Anyone BTDT? Autism/Not-Autism? Starting Kindergarten Next Year

[Anonymous]

Anonymous wrote:

Anonymous wrote:Will I get a differential diagnosis from a developmental psychologist? We're going in for a consult next week. They said they would then determine what further appointments we'd need. Does that sound right?

I would be concerned how well does this person understand language disorders especially given the medical piece. I would just do speech therapy a few times a week vs. wasting the money on an evaluation and evaluating again before K.

A en educational evaluation is helpful before K to help inform the IEP.

[Anonymous]

Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also, I don't know that the school would judge him for his diagnosis. I'm concerned that they might.

Does anyone have a kid whose symptoms mostly disappeared? Did you get a new diagnosis or just keep ASD?

Happens all the time on the MERLD boards. I've met several of those kids -- when their language comes in, their "autism" goes away.

This is my kid.

OP, we did a small private for a few years and it was wonderful. They had about 10 kids in a classroom and were very structured and had strict routines so he could easily learn them and follow. They were very warm and kind to him and gave him the extra support he needed. He thrived there and then successfully transferred to public. If you can afford it for a few years and the private is ok with it, I'd try private. They allowed my son to do a 1/2 day after we looked at the school and he loved it and didn't want to leave. They were ok with the delays and his needs and never once complained about his extra needs. It was the best thing we ever did for him.

My kid is a MERLD kid but now his receptive is mostly caught up so the school only has him coded as expressive (there are still minor receptive issues but he's mostly learned to compensate). It absolutely can happen and from what I've seen its more between 7-10 vs. 4-6 if is on the more severe side.

Your child has a higher likelihood to catch up as they know the cause, which was an issue with his ears vs an unknown cause.

Op, please take information with a grain of salt. Past preschool do not get diagnoses of MERLD.

Receptive skills can improve but please don't be so gullible to believe that they grow in like teeth. The chronic fluid even though corrected puts your kid more at risk for language based LDs.
https://www.ncbi.nlm.nih.gov/books/NBK356270/

You can get a diagnosis of a language disorder with expressive and receptive. However, at some point when they are testing at a specific level, one or both can be dropped. My child's receptive diagnosis has been dropped. The school system refuses to even recognize it at an issue.

If the cause is due to ears, its very different often than a child with unknown cause. Once the ears are treated, children can catch up quickly. They are very different.

No this not true once ears are treated everything catches up. It can, but not a given. Start reading at page 19 of the NIH article.

[Anonymous]

Anonymous wrote:Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

At this point child is really young so an educational evaluation should be included but very limited. My child has been evaluated by a variety of providers, not just our SLP but our SLP was the most detailed and accurate.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

At this point child is really young so an educational evaluation should be included but very limited. My child has been evaluated by a variety of providers, not just our SLP but our SLP was the most detailed and accurate.

The kid is 4.5 now and will be older by the time he gets an evaluation. It won't be limited at all. Since you've never done one you wouldn't know that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

At this point child is really young so an educational evaluation should be included but very limited. My child has been evaluated by a variety of providers, not just our SLP but our SLP was the most detailed and accurate.

The kid is 4.5 now and will be older by the time he gets an evaluation. It won't be limited at all. Since you've never done one you wouldn't know that.

How would you know if we have done evaluations or not? My child doesn't have any academic issues, grades are very good. Child was tested early on and no concerns. Early reader so it was easy to tell.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

At this point child is really young so an educational evaluation should be included but very limited. My child has been evaluated by a variety of providers, not just our SLP but our SLP was the most detailed and accurate.

The kid is 4.5 now and will be older by the time he gets an evaluation. It won't be limited at all. Since you've never done one you wouldn't know that.

How would you know if we have done evaluations or not? My child doesn't have any academic issues, grades are very good. Child was tested early on and no concerns. Early reader so it was easy to tell.

Have you done a neuropsch then?

Based on what you write and the vagueness of what you say, you sound like you've never done this. Differential evaluations aren't just for academic issues. They sometimes show them, but when a kid's had persistent delays throughout preschool, they're a good idea. It's a good baseline if issues crop later.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

At this point child is really young so an educational evaluation should be included but very limited. My child has been evaluated by a variety of providers, not just our SLP but our SLP was the most detailed and accurate.

The kid is 4.5 now and will be older by the time he gets an evaluation. It won't be limited at all. Since you've never done one you wouldn't know that.

How would you know if we have done evaluations or not? My child doesn't have any academic issues, grades are very good. Child was tested early on and no concerns. Early reader so it was easy to tell.

Have you done a neuropsch then?

Based on what you write and the vagueness of what you say, you sound like you've never done this. Differential evaluations aren't just for academic issues. They sometimes show them, but when a kid's had persistent delays throughout preschool, they're a good idea. It's a good baseline if issues crop later.

No, the developmental ped said no when I contacted at the age appropriate time he said to get one. We had many baselines. Why do you push unnecessary evaluations if child is doing well over all? What would they be looking for? We know the strengths and areas needed to work on. Child is testing on target or ahead. Child's test scores this year already show he has passed all the necessary things to pass the current grade level. If something crops up later we will deal with it. At some point as our developmental ped told us was you have to let go of services and supports and give the child the opportunity to succeed. If they aren't, you reevaluate and restart services. We kept our child in services a year longer than recommended to be on the safe side. Now its time to shut them down and see what happens. Some kids benefit from early on supports and can thrive. I'm not worried about the what if's in the future but the here and now.

OP is asking do some kids do ok... the answer is yes, they do and some thrive. Many still need supports and help, but not all do. We'll see what ours needs in the future but right now the future looks good.

[Anonymous]

How is your child’s joint attention?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Again, pp, I told the op not to expect a diagnosis of MERLD. Of course a child can have expressive and receptive delays or a disorder. It may have a MERLD ICD code for billing, but a psychologist isn't going to give a diagnosis of MERLD since it hasn't been in the DSM for 5 years.

She's asking for BTDT experience, and you would know this if your kid had an educational evaluation and not just your SLP.

At this point child is really young so an educational evaluation should be included but very limited. My child has been evaluated by a variety of providers, not just our SLP but our SLP was the most detailed and accurate.

The kid is 4.5 now and will be older by the time he gets an evaluation. It won't be limited at all. Since you've never done one you wouldn't know that.

How would you know if we have done evaluations or not? My child doesn't have any academic issues, grades are very good. Child was tested early on and no concerns. Early reader so it was easy to tell.

Have you done a neuropsch then?

Based on what you write and the vagueness of what you say, you sound like you've never done this. Differential evaluations aren't just for academic issues. They sometimes show them, but when a kid's had persistent delays throughout preschool, they're a good idea. It's a good baseline if issues crop later.

No, the developmental ped said no when I contacted at the age appropriate time he said to get one. We had many baselines. Why do you push unnecessary evaluations if child is doing well over all? What would they be looking for? We know the strengths and areas needed to work on. Child is testing on target or ahead. Child's test scores this year already show he has passed all the necessary things to pass the current grade level. If something crops up later we will deal with it. At some point as our developmental ped told us was you have to let go of services and supports and give the child the opportunity to succeed. If they aren't, you reevaluate and restart services. We kept our child in services a year longer than recommended to be on the safe side. Now its time to shut them down and see what happens. Some kids benefit from early on supports and can thrive. I'm not worried about the what if's in the future but the here and now.

OP is asking do some kids do ok... the answer is yes, they do and some thrive. Many still need supports and help, but not all do. We'll see what ours needs in the future but right now the future looks good.

Are you the one who was prattling on about the ears? I'm not recommended anything for your child and your weird paranoia about educational testing is apparent b/c you were obviously trying to avoid the autism school label for your kid. You haven't BTDT.

Op, my kid is not on the spectrum, but did have chronic fluid, and does have language based LDs. I don't know what your evaluation will tell you about your kid, but with preschool delays plus the fluid, getting one for your kid makes sense. Read the NIH article, talk to your kid's current teacher, pediatrician, SLP etc and ask them. Based on the evaluation done previously, you need more and more up to date information on your kid.

[Anonymous]

Anonymous wrote:NP here.

Are there any signs, right now, that make you think he would receive an ASD diagnosis if tested by someone else?

This is the OP. He's still working on typical language - he can have back and forth conversations now but not to the level of typical kids - his sentences are shorter, words are sometimes in the wrong order, it may take him a little bit longer to respond to a question or get a sentence out. Otherwise, he shows interest in peers, engages in imaginative play with peers (getting more and more complex as he gets more language), responds when someone talks to him and makes eye contact, etc.

For the repetitive/restrictive behaviors, he will jump up and down when he's very excited. Otherwise, he's never had a fixation on just one topic and his rigidity is almost gone. One of his therapists actually said in our last meeting that she thought his flexibility was one of his strengths.

Sensory-wise he seems to be a super taster. We tried to hide his medicine in things and even my husband couldn't taste it but somehow my son could.

The way he talks does sound the way some kids with autism speak.

[Anonymous]

OP again. Not sure I'm following all this discussion on types of evaluations. My son has had an IEP since he was 3 years old and we've had regular educational evaluations as he's progressed to update his placements and IEP goals.

Would we already see the language-based LD issues? My son is doing well with letter sounds and has started with sight words, can sound out two and three letter combos, etc. He's also doing basic addition. Academically he's doing very well and that's never been an issue to this point. Is the idea that an issue will crop up in the future?

[Anonymous]

Anonymous wrote:How is your child’s joint attention?

This is an area where he just recently made a lot of progress. His teacher last year said that he had trouble in circle time and following group directions. His new teacher said that she sees no issues in this area.

[Anonymous]

Anonymous wrote:OP again. Not sure I'm following all this discussion on types of evaluations. My son has had an IEP since he was 3 years old and we've had regular educational evaluations as he's progressed to update his placements and IEP goals.

Would we already see the language-based LD issues? My son is doing well with letter sounds and has started with sight words, can sound out two and three letter combos, etc. He's also doing basic addition. Academically he's doing very well and that's never been an issue to this point. Is the idea that an issue will crop up in the future?

It really varies. For some kids it's quite obvious early on. Other kids can compensate with a language based LDs for quite long if not life long. Lots of successful people didn't get diagnosed with dyslexia for example until they were adults. Your kid's more at risk, but doesn't me he will have these issues.

My kid had an IEP early on before starting elementary school. I preferred to do outside testing because the schools didn't seem to unless there was a problem. Since you're applying to a private and already have an IEP, you'll probably have to disclose this in the application. Depending on the application you may or may not need to submit the testing. However, if he doesn't get in or it doesn't go well, you'll need to be prepared on how best to help him.

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP here.

Are there any signs, right now, that make you think he would receive an ASD diagnosis if tested by someone else?

This is the OP. He's still working on typical language - he can have back and forth conversations now but not to the level of typical kids - his sentences are shorter, words are sometimes in the wrong order, it may take him a little bit longer to respond to a question or get a sentence out. Otherwise, he shows interest in peers, engages in imaginative play with peers (getting more and more complex as he gets more language), responds when someone talks to him and makes eye contact, etc.

For the repetitive/restrictive behaviors, he will jump up and down when he's very excited. Otherwise, he's never had a fixation on just one topic and his rigidity is almost gone. One of his therapists actually said in our last meeting that she thought his flexibility was one of his strengths.

Sensory-wise he seems to be a super taster. We tried to hide his medicine in things and even my husband couldn't taste it but somehow my son could.

The way he talks does sound the way some kids with autism speak.

OP, I am the poster who asked this. He sounds strikingly similar to my son, 4.5 years old. My DS does not have autism. I hope some of this is helpful.

My DS never really showed any "red flags," but even as in infant, it was clear he was a tense, anxious little guy. We bent over backwards for his sleep schedule. He didn't like large groups/gatherings, and as he aged closer to 3 it was clear his speech was behind peers. He was excruciatingly shy, though eye contact and play was always appropriate. He would throw epic meltdowns and tantrums, and for a while, it seemed like we walked on eggshells around his behavior. (He was never aggressive or misbehaved, but was rigid and freaked out very easily. He was moody).

We began twice weekly speech therapy and everything improved by leaps and bounds. His anxiety lessened to a degree, and he began showing interest in playing with other children. He "lightened up" considerably, and began taking more of an interest in the world around him. Once he had the language to ask questions, I think he felt a bit more in control. His language is delayed: we are currently working on pronouns, increasing sentence length, and appropriate word order (on occasion). He is conversational with peers, family, and teachers though it is obvious he speaks more like a 3 year-old. He can not keep up in a zippy, quick conversation with other 4 year-olds, often taking a bit longer to answer questions and follow along. Many of his friends don't really seem to notice, and if they do, are sweet enough to keep just playing along. He does well on 1:1 playdates, especially when he can sit with a friend and do a project, play trains, etc.

He may never be the life of the party; he is an introvert. He needs a lot more reassurance than other children his age. I still prompt correct sentence formation, and help him "keep up" when an adult may be speaking too rapidly. We worried for a very long time about autism, but he was always in a "grey area." He flaps and jumps when excited, had/has the language delay, was rigid, etc. However, he did not have any restricted interests, was completely comfortable with family members, always had normal joint attention, etc.

We are still working on the language. We are also working on the anxiety. One thing to ask yourself and/or his doctor: "If the speech delay was removed, what else about his behavior leads you to an autism diagnosis?" Autism can be a subjective diagnosis. We recently went to a child psychiatrist to get the ball rolling on his anxiety. Within half an hour, he mentioned "Of course he doesn't have autism, look at his fantastic eye contact and pretend play." Two years ago, we were dancing around the diagnosis of MERLD or Social Pragmatic Communication Disorder, though again, neither seemed to quite fit him. His psychiatrist is confident he truly just has/had a speech delay (and anxiety).

My family insists he is just like I was as a child: I often kept to myself, seemed oblivious as to whether or not I had friends, didn't care for groups, and was extremely shy. I was eventually asked to leave preschool because I didn't interact with others. (I am a completely normal, outgoing adult). We have debated the private vs. public kindergarten issue for next year, and have ultimately decided to go public. For many reasons: I won't have to drive him to private speech therapy (I have younger children), and should he need an accommodation, it will be in place. (Private schools are never "required" to do anything. I am not sure if some of his rigidity will reappear once he starts kindergarten, and I imagine it will be an anxious time for him). My DS has come so, so far.