Are AS kids' social deficits exemplified at home? Confused about the DSM criteria.

[Anonymous]

DS shows AS symptoms according to a Child Find psychologist. My question is whether AS kids's social deficits are exemplified at home. 3.9 year old DS interacts well with family members. He has good eye contact, affection, reciprocal conversation, initiation of games, pretending play all the time. He can recognize facial expressions easily. He wants to be hugged and kissed; also hugs and kisses others. However, he does not play much with other children outside our home. Although he seems interested in interacting with them, as exemplified by hanging around them and chasng them some times, he also says he's afraid of other kids and has no friends. He changes from an active bubbly three years old to a very shy child in his preschool. He does not sing at all in his preschool's music class but sings in his own bedroom.

He walks tiptoeing quite often. He loves fans, windshield wipers, but also likes trees, houses, dogs etc. just not as much as the mechanical stuff, esp those that move, turn and spin. He has no sensitivity to lights, sounds. On the contrary, he enjoys going to noisy and crowded places such as shops, parks, large restaurants. He does not like to stay home.

If you have an AS child, are the social awkwardness shown both inside and outside home, or only outside home? When I read the DSM's criteria on AS or Autism, I don't know how to answer them because DS behaves completely different in and outside his home.

[Anonymous]

Anonymous wrote:DS shows AS symptoms according to a Child Find psychologist. My question is whether AS kids's social deficits are exemplified at home. 3.9 year old DS interacts well with family members. He has good eye contact, affection, reciprocal conversation, initiation of games, pretending play all the time. He can recognize facial expressions easily. He wants to be hugged and kissed; also hugs and kisses others. However, he does not play much with other children outside our home. Although he seems interested in interacting with them, as exemplified by hanging around them and chasng them some times, he also says he's afraid of other kids and has no friends. He changes from an active bubbly three years old to a very shy child in his preschool. He does not sing at all in his preschool's music class but sings in his own bedroom.

He walks tiptoeing quite often. He loves fans, windshield wipers, but also likes trees, houses, dogs etc. just not as much as the mechanical stuff, esp those that move, turn and spin. He has no sensitivity to lights, sounds. On the contrary, he enjoys going to noisy and crowded places such as shops, parks, large restaurants. He does not like to stay home.

If you have an AS child, are the social awkwardness shown both inside and outside home, or only outside home? When I read the DSM's criteria on AS or Autism, I don't know how to answer them because DS behaves completely different in and outside his home.

Many of these characteristics are very similar to our DS (now 4.5). At 3.9, DS' preschool teachers raised similar concerns. However, evaluations from a developmental pediatrician and Early Stages in DC did not show any AS characteristics. Nevertheless, he has an IEP for social/developmental delays and goes to social skills groups once a week. DS again was two different children with family and away from home, very shy and quiet. He didn't show any sensitivities nor any particular affection for things that spun or moved, is/was an excellent traveler with no consideration for routine. Even now, he is a bit tentative around other children in his preschool but will join in and play. He seems to join in when the games involve running around or pretending to be pirates/superheros/cops and robbers while pretend play at home is considerably more involved. Apparently AS kids can deal with social norms more easily in familiar environments (home/close family) but are less able to cope when more is expected socially. Are Child Find psychologists allowed to make clinical diagnoses? Perhaps you should get an appointment with a developmental pediatrician (KKI or Children's or Dr. Dan Shapiro). They can be an invaluable resource for coordinating and suggesting therapies going forward, if any are needed.

[Anonymous]

You describe my AS kid who is 5 and in K. I did not realize he had anything unusual until he started school, preK, and his teacher suggested he be evaluated. I observed him at school and barely recognized him: Like two different kids.

my child was diagnosed with AS when he was 4. He is doing much better at school with an IEP, completely mainstreamed at a language immersion school. I posted about him in the "Growing out of Asperger's" thread.

If you haben't already, please get in touch with Dr Dan Shapiro, who is my son's developmental pediatrician. He was so helpful when my son first got diagnosed. he only takes new patients up to 4 yrs old. Really worth getting if you can.

[Anonymous]

23:55 again. Wanted to add that the most useful "therapy" for DS to help him engage with same age peers/classmates are all school based with an IEP. We tried home based play therapy where tha adult therapist came to our house, useless although DS had a great time playing with her. Private OT. These Did not help his relationship with peers one iota.

Social skills group at school, facilitated social interactions and play with peers by teachers, school provided OT, PT, etc is what has been most useful for us. Plus a caring, nurturing inclusive school with small class size, 17:3.

[Anonymous]

Kids with AS will do better at home both because they are used to and cOmfortable with you, and they've learned your forms of social communication. Also you may be compensating for his differences unconsciously, communicatin in ways you know are effective without realizing it. School is much harder.

[Anonymous]

Anonymous wrote:23:55 again. Wanted to add that the most useful "therapy" for DS to help him engage with same age peers/classmates are all school based with an IEP. We tried home based play therapy where tha adult therapist came to our house, useless although DS had a great time playing with her. Private OT. These Did not help his relationship with peers one iota.

Social skills group at school, facilitated social interactions and play with peers by teachers, school provided OT, PT, etc is what has been most useful for us. Plus a caring, nurturing inclusive school with small class size, 17:3.

Thank you for the advice. Was the class he entered before he was mainstreamed an inclusive class (including neurotypical children) or a class with only SN kids? Was he in an autism class or non-category class when he was first diagnosed?

[Anonymous]

Anonymous wrote:DS shows AS symptoms according to a Child Find psychologist. My question is whether AS kids's social deficits are exemplified at home. 3.9 year old DS interacts well with family members. He has good eye contact, affection, reciprocal conversation, initiation of games, pretending play all the time. He can recognize facial expressions easily. He wants to be hugged and kissed; also hugs and kisses others. However, he does not play much with other children outside our home. Although he seems interested in interacting with them, as exemplified by hanging around them and chasng them some times, he also says he's afraid of other kids and has no friends. He changes from an active bubbly three years old to a very shy child in his preschool. He does not sing at all in his preschool's music class but sings in his own bedroom.

He walks tiptoeing quite often. He loves fans, windshield wipers, but also likes trees, houses, dogs etc. just not as much as the mechanical stuff, esp those that move, turn and spin. He has no sensitivity to lights, sounds. On the contrary, he enjoys going to noisy and crowded places such as shops, parks, large restaurants. He does not like to stay home.

If you have an AS child, are the social awkwardness shown both inside and outside home, or only outside home? When I read the DSM's criteria on AS or Autism, I don't know how to answer them because DS behaves completely different in and outside his home.

A lot of kids don't have friends at 3.9. And being shy isn't AS. Your child could have some anxiety.

Get yourself a good outside evaluation with someone who is looking at every possibilty, not just doing a checklist for ASD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:23:55 again. Wanted to add that the most useful "therapy" for DS to help him engage with same age peers/classmates are all school based with an IEP. We tried home based play therapy where tha adult therapist came to our house, useless although DS had a great time playing with her. Private OT. These Did not help his relationship with peers one iota.

Social skills group at school, facilitated social interactions and play with peers by teachers, school provided OT, PT, etc is what has been most useful for us. Plus a caring, nurturing inclusive school with small class size, 17:3.

Thank you for the advice. Was the class he entered before he was mainstreamed an inclusive class (including neurotypical children) or a class with only SN kids? Was he in an autism class or non-category class when he was first diagnosed?

My son started school when he was 4 in a NT class. He was never in an autism or non-cat class b/c I had no clue there were any issues. This was his first exposure to a group setting with same age peers. DS really has to be seen in a classroom setting for his issues to be apparent. He engages very well with adults even strangers he has just met: Downright charming. He is not shy at all and has no signs of anxiety. This is probably the main reason that adult led therapy has been useless. DS PREFERS adults and given a choice will always "hang" with the grownups.

[Anonymous]

Anonymous wrote:
Get yourself a good outside evaluation with someone who is looking at every possibilty, not just doing a checklist for ASD.

This.

OP, get your DS evaluated, preferably by a developmental pediatrician. A thorough evaluation involves an ADOS (the gold standard test), a classroom evaluation, OT/PT evaluation among other things. And sometimes, even with these, no clear diagnosis may be forthcoming (like for our DS). A competent evaluator will provide you with a detailed report and recommendations, which may be useful for planning.

Our DS' pediatrician did mention that he has come across many first born boys who have similar temperaments, which oftentimes clear up. Even if they don't, an evaluation won't hurt. You could also look into the NIH, which runs large, longitudinal studies. As part of the screening, they administer comprehensive tests and provide a detailed report. And to top it, the evaluation is free. GL

[Anonymous]

Anonymous wrote:
DS really has to be seen in a classroom setting for his issues to be apparent. He engages very well with adults even strangers he has just met: Downright charming. He is not shy at all and has no signs of anxiety. This is probably the main reason that adult led therapy has been useless. DS PREFERS adults and given a choice will always "hang" with the grownups.

Sorry to thread-jack but 9:26, how did your DS do at the ADOS? Our DS is very similar (but with no repetitive behaviors or restricted interests) in that he prefers adults or younger kids than his classroom peers. At the ADOS, he just decided that the evaluators were his "friends" and he just played with them like he does with us at home. Hence the evaluation did not find him on the spectrum. His current social skills class is also largely useless for the largely the same reason.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
DS really has to be seen in a classroom setting for his issues to be apparent. He engages very well with adults even strangers he has just met: Downright charming. He is not shy at all and has no signs of anxiety. This is probably the main reason that adult led therapy has been useless. DS PREFERS adults and given a choice will always "hang" with the grownups.

Sorry to thread-jack but 9:26, how did your DS do at the ADOS? Our DS is very similar (but with no repetitive behaviors or restricted interests) in that he prefers adults or younger kids than his classroom peers. At the ADOS, he just decided that the evaluators were his "friends" and he just played with them like he does with us at home. Hence the evaluation did not find him on the spectrum. His current social skills class is also largely useless for the largely the same reason.

This is exactly what happened with DS on the ADOS. His social communication was found to be "normal" - low end of normal but still normal. However, unlike your DS he has repetitive behaviors: some stims that come and go, finger posturing, running in circles, jumping up and down when excited, etc. which he did not demonstrate on the ADOS but I noted them in the parent interview, ADI-R. His stims come and go and are subtle or can seem "normal" enough for his age that they're not an issue. For instance, his teachers don't seem to notice and I ask frequently. Like OP's kid, he is not bothered by noise, crowds even though a "sensory seeker" according to his former private OT. Other than being a picky eater, DS does not have "sensory issues."

The big issue with DS was the obsessive/restricted interests: Fans, switches, lighting, etc. His current obsessions are Star Wars and Angry Birds so it's improved but his scores on the repetitive behaviors and restricted interests are what qualifies him for an ASD dx.

Also, DS has other characteristics like fine/gross motor issues, is very literal, focus on details rather than the big picture, amazing memory, etc. On the other hand, he has no problems with transitions, is very sweet and easygoing/does not throw tantrums, excellent traveler, etc. I have no problems or concerns about his AS diagnosis and think it is correct.

[Anonymous]

Maybe the op's son is just an introvert. Only likes to play with those he knows. Also adults are safer to children because they are less likely to move/hit suddenly and generally are more forgiving and understanding. I preferred adults as a child. I don't have Autism.

[Anonymous]

^There's a difference between a child who prefers to play with adults b/c they like adults better than other kids and kids who have Asperger's who are drawn to adults by default b/c they don't know how to interact with other children.

10:14 again. DS is MUCH better with playing and engaging with his peers with supports/services at school. Very happy to go to school, likes school, has friends. Getting help for these kids is a must.

[Anonymous]

Anonymous wrote:You describe my AS kid who is 5 and in K. I did not realize he had anything unusual until he started school, preK, and his teacher suggested he be evaluated. I observed him at school and barely recognized him: Like two different kids.

my child was diagnosed with AS when he was 4. He is doing much better at school with an IEP, completely mainstreamed at a language immersion school. I posted about him in the "Growing out of Asperger's" thread.

If you haven't already, please get in touch with Dr Dan Shapiro, who is my son's developmental pediatrician. He was so helpful when my son first got diagnosed. he only takes new patients up to 4 yrs old. Really worth getting if you can.

OP, you've received much good information here.
We too, like pp above, did not realized anything was out of the ordinary until he started K. At home, he is interactive, affectionate, etc., but at school, birthday parties, camp--basically everywhere else--he is different and stands out. This only worsened as 1st grade and then 2nd grade came around, and playing at the trains/lego table is no longer the great social skills equalizer.

It became clear that despite numerous therapies and play groups, he was not going to grow out of this and his school was not equipped to mainstream him or do pullouts...so we've moved along to a private SN prgm.


DS PREFERS adults and given a choice will always "hang" with the grownups.

This line from a pp also stood out to me. This week, while DS is on break, he begs me each morning to forgo camp and instead let him come to my office--in cubicle land--where he can stop in and see my adult co-workers and talk at them about his narrow range of preferred topics.

[Anonymous]

^ LOL! That's hilarious.

This morning we had to go by reception to get a late pass and DS insisted on going to visit the Vice Principal and socializing with her: He considers her a friend/playmate which is nice but kind of weird. Had a hard time getting him out of there and to his K class.