Loaded question: MERLD and autism

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

FYI, I am
Not the OP


MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

FYI, I am
Not the OP


MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Do you not understand that evaluations are only good if you need to know what services/supports your child needs? It makes no sense to give a educational evaluation if your child does not need one. If this poster's child is doing well with the services and supports in place, why would you waste the money to get an unnecessary educational assessment. Your child may have educational issues, but not all kids with MERLD and Autism do. Many function just fine with supports and those parents know best how to help their kids.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:MERLD is only relevant for the preschool age at this point mainly b/c speech delays b/f school age often resolve: http://www.asha.org/public/speech/disorders/Preschool-Language-Disorders/

Past preschool age, children will be given a differential diagnosis according to the latest DSM V in which MERLD does not exist. This could include a language disorder, communication disorder (autism is one, but there are others), and/or ADHD.

MERLD is still relevant for kids after preschool age as it can and often continues into elementary school if not life long. Many kids learn to adapt and cope but the residual effects are still present. It really doesn't matter if it is called a language disorder or MERLD but MERLD is a specific type of language disorder identifying concerns with both expressive and receptive language. For most MERLD kids without other diagnosis, it is called a language disorder but it makes it difficult to say language disorder without identifying receptive and expressive language. A language disorder could mean anything from receptive, expressive, both, apraxia, stuttering and many more. Most parents find it easier to continue to call it MERLD regardless of the official diagnosis if their kids still struggle with receptive and expressive language.

Not all kids with language disorders have communication disorders (including autism) or ADHD/ADD or a learning disorder. Some do, but many do not.

PP, kids can continue to have expressive and receptive language delays into elementary and beyond. However, in the latest DSM V published in 2013, the characteristics of MERLD fall under different diagnoses.

I have two kids who were diagnosed with MERLD as preschoolers by developmental pediatricians. Both have had full educational after age 6 and have received differential diagnoses, neither of which were autism. So either people are living in ignorance that there age 6+ have MERLD or they don't want to do full educational testing b/c they are avoiding a diagnosis.

We have not done full testing. It is not recommended for our child right now. Our developmental ped did some basic testing (including IQ) and did not feel more was warranted. Its not a good idea to keep testing kids over and over again. Not all kids have academic or other issues. You do a full evaluation to understand what is going on, but for some kids, the parents and professionals have a good handle on it, so it is not the best idea in less new issues crop up later. You keep insisting how important it is, and it is important and a good idea for many but not all. OP child is not 6. If your kids have dual or multiple diagnosis and you need to better understand it, it makes sense. You may have had a misdiagnosis of MERLD, but some of our kids actually have MERLD (or what ever you want to call it).

Also, the diagnosis are always ever changing. That doesn't mean even if clinically it falls under different diagnosis, that its not an appropriate term for some of our kids. By us just saying language disorder, you have no clue what is going on. If I say more specific, then you'd understand better.

Yes, it's evident that you haven't had a full educational diagnosis. The diagnoses aren't ever changing. The DSM is updated every few years based on review of the clinical evidence. DSM 4 was published in 2000. DSM 5 published in 2013.

I didn't say that all kids with MERLD end up with academic or other issues--that's your interpretation probably b/c you had a child initially diagnosed with autism. What I said was that a preschooler diagnosed with MERLD
--issues could resolve or could include
--language disorder AND/OR
--communication disorder AND/OR
--ADHD

Could doesn't mean will. An itemized list with commas ending with and/or in a sentence means these are possibilities. There are others.

(So it's great if your young child shows no social or educational issues at the moment. It would probably behoove you have a full educational evaluation b/f he finally leaves the tiny private that he currently attends, especially if he's transitioning to public.)

My child is in public and thriving. My child is not young and is educationally on target and ahead in some areas. If the school has no concerns, why would I get an educational evaluation? You may not understand your child's needs without the support of an evaluation and its great you got your kid one but there would be no benefit for my child. You do an evaluation to find out areas of concern. Not all kids with language disorders, ADHD or ASD have academic issues. You are pushing your agenda and I'm assuming your child needed one early on and you choose not to and feel guilty.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

FYI, I am
Not the OP


MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

I'm assuming this was meant as an insult. Its sad, as a culture, more people are like you, than welcoming and accepting of differences. Who cares if a child is quirky or awkward. Instead of looking at it as a negative, look at it as something that makes them special.

ABA or behavioral therapy only makes sense if there are concerns for those needs. MERLD is language disorder that should be treated by an SLP not ABA. An ABA therapist is not trained specifically on how to work with language disorders.

It would be nice if you would consider your comments to the OP and not based on your agenda.

[Anonymous]

If you have a preschooler with MERLD, you would of course have a full educational evaluation b/c a child is at higher risk of language based LDs and or ADHD. If your kid "didn't need" a educational evaluation, then either their delays resolved and they are NT or they HFA and you just don't want an evaluation to determine that whether or not they need academic/social supports.

[Anonymous]

To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

[Anonymous]

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

I honestly don't get this. If MERLD is a language disorder then why would you need behavioral interventions like ABA which are supposed to help remedy social weaknesses? At some point if you say the child has MERLD and social communication deficits and ADHD it's seems really hard to distinguish from and ASD. I fully understand feeling like teachers and administrators are making inappropriate or uninformed judgments about your child, and also the desire to have an accurate diagnosis. BTDT. But I can't understand why if your child looks to be having autism like symptoms you would not get them fully evaluated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

No, I am not the OP, and no, I am not scared of an autism diagnosis. My 11 year old son has severe ADHD, which given his family and birth history is not surprising, and he *may* additionally be barely on the cusp of Asperger's. I pursued the ADHD label in order to get school services and medication for him. A formal label for Asperger's will not get him the services he needs, so having spent 3.2K on a full neuropsych already, plus daily meds (2K annually), I don't think I need to spend one more cent on an evaluation for Asperger's right now. The psychologist told me the test might come back inconclusive, since he wasn't a clear-cut case.

And, PP, you're quite rude and ignorant.

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

I honestly don't get this. If MERLD is a language disorder then why would you need behavioral interventions like ABA which are supposed to help remedy social weaknesses? At some point if you say the child has MERLD and social communication deficits and ADHD it's seems really hard to distinguish from and ASD. I fully understand feeling like teachers and administrators are making inappropriate or uninformed judgments about your child, and also the desire to have an accurate diagnosis. BTDT. But I can't understand why if your child looks to be having autism like symptoms you would not get them fully evaluated.

A preschooler who has expressive and/or receptive delays, may also have behavioral issues. For example, a child who has expressive delays, may act inappropriately with classmates like hitting, kicking, or biting b/c they can't express themselves. A child with receptive delays may have difficulty following instruction during group activities or transitioning from one activity to another. Behavioral and/or ABA focus on behavior to help kids substitute/learn appropriate behaviors, follow sequences. I'm not sure why you think it's about social weaknesses.

A kid could have ADHD, MERLD, ASD--it really doesn't matter if these diagnoses are affecting their behavior at home or school as they can all create communication issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

No, I am not the OP, and no, I am not scared of an autism diagnosis. My 11 year old son has severe ADHD, which given his family and birth history is not surprising, and he *may* additionally be barely on the cusp of Asperger's. I pursued the ADHD label in order to get school services and medication for him. A formal label for Asperger's will not get him the services he needs, so having spent 3.2K on a full neuropsych already, plus daily meds (2K annually), I don't think I need to spend one more cent on an evaluation for Asperger's right now. The psychologist told me the test might come back inconclusive, since he wasn't a clear-cut case.

And, PP, you're quite rude and ignorant.

PP, you are responding to two different PPs BTW and neither of us said you were scared of a diagnosis. And you must also be aware that there hasn't been an "Asperger" diagnosis since 2013.

You also know next to zip about a MERLD diagnosis. It's not a "catch all" or primarily based on observations and never was even when it was in the DSM. Receptive and expressive delays can be measured in a host of standardized tests. Currently according to ASHA and the DSM, it's not applied today (accurately) to anyone above preschool age.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

No, I am not the OP, and no, I am not scared of an autism diagnosis. My 11 year old son has severe ADHD, which given his family and birth history is not surprising, and he *may* additionally be barely on the cusp of Asperger's. I pursued the ADHD label in order to get school services and medication for him. A formal label for Asperger's will not get him the services he needs, so having spent 3.2K on a full neuropsych already, plus daily meds (2K annually), I don't think I need to spend one more cent on an evaluation for Asperger's right now. The psychologist told me the test might come back inconclusive, since he wasn't a clear-cut case.

And, PP, you're quite rude and ignorant.

NP. Just FYI, a child with delays in expressive and receptive language would never receive an Asperger's diagnosis under the DSM-4 no matter how much "barely on the cusp" Aspie tendencies he has.

[Anonymous]

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

I was told to stay away from it for my MERLD child by the professionals who saw him.

Now, we DID have a Functional Behavior Assessment done and put in some school supports that modified his behavior there. But full-on ABA is wicked expensive, very time consuming (12 to 15 to 25 hours a week) and doesn't increase receptive language. And the expressive language it produces is often very scripted -- I've witnessed that firsthand with kids who have had intensive ABA.

Really, most MERLD kids don't need ABA. A good behavior support plan, a speech therapist and parents who understand modeling and recasting goes a long way. We saved that ABA money and went on fabulous vacations that truly sparked his conversational language.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Not so. There are many genes with identified links to autism. Many of them are linked to MERLD. My son's 1 deletion related to autism is also related to language disorders like MERLD. In fact, of the children with autism who had it every single one had multiple deletions unlike my child. Many experts have told us MERLD and a few have said autism. I don't care. Autism has gotten us great services and it is well known kids with autism have receptive and expressive delays often. It is also supposed to be standard protocol (as per Wright's law) to make sure kids with HFA get speech and language services. As long as your child gets the speech and language services and other needed interventions I would not get hung up on HFA vs. MERLD since both involve the same delays.

I am not expecting an onslaught of angry MERLD parents. This is my 2 cents and many will probably disagree.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Not so. There are many genes with identified links to autism. Many of them are linked to MERLD. My son's 1 deletion related to autism is also related to language disorders like MERLD. In fact, of the children with autism who had it every single one had multiple deletions unlike my child. Many experts have told us MERLD and a few have said autism. I don't care. Autism has gotten us great services and it is well known kids with autism have receptive and expressive delays often. It is also supposed to be standard protocol (as per Wright's law) to make sure kids with HFA get speech and language services. As long as your child gets the speech and language services and other needed interventions I would not get hung up on HFA vs. MERLD since both involve the same delays.

I am not expecting an onslaught of angry MERLD parents. This is my 2 cents and many will probably disagree.

Your posts have nothing to do with the OP questions and comments. You keep derailing them to push your neuropsych and Autism agenda. Ok, we get it that you struggle with your kid having Autism and its more comfortable for you for all kids with SN to have it. For as much as you'd like the support, how about giving it.

You do realize some of us have had genetic testing and autism screens on our kids and nothing was found. This, again has nothing to do with MERLD. Its a good idea to get genetic testing of all the tests done if there is a concern but on the flip side, if something is found that is not curable, then is it such a good idea to do testing as it may prevent your child from getting health insurance in the future?

You are hung up on Autism vs. MERLD. OP is asking specifically about MERLD and saying her kid was ruled out for Autism. You keep insisting it could be a form of autism and to get a neuropsych. Even if those of us who haven't done them, did them with your provider, if it is not the same result as your child, you'd insist we get a second opinion to get the right diagnosis.

[Anonymous]

Anonymous wrote:

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

I was told to stay away from it for my MERLD child by the professionals who saw him.

Now, we DID have a Functional Behavior Assessment done and put in some school supports that modified his behavior there. But full-on ABA is wicked expensive, very time consuming (12 to 15 to 25 hours a week) and doesn't increase receptive language. And the expressive language it produces is often very scripted -- I've witnessed that firsthand with kids who have had intensive ABA.

Really, most MERLD kids don't need ABA. A good behavior support plan, a speech therapist and parents who understand modeling and recasting goes a long way. We saved that ABA money and went on fabulous vacations that truly sparked his conversational language.

We tried ABA too. The provider was sweet and my child liked seeing her. However after 6 months we saw no benefit and her work was very simplistic vs. the speech therapy. The speech therapist really catered their work to my child's specific needs vs. the ABA would spend weeks working on one word. ABA is good for behavioral issues and other task oriented needs, but it is not good for language as they are very different needs. You cannot force receptive or expressive language to come. You can give a child the tools they need and when they are ready they will use those tools and talk. There are many things we knew our child grasped the concept of but someone else may not know. It didn't come out till the language came to see the success of it.

Vacations and travel also help with language here as well. That and colds. For us, the money is better spent saving for college.