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

[Anonymous]

<<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. >>

So can a MERLD kid eventually "catch up" without an intensive language program that you'd get in a private school?

[Anonymous]

I think part of the confusion is people are saying kids with MERLD can look autistic before language catches up and have all sorts of symptoms and lose them. plenty of autistic kids lose thosesame symptoms over time.

Have there been MRI studies of MERLD kids with autistic like features and kids on the spectrum. Everyone is saying they are different and I think someone said they involve different areas of the brain which doesn't make sense to me since language centers and language centers. Have there been imaging studies or is this all just speculation?

Plenty of kids with hyperlexia lose autism like features with language therapy, yet many professionals consider hyperlexia to be on the spectrum.

[Anonymous]

Anonymous wrote:I think part of the confusion is people are saying kids with MERLD can look autistic before language catches up and have all sorts of symptoms and lose them. plenty of autistic kids lose thosesame symptoms over time.

Have there been MRI studies of MERLD kids with autistic like features and kids on the spectrum. Everyone is saying they are different and I think someone said they involve different areas of the brain which doesn't make sense to me since language centers and language centers. Have there been imaging studies or is this all just speculation?

Plenty of kids with hyperlexia lose autism like features with language therapy, yet many professionals consider hyperlexia to be on the spectrum.

Lots of things are related disorders that are "on the spectrum" but are not ASDs. There are a host of disorders that can be grouped together as related disorders. Researchers call this the broad autism phenotype.

To me, it's like the relationship between bipolar disorder and unipolar depression. Individuals who are relatives of people suffering from bipolar disorder suffer from unipolar disorder much more often. They get part of the disorder, (depression) but not the whole disorder (mania). Interventions that are correct for bipolar are not correct for unipolar depression. Hyperlexia and/or some specific language disorder (semantic pragmatic disorder, maybe MERLD) may be like that. The child gets part of the ASD, but not all of it.

You can read a discussion of it here: ttp://www.psychologytoday.com/blog/making-sense-autistic-spectrum-disorders/201006/006-not-quite-autism-the-borderland-asd

[Anonymous]

Anonymous wrote:<<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. >>

So can a MERLD kid eventually "catch up" without an intensive language program that you'd get in a private school?

I know of many kids who caught up in public school, or with homeschooling.

[Anonymous]

Anonymous wrote:I think part of the confusion is people are saying kids with MERLD can look autistic before language catches up and have all sorts of symptoms and lose them. plenty of autistic kids lose thosesame symptoms over time.

Have there been MRI studies of MERLD kids with autistic like features and kids on the spectrum. Everyone is saying they are different and I think someone said they involve different areas of the brain which doesn't make sense to me since language centers and language centers. Have there been imaging studies or is this all just speculation?

Plenty of kids with hyperlexia lose autism like features with language therapy, yet many professionals consider hyperlexia to be on the spectrum.

Yes, there have. Autistic children use their left sides of the brain, as NTs do, only in a lesser capacity. The study indicated that MERLD kids were using the RIGHT side of their brain. ALso "hylerlexia" is another term that's thrown around very loosely and has strayed far from its clinical meaning. If a child is reading early and knows what they are reading, they are NOT hyperlexic. They are early readers. The definitiion of hyperlexia is to read without comprehension.


Monday, February 02, 2009
Late-Talking Children Confused with Autism Spectrum

http://eideneurolearningblog.blogspot.com/2009/02/late-talking-children-confused-with.html

When late-talking children listened to their mother's voices "recalling relatives, pets, and events; and singing familiar songs", they listened with their right language areas rather than their left (controls). Language problems associated with autism showed reduced connectivity with sentence comprehension tasks, but the activity is still on the left hemisphere, not the right.

[Anonymous]

Anonymous wrote:

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.

Going straight to the creator of the term Austism Spectrum Disorder, here is the level of social impairment involved in autism. MERLD children don't have this social communication problem; instead, their social difficulties come from their receptive language issues. A good evaluator can tell the difference.

http://www.awares.org/static_docs/about_autism.asp?docSection=3
3.2 Impairments of social interaction

3.2.1 The aloof group

This is the most common type of social impairment. Behavior may include:

* Behaving as if other people do not exist;
* Little or no eye contact made;
* No response when spoken to;
* Faces empty of expression except with extreme joy, anger or distress;
* No response to cuddling;
* If something is wanted, carers' hands may be pulled towards the object;
* May respond to rough and tumble play well, but when this stops return to aloof pattern;
* Seem to 'be in a world of their own'.

3.2.2 The passive group

Least common group, features include:

* The child accepts social approaches;
* May meet the gaze of others;
* May become involved as a passive part of a game.

3.2.3 The active but odd group

Children of this group make active approaches to others but make that contact in strange ways, including:

* Paying no attention to the other party;
* Poor eye contact although sometimes may stare too long;
* May hug or shake hands too hard.

3.2.4 The over-formal, stilted group

Seen in later life, this behavior is common in the most able person with autism. The following characteristics tend to be displayed:

* Excessively polite and formal;
* Have a good level of language;
* Try very hard to stick to the rules of social interaction without really understanding them.

[Anonymous]

This doesn't answer the question-are their MRI studies showing that the disorders are indeed different?

[Anonymous]

Anonymous wrote:This doesn't answer the question-are their MRI studies showing that the disorders are indeed different?

Not the PP who provided the information (thanks!) but I read the article as well as a couple of the research studies and the question IS answered. MERLD is a type of speech delay. According to this study http://radiology.rsna.org/content/229/3/651.full , they did brain MRIs on kids who were referred to their clinic for speech delays. The mean age of the test group was age 4.2. The conclusion is that kids with speech delays ('late talkers') older than age 3 use the right side of their brains more frequently than kids that don't have delays.


Are you really asking if there are studies out there that indicate you can diagnose disorders based on MRI results? Not yet.

[Anonymous]

Anonymous wrote:This doesn't answer the question-are their MRI studies showing that the disorders are indeed different?

I answered the question in 22:51 -- Yes, there are MRI studies that show this. You can see the pictures yourself by clicking on the link.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Going straight to the creator of the term Austism Spectrum Disorder, here is the level of social impairment involved in autism. MERLD children don't have this social communication problem; instead, their social difficulties come from their receptive language issues. A good evaluator can tell the difference.

http://www.awares.org/static_docs/about_autism.asp?docSection=3
3.2 Impairments of social interaction

3.2.1 The aloof group

This is the most common type of social impairment. Behavior may include:

* Behaving as if other people do not exist;
* Little or no eye contact made;
* No response when spoken to;
* Faces empty of expression except with extreme joy, anger or distress;
* No response to cuddling;
* If something is wanted, carers' hands may be pulled towards the object;
* May respond to rough and tumble play well, but when this stops return to aloof pattern;
* Seem to 'be in a world of their own'.

3.2.2 The passive group

Least common group, features include:

* The child accepts social approaches;
* May meet the gaze of others;
* May become involved as a passive part of a game.

3.2.3 The active but odd group

Children of this group make active approaches to others but make that contact in strange ways, including:

* Paying no attention to the other party;
* Poor eye contact although sometimes may stare too long;
* May hug or shake hands too hard.

3.2.4 The over-formal, stilted group

Seen in later life, this behavior is common in the most able person with autism. The following characteristics tend to be displayed:

* Excessively polite and formal;
* Have a good level of language;
* Try very hard to stick to the rules of social interaction without really understanding them.

M

My child got the Asperger's/ASD diagnosis this year. We got three evaluations; one at his school with a child psych the school hired, one with a private developmental pediatrician mentioned a lot on this board and with a team at the Center for Autism Spectrum Disorders, Children's hospital. Part of the reason we got so many evaluations is b/c DC presents as NT outside the classroom. People, friends, etc. kept telling us there was nothing wrong with our child and from my reading things like the above quote on the internet, it appeared he did not qualify for an ASD diagnosis. Well, he does. All three evaluations came up with Asperger's/ASD and Children's even pointed out that DC had "strong social motivation and intent". My DC social communication problems center on reading social cues and social pragmatics. His eye contact is fine/normal and he is very engaging/loving and affectionate with people he knows.

[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.

What county are you in? What is your child coded as? What age is your child? Was your child performing below grade level when you went for the IEP? Our child is MERLD, but no suggestion of any autism spectrum. We are having a hard time getting the school to provide any services.

[Anonymous]

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.

What county are you in? What is your child coded as? What age is your child? Was your child performing below grade level when you went for the IEP? Our child is MERLD, but no suggestion of any autism spectrum. We are having a hard time getting the school to provide any services.


We are in the Midwest. He's now 10, but has been receiving services since he was 2. He was coded with a developmental disability until age 8, now he has the language impairment label. Yes, he was performing under grade level, which is why he gets services. My child can't access the curriculum unless it's put into a more visual form.

May I ask what services do you feel your child needs? My child has routinely been in the lowest percentiles for language performance...like between 1 and 3 percentile.

[Anonymous]

Our DD is nearing 12 and just diagnosed with MERLD. Must be mild, though because she makes a friend everywhere she goes. She has lots of friends but does not understand complex language or express things this way. Has gone to private and public school. We have wondered about ADHD, but testing showed anxiety.

[Anonymous]

1649: how did you get your school to put things in a more visual form?

[Anonymous]

Anonymous wrote:1649: how did you get your school to put things in a more visual form?

We have full testing from Vanderbilt researchers, so we kept re-directing the school to actually follow their recommendations. And in that report is to make the lessons as visual as possible, because MERLD kids often have very, very weak auditory working memories. So you need to get that lesson into their visual memory....my MERLD child's visual memory is outstanding.

So we do sight word reading instead of phonics, we do Touch Math (he's now dividing with it) and we get them to revamp the science into as hands-on and visually supported as possible with visual study guies. We've skipped a lot of the Social Studies lessons except for the projects, because they are so abstract and talky. Writing is done with pictures from his life, so he has all the visual subtext that goes along with them.

Once the school system stopped fighting us and actually modified their curriculum, my son's learning frustration dropped immensely and his learning increased rapidly. They wasted way more time fighting us than making the simple switches to a visual curriculum.