teachers and doctors are most confused by my son's behavior because they see that he stims, has trouble with transitions, rigid (rule bound) and has intense special interests, but he is social (loves talking to adults that he knows) and will play with a preferred "friend" at preschool. They dismiss his social awkwardness, rudeness (yes, my son is rude and he is only 4) and lack of interest in other kids as normal preschooler behavior (I also believe that they generally think of him as "quirky"). However, I see him at home and in the community (e.g. on the playground) and he doesn't know how to engage/play with kids in general. His psychologist tried to explain to his teacher that he plays with one or two kids because he wants to be social and they are familiar and part of his routine.

[Anonymous]

Anonymous wrote:Except for the pointing this could be my DS. ASD is not the only developmental delay this could be; our diagnosis is global dev delays. You should see a dev ped.

I agree. My youngest didn't have fixations but had no words at 16 months and didn't walk until 18 months. He's now 5 and ASD has been ruled out by several specialists (including NIH and a dev ped). He has apraxia of speech (the apraxia also impacts his large muscle motor planning/coordination), developmental delays, executive functioning deficits (which will likely lead to an ADHd diagnosis at some point - not hyperactive). I'm not saying it's not ASD but there are a lot of other developmental things it could be. That's why a global evaluation is so important. Good luck.

[Anonymous]

http://www.dsm5.org/Pages/Default.aspx

Hunt around on that site for a while. The "spectrum" is being narrowed.

Autism is being WAY overdiagnosed right now, and these new guidelines are an attempt to correct that.

I have a kid who was much like yours and who has been to many respected docs/therapists. Anyone worth their salt will tell you that the core of autism is a lack of desire to communicate. When that desire is present, it is likely you are not looking at a child with autism, but rather a child with a different issue. At young ages, language disorders, adhd, and various other issues can present with autism-like symptoms. The key there is that the symptoms are not a reflection of a lack of desire to communicate, but of the other, real issue that the kid is dealing with.

Take the lack of pointing for example. This symptom had me worried for months. Neither of my kids pointed on time, or anywhere near on time. It wasn't until I sat down with a dev ped and had the pointing issue explained to me that I was able to relax about it. A total lack of pointing is not a red flag for autism. If a child consistently points to request but NEVER points to show you something, that is the autism red flag. If a child doesn't point at all, that could be a flag for tons of different stuff -- motor planning problems, attention problems, cultural exposure, etc.

I hope that helps a little. I am not a doctor and I really have no idea whether your child is on the autism spectrum or not, but it is my understanding and my belief that if the child has a desire to be social, it is likely that the issues are stemming from something else.

[Anonymous]

Anonymous wrote:http://www.dsm5.org/Pages/Default.aspx

Hunt around on that site for a while. The "spectrum" is being narrowed.

Autism is being WAY overdiagnosed right now, and these new guidelines are an attempt to correct that.

I have a kid who was much like yours and who has been to many respected docs/therapists. Anyone worth their salt will tell you that the core of autism is a lack of desire to communicate. When that desire is present, it is likely you are not looking at a child with autism, but rather a child with a different issue. At young ages, language disorders, adhd, and various other issues can present with autism-like symptoms. The key there is that the symptoms are not a reflection of a lack of desire to communicate, but of the other, real issue that the kid is dealing with.

Take the lack of pointing for example. This symptom had me worried for months. Neither of my kids pointed on time, or anywhere near on time. It wasn't until I sat down with a dev ped and had the pointing issue explained to me that I was able to relax about it. A total lack of pointing is not a red flag for autism. If a child consistently points to request but NEVER points to show you something, that is the autism red flag. If a child doesn't point at all, that could be a flag for tons of different stuff -- motor planning problems, attention problems, cultural exposure, etc.

I hope that helps a little. I am not a doctor and I really have no idea whether your child is on the autism spectrum or not, but it is my understanding and my belief that if the child has a desire to be social, it is likely that the issues are stemming from something else.

I'm sorry, but I have to strongly disagree with much of what you have written. It simply isn;t true that if a child has a desire to communicate they don't have an ASD. Many kids with HFA or AS desire communication but are impaired in their ability. The kid with Aspergers who is rattling on and on about his special interest? He wants to communicate. I've seen plenty of kids with ASDs approach other kids and adults and communicate. However, they don't necessarily communicate in ways that other kids do. My DS, who has AS, will walk down the hall at his school and greet other kids. But he is very much on the spectrum.

A total lack of pointing is very much a red flag for autism. Yeah, it could be a sign of all sorts of things but one of those things is autism. My DS never pointed when he was young. never.

And they are not "narrowing" the definition of autism, if anything they are expanding it by bringing other disorders -- PDD-NOS, Aspergers -- under the general autism diagnosis.

Honestly, it sounds like you have latched on to this idea that a desire to communicate rules out an ASD and you are hanging on to it for dear life. I am not saying your DS has an ASD, I have no idea. But if thats your only out, it simply isn't true.

[Anonymous]

Also, if you read the proposed definition you cite, the example of lack of initiation or interest in socializing is referred to as the outer limit of the definition. All deficits in communication, not just lack if interest of initiation, are included.

[Anonymous]

21:41 here again.

This article was written by Dr. Allen Francis, one of the doctors who wrote the DSM-IV (the criteria by which autism is diagnosed). The quotes below are from this article. There is nothing "mild" about autism, including aspergers. The DSM (both IV and V) are very clear that symptoms must be SEVERE.

As for autism encompassing more kids with the new DSM-V, the addition of several language-based disorders is a recent change that should mitigate much of that.

http://www.project-syndicate.org/commentary/frances1/English

"The most likely cause of the autism epidemic is that autism has become fashionable – a popular fad diagnosis. Once rare and unmistakable, the term is now used loosely to describe people who do not really satisfy the narrow criteria intended for it by DSM IV. Autism now casts a wide net, catching much milder problems that previously went undiagnosed altogether or were given other labels. Autism is no longer seen as an extremely disabling condition, and many creative and normally eccentric people have discovered their inner autistic self.

This dramatic swing from under- to overdiagnosis has been fueled by widespread publicity, Internet support and advocacy groups, and the fact that expensive school services are provided only for those who have received the diagnosis. The Korean study, for example, was financed by an autism advocacy group, which could barely contain its enthusiasm at the high rates that were reported."