best place for second opinion on ASD diagnosis?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

Therapies are "informed by diagnosis" but not determined by it. My ASD kid goes to a lot therapies. Each therapist makes an independent evaluation of specific deficits, which sometimes are unrelated to her core ASD diagnosis. Then they make a treatment plan based on that evaluation, not just the diagnosis we showed up with.

So it's most important right now to know what the actual deficits are rather than pin down the diagnosis.

Well, OP clearly thinks a misdiagnosis is driving inappropriate therapies here. A professional has told her that her child needs ABA, which is tested on kids with ASD, and is generally specifically intended for that. It's costing her money, and she perceives it as "torturing" her child. OP is exactly right to seek a second opinion here, to know what kind of therapy she needs to focus on.

The question of whether ABA is appropriate for the child is separate from the question of whether her child is ASD. Many people believe that the kind of ABA OP is describing is inappropriate for any child. OP can simply stop the ABA.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

I’m not sure it does. Therapies are determined by the child’s needS. I have a kid with ASD and he is socially motivated and cuddly (or was—he’s a teen now). Deficits in pragmatics aren’t the same thing as not being social or wanting to connect. I find that people unfamiliar with ASD often expect ASD kids to be asocial and cold, but that isn’t what I see in my son or his friends, and I think OP’s description of her dad reflects an inaccurate perception of ASD.

And yes, ASD looks nothing like what I thought before we had our kid.

Oh her *dd*. I didn’t read it that she was saying her dad had the same level of social skills as the twin, only that she shows social motivation and makes some eye contact. Neither of these are inconsistent with ASD.

Fixed quotes:

Same with my kid. Very social and affectionate but poor pragmatic skills. Like OP, my kid was also a preemie. A followup assessment at 18 months found advanced cognitive and behavioral skills. Poor social pragmatic skills weren't apparent until about age 4.5.

And yes, ASD looks nothing like what I thought before we had our kid.

I'm sure you subjectively perceive your child as social and affectionate, but *differences* in social skills is a core aspect of ASD. That isn't to say that kids with ASD are feelingless automatons. They just have visible differences in how they interact socially. If OP is not seeing those differences, that's very important.

Yes, there are differences in social skills. But the issue of not being "social and affectionate" is just a false stereotype and a red herring that you are perpetrating. Stop it.

[Anonymous]

yes- ASD can be misdiagnosed. OP- I would try to get a second opinion so that you can have more clarity on how to approach your dd’s needs. It sounds like she is doing great though and that’s really positive!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

I’m not sure it does. Therapies are determined by the child’s needS. I have a kid with ASD and he is socially motivated and cuddly (or was—he’s a teen now). Deficits in pragmatics aren’t the same thing as not being social or wanting to connect. I find that people unfamiliar with ASD often expect ASD kids to be asocial and cold, but that isn’t what I see in my son or his friends, and I think OP’s description of her dad reflects an inaccurate perception of ASD.

And yes, ASD looks nothing like what I thought before we had our kid.

Oh her *dd*. I didn’t read it that she was saying her dad had the same level of social skills as the twin, only that she shows social motivation and makes some eye contact. Neither of these are inconsistent with ASD.

Fixed quotes:

Same with my kid. Very social and affectionate but poor pragmatic skills. Like OP, my kid was also a preemie. A followup assessment at 18 months found advanced cognitive and behavioral skills. Poor social pragmatic skills weren't apparent until about age 4.5.

And yes, ASD looks nothing like what I thought before we had our kid.

I'm sure you subjectively perceive your child as social and affectionate, but *differences* in social skills is a core aspect of ASD. That isn't to say that kids with ASD are feelingless automatons. They just have visible differences in how they interact socially. If OP is not seeing those differences, that's very important.

Yes, there are differences in social skills. But the issue of not being "social and affectionate" is just a false stereotype and a red herring that you are perpetrating. Stop it.

Kids with ASD just don't socialize and respond to others the same way NT kids do. This is a basic fact. It's not false - it's the defining feature of autism!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

I’m not sure it does. Therapies are determined by the child’s needS. I have a kid with ASD and he is socially motivated and cuddly (or was—he’s a teen now). Deficits in pragmatics aren’t the same thing as not being social or wanting to connect. I find that people unfamiliar with ASD often expect ASD kids to be asocial and cold, but that isn’t what I see in my son or his friends, and I think OP’s description of her dad reflects an inaccurate perception of ASD.

And yes, ASD looks nothing like what I thought before we had our kid.

Oh her *dd*. I didn’t read it that she was saying her dad had the same level of social skills as the twin, only that she shows social motivation and makes some eye contact. Neither of these are inconsistent with ASD.

Fixed quotes:

Same with my kid. Very social and affectionate but poor pragmatic skills. Like OP, my kid was also a preemie. A followup assessment at 18 months found advanced cognitive and behavioral skills. Poor social pragmatic skills weren't apparent until about age 4.5.

And yes, ASD looks nothing like what I thought before we had our kid.

I'm sure you subjectively perceive your child as social and affectionate, but *differences* in social skills is a core aspect of ASD. That isn't to say that kids with ASD are feelingless automatons. They just have visible differences in how they interact socially. If OP is not seeing those differences, that's very important.

Yes, there are differences in social skills. But the issue of not being "social and affectionate" is just a false stereotype and a red herring that you are perpetrating. Stop it.

Kids with ASD just don't socialize and respond to others the same way NT kids do. This is a basic fact. It's not false - it's the defining feature of autism!

This is the problem with terming everything now ASD. ASD will look different for each kid as will a language disorder. ASD and receptive language issues look very similar when kids are little. It only teases out more when they are older and the speech comes in.

[Anonymous]

Anonymous wrote:yes- ASD can be misdiagnosed. OP- I would try to get a second opinion so that you can have more clarity on how to approach your dd’s needs. It sounds like she is doing great though and that’s really positive!!

At this point, until the child speaks/progresses more, a new evaluation isn't going to be that helpful in less its to access specific services. Far better to workonthe language issues and wait till the speech comes in more (especially with receptive) and then reassess.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

Therapies are "informed by diagnosis" but not determined by it. My ASD kid goes to a lot therapies. Each therapist makes an independent evaluation of specific deficits, which sometimes are unrelated to her core ASD diagnosis. Then they make a treatment plan based on that evaluation, not just the diagnosis we showed up with.

So it's most important right now to know what the actual deficits are rather than pin down the diagnosis.

Well, OP clearly thinks a misdiagnosis is driving inappropriate therapies here. A professional has told her that her child needs ABA, which is tested on kids with ASD, and is generally specifically intended for that. It's costing her money, and she perceives it as "torturing" her child. OP is exactly right to seek a second opinion here, to know what kind of therapy she needs to focus on.

The question of whether ABA is appropriate for the child is separate from the question of whether her child is ASD. Many people believe that the kind of ABA OP is describing is inappropriate for any child. OP can simply stop the ABA.

I think its worth trying ABA if insurance is paying. We did and stopped it. It wasn't as everyone describes it on here and online. It really varies by provider. BUT, I also didn't find it helpful in getting speech or language skills which is why we didn't continue. ABA is good for behavioral and other issues. It would be better for a low functioning child or one with behavioral issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

I’m not sure it does. Therapies are determined by the child’s needS. I have a kid with ASD and he is socially motivated and cuddly (or was—he’s a teen now). Deficits in pragmatics aren’t the same thing as not being social or wanting to connect. I find that people unfamiliar with ASD often expect ASD kids to be asocial and cold, but that isn’t what I see in my son or his friends, and I think OP’s description of her dad reflects an inaccurate perception of ASD.

And yes, ASD looks nothing like what I thought before we had our kid.

Oh her *dd*. I didn’t read it that she was saying her dad had the same level of social skills as the twin, only that she shows social motivation and makes some eye contact. Neither of these are inconsistent with ASD.

Fixed quotes:

Same with my kid. Very social and affectionate but poor pragmatic skills. Like OP, my kid was also a preemie. A followup assessment at 18 months found advanced cognitive and behavioral skills. Poor social pragmatic skills weren't apparent until about age 4.5.

And yes, ASD looks nothing like what I thought before we had our kid.

I'm sure you subjectively perceive your child as social and affectionate, but *differences* in social skills is a core aspect of ASD. That isn't to say that kids with ASD are feelingless automatons. They just have visible differences in how they interact socially. If OP is not seeing those differences, that's very important.

Yes, there are differences in social skills. But the issue of not being "social and affectionate" is just a false stereotype and a red herring that you are perpetrating. Stop it.

Kids with ASD just don't socialize and respond to others the same way NT kids do. This is a basic fact. It's not false - it's the defining feature of autism!

You did not understand my post!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

I’m not sure it does. Therapies are determined by the child’s needS. I have a kid with ASD and he is socially motivated and cuddly (or was—he’s a teen now). Deficits in pragmatics aren’t the same thing as not being social or wanting to connect. I find that people unfamiliar with ASD often expect ASD kids to be asocial and cold, but that isn’t what I see in my son or his friends, and I think OP’s description of her dad reflects an inaccurate perception of ASD.

And yes, ASD looks nothing like what I thought before we had our kid.

Oh her *dd*. I didn’t read it that she was saying her dad had the same level of social skills as the twin, only that she shows social motivation and makes some eye contact. Neither of these are inconsistent with ASD.

Fixed quotes:

Same with my kid. Very social and affectionate but poor pragmatic skills. Like OP, my kid was also a preemie. A followup assessment at 18 months found advanced cognitive and behavioral skills. Poor social pragmatic skills weren't apparent until about age 4.5.

And yes, ASD looks nothing like what I thought before we had our kid.

I'm sure you subjectively perceive your child as social and affectionate, but *differences* in social skills is a core aspect of ASD. That isn't to say that kids with ASD are feelingless automatons. They just have visible differences in how they interact socially. If OP is not seeing those differences, that's very important.

Yes, there are differences in social skills. But the issue of not being "social and affectionate" is just a false stereotype and a red herring that you are perpetrating. Stop it.

Kids with ASD just don't socialize and respond to others the same way NT kids do. This is a basic fact. It's not false - it's the defining feature of autism!

You did not understand my post!

+1 the PP seems to either not get or to willfully misunderstand the point several of us are making.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

Therapies are "informed by diagnosis" but not determined by it. My ASD kid goes to a lot therapies. Each therapist makes an independent evaluation of specific deficits, which sometimes are unrelated to her core ASD diagnosis. Then they make a treatment plan based on that evaluation, not just the diagnosis we showed up with.

So it's most important right now to know what the actual deficits are rather than pin down the diagnosis.

Well, OP clearly thinks a misdiagnosis is driving inappropriate therapies here. A professional has told her that her child needs ABA, which is tested on kids with ASD, and is generally specifically intended for that. It's costing her money, and she perceives it as "torturing" her child. OP is exactly right to seek a second opinion here, to know what kind of therapy she needs to focus on.

The question of whether ABA is appropriate for the child is separate from the question of whether her child is ASD. Many people believe that the kind of ABA OP is describing is inappropriate for any child. OP can simply stop the ABA.

I think its worth trying ABA if insurance is paying. We did and stopped it. It wasn't as everyone describes it on here and online. It really varies by provider. BUT, I also didn't find it helpful in getting speech or language skills which is why we didn't continue. ABA is good for behavioral and other issues. It would be better for a low functioning child or one with behavioral issues.

ABA is also a big time commitment so why should OP waste her time when it's not helping?

[Anonymous]

Op, does she have delays or not? I understand wanting a correct or accurate diagnosis but that’s not possible at this age really. Professionals often differ on diagnoses and at this age it’s very difficult. So I wouldn’t put too much stock in predictions re prognosis at this point. But you’re losing sight of the bigger picture. What are her needs? What are her delays? You almost sound like you don’t think there are any. If that’s true, you need some new assessments. Go get a new speech eval and other evals.
Cognitive assessments are virtually useless at this age.

[Anonymous]

We went for a third opinion when DS was diagnosed with ASD when he was 4. His school had a psych ed eval which diagnosed ASD/Asperger's and then we took to a well known developmental pediatrician who also diagnosed ASD.

For the third opinion, we took DS to Children's for ADOS/ADI-R which also diagnosed ASD. DS is highly socially motivated without language delays and attended a dual language school from prek-5.

He is 11 now the diagnosis is correct plus add in, ADHD combined type. In RL, most people never think DS has any diagnosis, he presents as NT.

Get the ADOS/ADI-R if you want a second (or third) opinion.

[Anonymous]

Op, she was a 25 week preemie? And a twin? It would be unexpected for there to be some serious delays that may or may not be permanent, right?

[Anonymous]

Anonymous wrote:Op, she was a 25 week preemie? And a twin? It would be unexpected for there to be some serious delays that may or may not be permanent, right?

Sorry - it would not be unusual, right?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think it probably doesn’t matter, as a practical matter, if she has ASD or not. So I would wait to reassess until she’s a little older. You may never get a definitive answer or unanimous agreement. But some of the things you mention as counter-evidence, like being social and affectionate, are common in children with ASD, so you also may have a skewed sense of what the current diagnostic criteria are.

Of course a correct diagnosis matters. Nobody has unlimited time and money for therapies; so OP needs to focus on what is actually needed, which is informed by the diagnosis. Also, kids with ASD are not "social and affectionate' in the same way NT kids are. Social deficits are core ASD deficits. You can't get an ASD diagnosis without serious impairment in that area. So, if OP is observing that her child has similar social skills as her twin, then that's pretty important evidence to consider.

Therapies are "informed by diagnosis" but not determined by it. My ASD kid goes to a lot therapies. Each therapist makes an independent evaluation of specific deficits, which sometimes are unrelated to her core ASD diagnosis. Then they make a treatment plan based on that evaluation, not just the diagnosis we showed up with.

So it's most important right now to know what the actual deficits are rather than pin down the diagnosis.

Well, OP clearly thinks a misdiagnosis is driving inappropriate therapies here. A professional has told her that her child needs ABA, which is tested on kids with ASD, and is generally specifically intended for that. It's costing her money, and she perceives it as "torturing" her child. OP is exactly right to seek a second opinion here, to know what kind of therapy she needs to focus on.

The question of whether ABA is appropriate for the child is separate from the question of whether her child is ASD. Many people believe that the kind of ABA OP is describing is inappropriate for any child. OP can simply stop the ABA.

I think its worth trying ABA if insurance is paying. We did and stopped it. It wasn't as everyone describes it on here and online. It really varies by provider. BUT, I also didn't find it helpful in getting speech or language skills which is why we didn't continue. ABA is good for behavioral and other issues. It would be better for a low functioning child or one with behavioral issues.

ABA is also a big time commitment so why should OP waste her time when it's not helping?

ABA time varies depending on the provider and child. We did it 4 hours a week - 2 - 2 hour sessions. Its not a bad idea to try it as it may help. We did it for a few months and moved on to more speech. There was no harm, child liked the provider.