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

[Anonymous]

<<<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. >>>


Is the treatment the same? IE - how do you get a kid with merld to significantly improve his ability to communicate (ie practical language). Is it through ABA?

[Anonymous]

Anonymous wrote:

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.

You're not hearing what we're saying. We agree there are many symptoms common to disorders such as ASD, ADHD, MERLD, etc. But, it's frustrating and annoying when people opine that our kids don't actually have the disorders they've been diagnosed with and that we concur with. Yes, you can offer you're opinion but it's not welcome and is alienating.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

You're not hearing what we're saying. We agree there are many symptoms common to disorders such as ASD, ADHD, MERLD, etc. But, it's frustrating and annoying when people opine that our kids don't actually have the disorders they've been diagnosed with and that we concur with. Yes, you can offer you're opinion but it's not welcome and is alienating.

I would respectfully suggest that you're the one who is "alienating" by stating that those with suggestions or thoughts different from your own are "not welcome." No one has said that your children's diagnoses aren't accurate for them.

[Anonymous]

Anonymous wrote: <<<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. >>>


Is the treatment the same? IE - how do you get a kid with merld to significantly improve his ability to communicate (ie practical language). Is it through ABA?

Speech and Language therapy is the primary thing. An SLP will do focused exercises to help a child learn verbal reasoning and vocabulary. We work a lot with just explaining with my son at home -- he doesn't get vocabulary from context and he doesn't inference well. We make sure everything is explained. We rehearse social situations and learn scripts for dealing with them (This is very like learning social scripts for kids with HFA or ASD.) His SLP teaches the same things socially. For my son, his reading ability is much better than his listening ability, so if we need to explain something or talk about something (bullies, sex education) we give him a book and have him read it and then we talk about it.

[Anonymous]

My son has ADHD - its primarily a problem in the classroom. Friends/aquaintence constantly tell me he doesn't really have it, it's just because he sometimes eats pop tarts, oh and the best, parents just pay private evaluators to gets diagnosies. Any one who has observed him in the classroom totally gets it. So I agree thrown out diagnosies from other parents and friends are annoying.

[Anonymous]

Anonymous wrote:My son has ADHD - its primarily a problem in the classroom. Friends/aquaintence constantly tell me he doesn't really have it, it's just because he sometimes eats pop tarts, oh and the best, parents just pay private evaluators to gets diagnosies. Any one who has observed him in the classroom totally gets it. So I agree thrown out diagnosies from other parents and friends are annoying.

+1 except my DS has Asperger's/ASD. People have to see him in the classroom. It's frustrating especially b/c we aren't sure the therapies outside school (where he presents as NT) will translate into the classroom. We try to get in school therapies as much as possible.

[Anonymous]

You're not hearing what we're saying. We agree there are many symptoms common to disorders such as ASD, ADHD, MERLD, etc. But, it's frustrating and annoying when people opine that our kids don't actually have the disorders they've been diagnosed with and that we concur with. Yes, you can offer you're opinion but it's not welcome and is alienating.

I would respectfully suggest that you're the one who is "alienating" by stating that those with suggestions or thoughts different from your own are "not welcome." No one has said that your children's diagnoses aren't accurate for them.

What thread do you think you're posting to? The this one "Does anyone get defensive when it is suggested SOME kids with language disorders MAY have ADHD to" is spin off another this one http://www.dcurbanmom.com/jforum/posts/list/222006.page where people were saying MERLD really is ASD and parents were in denial.

[Anonymous]

Anonymous wrote:

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.

Any one of the educational assessments gets you ALL the help you need by FEDERAL law. Many school districts don't follow this (our district tried to tell us my son would only get speech with a language label), but we forced our IEPT to take a look and they came back, and said, you are right, we are wrong.

So my child gets an aide, pullouts, pull-ins, speech, OT and a modified curriculum with his language label.

[Anonymous]

Anonymous wrote: <<<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. >>>


Is the treatment the same? IE - how do you get a kid with merld to significantly improve his ability to communicate (ie practical language). Is it through ABA?

People who specialize in language disorders will tell you the treatment is NOT the same for MERLD and Autism. The underlying problems are not identical, the etiology is different. MERLD kids rarely need true ABA, because they are socially motivated. A MERLD child doesn't respond appropriately because he has no idea what you are saying. He gets frustrated, he shuts down. The receptive part slowly gets better over time, and targeting words, first nouns, then verbs, then stringing words together often work best. Speaking at the child's utterance length plus one word helps a child progress more quickly.

A PP makes the point that both MERLD kids and Autistic or Asperger's child improves with time. The difference is, once a MERLD child's language catches up, he'll be almost indistinguishable from a typical child -- his core issue is gone, he understands language and responds appropriately, not because he was taught or is "coping," but because he simply understands what's being said to him. (I say almost because school tends to remain difficult as the verbal load is so heavy and so quick.) The autistic child whose language comes in is still autistic and has the core social issues that are the defining hallmark of autism.

[Anonymous]

Anonymous wrote:
People who specialize in language disorders will tell you the treatment is NOT the same for MERLD and Autism. The underlying problems are not identical, the etiology is different. MERLD kids rarely need true ABA, because they are socially motivated. A MERLD child doesn't respond appropriately because he has no idea what you are saying. He gets frustrated, he shuts down. The receptive part slowly gets better over time, and targeting words, first nouns, then verbs, then stringing words together often work best. Speaking at the child's utterance length plus one word helps a child progress more quickly.

A PP makes the point that both MERLD kids and Autistic or Asperger's child improves with time. The difference is, once a MERLD child's language catches up, he'll be almost indistinguishable from a typical child -- his core issue is gone, he understands language and responds appropriately, not because he was taught or is "coping," but because he simply understands what's being said to him. (I say almost because school tends to remain difficult as the verbal load is so heavy and so quick.) The autistic child whose language comes in is still autistic and has the core social issues that are the defining hallmark of autism.

I'm the parent of an Asperger's/ASD child and want to clarify that you can STILL get an ASD diagnosis if the child is socially motivated. Mine did. It confuses parents somewhat if you use lack of "social motivation" and "social intent" as a defining feature of ASD. I know it confused me. The key three features of Asperger's is problems in social communication, repetitive behaviors and obsessive interests.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Any one of the educational assessments gets you ALL the help you need by FEDERAL law. Many school districts don't follow this (our district tried to tell us my son would only get speech with a language label), but we forced our IEPT to take a look and they came back, and said, you are right, we are wrong.

So my child gets an aide, pullouts, pull-ins, speech, OT and a modified curriculum with his language label.

Based on his level of support, it would seem he has severe language delays. I'm happy for you that you were able to get what he needed with only a speech/language eligibility.

[Anonymous]

Anonymous wrote:

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?

Repetitive behaviors and stimming?

[Anonymous]

Another parent of a child on the spectrum here. He is socially motivated and has friends. His mind works differently, but he is and has always been social.

ABA keeps coming up. Tried it and it wasn't for him, nor is it for a number of kids on the spectrum. I have been told he is often indistiguishable from peers now that social pragmatics have improved so it's not only MERLD kids who can be indistinguishable.

Yep my child is still autistic. He has incredible number ability and taught himself to read among other things. His memory is incredible. Maybe this is one of the things that distiguishes MERLD kids? It's not MERLD if they have hyperlexia, a unusually above average memory and or innate math skills? Perhaps this what you mean by "they will always be autisitic?"

[Anonymous]

Anonymous wrote:

Anonymous wrote: <<<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. >>>


Is the treatment the same? IE - how do you get a kid with merld to significantly improve his ability to communicate (ie practical language). Is it through ABA?

People who specialize in language disorders will tell you the treatment is NOT the same for MERLD and Autism. The underlying problems are not identical, the etiology is different. MERLD kids rarely need true ABA, because they are socially motivated. A MERLD child doesn't respond appropriately because he has no idea what you are saying. He gets frustrated, he shuts down. The receptive part slowly gets better over time, and targeting words, first nouns, then verbs, then stringing words together often work best. Speaking at the child's utterance length plus one word helps a child progress more quickly.

A PP makes the point that both MERLD kids and Autistic or Asperger's child improves with time. The difference is, once a MERLD child's language catches up, he'll be almost indistinguishable from a typical child -- his core issue is gone, he understands language and responds appropriately, not because he was taught or is "coping," but because he simply understands what's being said to him. (I say almost because school tends to remain difficult as the verbal load is so heavy and so quick.) The autistic child whose language comes in is still autistic and has the core social issues that are the defining hallmark of autism.

We have a top notch speech therapist and she focuses on symptoms. My child is on the spectrum, but the diagnostic code she uses is MERLD and our developmental pediatrician finds that perfectly appropriate because those are the symptoms she addresses.

Have there been MRI studies comparing and contrasting the brains of kids on the spectrum and those with MERLD that definitively show they 2 diagnosis are substantially different? This seems to be implied by some people's posts so if you have any links to scientific studies I would be very curious to read them.

[Anonymous]

I don't know about MERLD but ASD/asperger kids have to have all three issues: problems with social communication (problems reading social cues, etc), repetitive behavior, obsessive interests. If they have only one or two of the three they don't get an ASD diagnosis but something like social communication disorder, anxiety, OCD, etc. And are not considered on the spectrum.

The confusion about MERLD comes from the fact that it can share other comorbid issues like language delay, anxiety, that can also appear with ADHD and ASD.