Early Stages Autism Classification

[Anonymous]

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

Op clearly believes it is a language disorder. If she has to spend money and put her kid through that to prove them wrong she might as well use that money for private services. Public school services are a joke for language disorders. She should not have to prove her child does not have ASD. They need to provide good reason why child has it. Op made a huge mistake in agreeing. The school system is not set up in the kids best interests.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

This is why you should get private evals before Early Stages!

Since OP is working on a quick timeframe, I'd concentrate efforts on:
1) an advocate knowledgeable about self-contained placements in DC (any hints??)
2) private speech assessment - should be a practitioner who takes insurance w/o a long wait list
3) autism assessment by whoever will do it quickly and takes insurance
4) make an appointment for KKI or Childrens for the longer term

Some ideas about where to get these evals:

Connections in DC and MD http://www.thectcenter.com/therapy-services/special-programs/ -- they take BCBS and other insurance

mt washington in Baltimore - I have heard here that wait times are shorter
https://www.mwph.org/programs/behavioral-health/autism

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This study investigated the childhood autism rating scale (CARS) as a tool for ASD diagnoses for 2-year-old (n = 376) and 4-year-old (n = 230) children referred for possible autism. The cut-off score to distinguish autistic disorder from PDD-NOS was 32 in the 2-year-old sample (consistent with Lord in J Child Psychol Psychiatry Allied Discipl, 36, 1365–1382, 1995), and 30 in the 4-year-old sample, with good sensitivity and specificity at both ages. The cut-off score to distinguish ASD from non-ASD at both ages was 25.5, with good sensitivity and specificity. Results confirm the utility of the CARS in distinguishing autistic disorder from PDD-NOS, and distinguishing ASD from other developmental disorders and typical development and suggest that an ASD cutoff around 25, which is in common clinical use, is valid.



www.ncbi.nlm.nih.gov/pmc/articles/PMC3612531/


Here's one citation. It's older, but from the time when my child took the test.


It maybe your gold standard for ASD but it is not with language disorders. You are probably the same person who screams when MERLD is used but are pulling an old study with an outdated disorder which was basically the catch all of we don’t know what is wrong with your child.

PDD Nos is not a diagnosis anymore. It used to be the catch all for everything. Children with language delays early on look very similar but it teases out in the later years.

Did you read the part where I said it was older? ALso, does not change it's accuracy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

Op clearly believes it is a language disorder. If she has to spend money and put her kid through that to prove them wrong she might as well use that money for private services. Public school services are a joke for language disorders. She should not have to prove her child does not have ASD. They need to provide good reason why child has it. Op made a huge mistake in agreeing. The school system is not set up in the kids best interests.

I don't think such an adversarial view is warranted. And don't you think OP's belief should be supplemented by an expert evaluation? It's not about proving anything, but getting the help her child needs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

Op clearly believes it is a language disorder. If she has to spend money and put her kid through that to prove them wrong she might as well use that money for private services. Public school services are a joke for language disorders. She should not have to prove her child does not have ASD. They need to provide good reason why child has it. Op made a huge mistake in agreeing. The school system is not set up in the kids best interests.

I don't think such an adversarial view is warranted. And don't you think OP's belief should be supplemented by an expert evaluation? It's not about proving anything, but getting the help her child needs.

Exactly. OP said she "isn't 100% sure," that it's autism. So it sounds like she is considering that autism may be correct. Her main concern is keeping her kid in general ed. Meanwhile Early Stages has told not just that it's autism, but that the disability is severe enough to warrant full time self-contained classroom. They probably would not do that for a language disorder alone. There is more going on and she will not get a full picture from either Early Stages or an SLP alone. And if she wants to get her kid the correct placement, she will need information, not just private speech.

[Anonymous]

Anonymous wrote:This study investigated the childhood autism rating scale (CARS) as a tool for ASD diagnoses for 2-year-old (n = 376) and 4-year-old (n = 230) children referred for possible autism. The cut-off score to distinguish autistic disorder from PDD-NOS was 32 in the 2-year-old sample (consistent with Lord in J Child Psychol Psychiatry Allied Discipl, 36, 1365–1382, 1995), and 30 in the 4-year-old sample, with good sensitivity and specificity at both ages. The cut-off score to distinguish ASD from non-ASD at both ages was 25.5, with good sensitivity and specificity. Results confirm the utility of the CARS in distinguishing autistic disorder from PDD-NOS, and distinguishing ASD from other developmental disorders and typical development and suggest that an ASD cutoff around 25, which is in common clinical use, is valid.



www.ncbi.nlm.nih.gov/pmc/articles/PMC3612531/


Here's one citation. It's older, but from the time when my child took the test.

Interesting that CARS came out similar to ADOS. The general recommendation still seems to be using the ADOS together ADI-R
https://www.ncbi.nlm.nih.gov/pubmed/23322184

https://www.cadth.ca/sites/default/files/pdf/RC0461%20Screening%20and%20Diagnosis%20in%20ASD%20Final.pdf

I did find a PhD paper that also found the CARS and ADOS to have similar results.
https://www.researchgate.net/publication/35405265_Diagnosing_autism_electronic_resource_comparison_of_the_childhood_autism_rating_scale_CARS_and_the_autism_diagnostic_observation_schedule_ADOS

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This study investigated the childhood autism rating scale (CARS) as a tool for ASD diagnoses for 2-year-old (n = 376) and 4-year-old (n = 230) children referred for possible autism. The cut-off score to distinguish autistic disorder from PDD-NOS was 32 in the 2-year-old sample (consistent with Lord in J Child Psychol Psychiatry Allied Discipl, 36, 1365–1382, 1995), and 30 in the 4-year-old sample, with good sensitivity and specificity at both ages. The cut-off score to distinguish ASD from non-ASD at both ages was 25.5, with good sensitivity and specificity. Results confirm the utility of the CARS in distinguishing autistic disorder from PDD-NOS, and distinguishing ASD from other developmental disorders and typical development and suggest that an ASD cutoff around 25, which is in common clinical use, is valid.



www.ncbi.nlm.nih.gov/pmc/articles/PMC3612531/


Here's one citation. It's older, but from the time when my child took the test.


It maybe your gold standard for ASD but it is not with language disorders. You are probably the same person who screams when MERLD is used but are pulling an old study with an outdated disorder which was basically the catch all of we don’t know what is wrong with your child.

PDD Nos is not a diagnosis anymore. It used to be the catch all for everything. Children with language delays early on look very similar but it teases out in the later years.

Did you read the part where I said it was older? ALso, does not change it's accuracy.

No, they are definitely not the same person.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

Op clearly believes it is a language disorder. If she has to spend money and put her kid through that to prove them wrong she might as well use that money for private services. Public school services are a joke for language disorders. She should not have to prove her child does not have ASD. They need to provide good reason why child has it. Op made a huge mistake in agreeing. The school system is not set up in the kids best interests.

I don't think such an adversarial view is warranted. And don't you think OP's belief should be supplemented by an expert evaluation? It's not about proving anything, but getting the help her child needs.

Its already gone adversarial at this point if OP was forced to place her child in a classroom she doesn't think is best with a diagnosis that she doesn't think is best. Yes, a good evaluation is appropriate but I'd wait another year or so until the child is older and speech comes in. At this point, she either needs to back out of public services or get a good advocate.

[Anonymous]

first off- go see a developmental pediatrician. An autism diagnosis isn't thrown out just for language delays. There has to be more areas affected i.e. social and sensory. My nephew was language delayed but it was obvious he did not have autism.

second-You do not have to agree to any label until the child is 7. Despite his deficiencies even if under the developmental delay code they still need to provide the services he needs

third- I agree with PP's that if they are recommending autism self contained classrooms it is because the child can benefit from that. These classes cost the county a lot more money to run so they don't just put kids in there?? I had to fight to get my son, who clearly had autism and was non verbal into an autism classroom. For some reason parents think these classes will not be good for their kids as they have a bad stigma. The have a low, sometimes 1:1 ratio and the kids get the focused attention they need. At least that has been our experience in MOCO.

Good luck!

[Anonymous]

This is OP. To be honest I don’t really care about the disability classification. He has to be re-evaluated in three years. If it isn’t appropriate and they refuse to change it then I’ll fight. I’m more angry and upset about the self contained recommendation. I disagreed with the educational and told them I thought it was invalid. I think they tried to place him in there because of those results. He does lack some social skills but whether that’s from a receptive language delay, staying at home with a nanny or autism is yet to be seen. I just refuse to place my kid in a ces program without giving him the benefit of the doubt and letting him try pre-K gen ed. I know he will be absolutely fine in gen ed. There is no question. I just want to make sure they can’t place him there when I said no. I still want him to get the speech Services (we are starting private as well).

[Anonymous]

Anonymous wrote:This is OP. To be honest I don’t really care about the disability classification. He has to be re-evaluated in three years. If it isn’t appropriate and they refuse to change it then I’ll fight. I’m more angry and upset about the self contained recommendation. I disagreed with the educational and told them I thought it was invalid. I think they tried to place him in there because of those results. He does lack some social skills but whether that’s from a receptive language delay, staying at home with a nanny or autism is yet to be seen. I just refuse to place my kid in a ces program without giving him the benefit of the doubt and letting him try pre-K gen ed. I know he will be absolutely fine in gen ed. There is no question. I just want to make sure they can’t place him there when I said no. I still want him to get the speech Services (we are starting private as well).

The problem is I have never heard of a school changing an autism disability classification unless it saves them money. They are not matching your child to the best program for him. They are looking at their programs to see what is easiest and cost effective for them.

A developmental delay label would have bought you a lot of time to sort things out.

Language kids need specific help but they will offer you whatever they are doing for the kids with autism.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

Op clearly believes it is a language disorder. If she has to spend money and put her kid through that to prove them wrong she might as well use that money for private services. Public school services are a joke for language disorders. She should not have to prove her child does not have ASD. They need to provide good reason why child has it. Op made a huge mistake in agreeing. The school system is not set up in the kids best interests.

I don't think such an adversarial view is warranted. And don't you think OP's belief should be supplemented by an expert evaluation? It's not about proving anything, but getting the help her child needs.

Its already gone adversarial at this point if OP was forced to place her child in a classroom she doesn't think is best with a diagnosis that she doesn't think is best. Yes, a good evaluation is appropriate but I'd wait another year or so until the child is older and speech comes in. At this point, she either needs to back out of public services or get a good advocate.

Backing out of the IEP would likely mean her child, who has significant needs, is not getting therapy for a whole year. I agree that she should find the right placement, but I'm not sure that rejecting services is a good idea. Also OP could look into Bridges, which may have space in an inclusion classroom.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op would be far better off spending that $5K for a new evaluation on private speech therapy.

An autism evaluation at age 4 is not a full neuropsych and so is much cheaper. A lot of tests in a full neuropsych can't be done at age 4. Also Children's or KKI take insurance although the waiting list is long.

Op clearly believes it is a language disorder. If she has to spend money and put her kid through that to prove them wrong she might as well use that money for private services. Public school services are a joke for language disorders. She should not have to prove her child does not have ASD. They need to provide good reason why child has it. Op made a huge mistake in agreeing. The school system is not set up in the kids best interests.

I don't think such an adversarial view is warranted. And don't you think OP's belief should be supplemented by an expert evaluation? It's not about proving anything, but getting the help her child needs.

Its already gone adversarial at this point if OP was forced to place her child in a classroom she doesn't think is best with a diagnosis that she doesn't think is best. Yes, a good evaluation is appropriate but I'd wait another year or so until the child is older and speech comes in. At this point, she either needs to back out of public services or get a good advocate.

Backing out of the IEP would likely mean her child, who has significant needs, is not getting therapy for a whole year. I agree that she should find the right placement, but I'm not sure that rejecting services is a good idea. Also OP could look into Bridges, which may have space in an inclusion classroom.

Sometimes this the only leverage a parent has. It is like a game of Chicke. The school won"t want a child in a gen ed class without support, so they fold.

Again, once you start in a separate classroom, it is rare to get out.

[Anonymous]

Anonymous wrote:This is OP. To be honest I don’t really care about the disability classification. He has to be re-evaluated in three years. If it isn’t appropriate and they refuse to change it then I’ll fight. I’m more angry and upset about the self contained recommendation. I disagreed with the educational and told them I thought it was invalid. I think they tried to place him in there because of those results. He does lack some social skills but whether that’s from a receptive language delay, staying at home with a nanny or autism is yet to be seen. I just refuse to place my kid in a ces program without giving him the benefit of the doubt and letting him try pre-K gen ed. I know he will be absolutely fine in gen ed. There is no question. I just want to make sure they can’t place him there when I said no. I still want him to get the speech Services (we are starting private as well).

Why do you think he needs to be in the general ed program? I think what they are trying to tell you is that they don't think he can get the level of service he needs in a general ed setting. While they may be wrong, how do you know? The way I have seen this played out in DC, in both cases the child was not able thrive in the general ed class. In one case they ended up in a charter with a FT aide; the other in a self-contained classroom
where they are doing well. And getting this high level of support may also help them transition back to general ed.

I think you really need to get more information, about your child and about the potential placements.

I emphathize with feeling shocked/angry/confused. I sure did when my kid's Early Stages eval showed more severe issues than I had realized. On the other hand the progress he has made with the right level of supports is amazing. And you're starting at 4, which is amazing!

Before you make any sudden moves like rejecting the IEP, please get more information!