does this sound like regressive autism? is it time to seek another ASD evaluation?

[Anonymous]

My 3.5 year old DS was evaluated for autism by KKI about 8 months ago and did not receive a diagnosis of any kind. He was noted for one or two "red flags" but nothing substantial that required follow up. He was found within the range of "normal" for the OT and SLP evaluations. The evaluation by the neurodevelopmental pediatrician was underwhelming, but overall, the final conclusion made sense to me.

Fast forward to today, and DS is starting to exhibit concerning behaviors that has me wondering if he should be evaluated again. He still has a very strong interest in cars (that was one of the initial noted red flags). He will play with other toys and games, but he always return to cars. When we're out driving, he almost always comments on cars, their colors, wheels, etc. and not much else. When given a choice at a toy store, it will always be a little matchbox car. He play and pretend skills seem limited and repetitive. He likes to pretend cooking, or create different patterns with his cars (he refers to as "traffic jams"). He will play out scenarios with his cars and give them characters, but he doesn't do this with his stuffed animals, for example. He likes to play with DH and me, but he dictates how he wants us to play; he will say "chase me", or demand we play "puppy" while he's the puppy owner or whatever. He's been really struggling with transitioning from one activity to another recently. He's also been running in a particular pattern around the house, over and over for up to 30 minutes. Lately he will randomly let out a scream, or make raspberry sounds. He seems to be in his own world lately. We used to call his name and he will immediately respond. For the past month or so it takes 3 or 4 times of us calling him before he will respond. Outside of his love of cars, the other behaviors are fairly recent.

I'm very concerned, and sad. DH finds these behaviors concerning to a lesser degree and attributes much of it to DS' recent sleep issues (lack of sleep = irritability, tantrums, etc.). DH does not want to put DS through another evaluation nor does he want to spend the money. He also thinks these behaviors are not atypical of 3 year olds.

I agree that seeking another evaluation is time and money, and that the new behaviors and sleep issues coincide, but maybe it's all part of some kind of regression that we're seeing? Or maybe the older DS gets, the more apparent ASD-symptoms are becoming? We both want to do what's best for our son, yet we're stuck on what what direction to take. Does this sound possible that an ASD diagnosis was missed during the initial evaluation? I know that no one on DCUM can tell me whether or not my son has DS, but any kind of insight based on personal experience would be helpful.

[Anonymous]

OP again. Sorry for all the typos!

[Anonymous]

I think its less likely that a diagnosis was missed than maybe there is a diagnosis that is not appropriate yet - or maybe not, as it could pass. My son is very, very similar in behaviors, but he has speech and fine motor delays. The dev ped thinks we are looking at ADHD down the road. He was premature. Delays often cause things that look like autism. My son has a lot of joint attention - look at me, this, help me, come here, play with me, all day long - and is very social and engaging and affectionate and has a ton of empathy, and is very socially motivated/excited, which is why autism was ruled out. He had very limited pretend play until he was almost 4. In our case, our son has regulation/attention/hyperactive issues that make him unable to calm down and focus. This sounds more like what is going on with your child than autism. I think if no delays have been noted, I would wait a little.

[Anonymous]

The only thing that sounds remotely concerning is the not responding to his name. Otherwise, it seems age appropriate to have a favorite toy, especially since it sounds like he's playing with it appropriately.

How are his interactions with peers? His expressive and receptive language?

[Anonymous]

You posted before. Please get him checked out for seizures. Other than that none of what you are noting sounds like and ASD. And ASD is a deficit in social communication skills that causes at least significant interferes with functioning. You already had one complete evaluation that cleared him. But there are types of epilepsy that can look like regressive autism.

[Anonymous]

Anonymous wrote:The only thing that sounds remotely concerning is the not responding to his name. Otherwise, it seems age appropriate to have a favorite toy, especially since it sounds like he's playing with it appropriately.

How are his interactions with peers? His expressive and receptive language?

OP here. He understands everything, speaks well, has big vocabulary, great articulation, etc. but his speech is not quite conversational. For example, I will ask, "how was school today?" he might respond, "it was great mom." if I follow up with "what did you do?" I hear crickets. He is able to tell us when he's mad, or frustrated, etc. sometimes before a tantrum, sometimes after.

Most of his time around other children is at daycare, but as far as I know, his peer interactions are fine. He has a best friend at daycare that he loves and gets very excited to see outside of daycare on the rare occasion, but beyond that, has few consistent play dates. On the playground, he always seek out and find one kid that he will follow around and imitate. BUT, he's known to be pushy and territorial sometimes too, say, when we visit the train display at our local bookstore.

I forgot to mention in my original post that he often repeats phrases he hears from his favorite cartoons. Sometimes we'll ask him where he heard [whatever statement he made] and he will tell us which cartoon.

[Anonymous]

Anonymous wrote:You posted before. Please get him checked out for seizures. Other than that none of what you are noting sounds like and ASD. And ASD is a deficit in social communication skills that causes at least significant interferes with functioning. You already had one complete evaluation that cleared him. But there are types of epilepsy that can look like regressive autism.

Yes, I did post before, and yes, I am working to tease out possible medical issues -- it's a slow going process. I think my anxiety is growing the longer it's taking to figure out the sleep issues -- and as my anxiety grows, my mind reaches for the worst possible scenario. Not to suggest that ASD is the end of the world. But still. And yes, I know this is not healthy.

[Anonymous]

I would get him an evaluation at Children's Center for Autism Spectrum Disorders:

http://childrensnational.org/departments/center-for-autism-spectrum-disorderscasd

Specifically for ADOS/ADI-R, which is considered the gold standard for diagnosing ASDs.

Your son sounds a lot like my son who was diagnosed with Aspergers's when he was 4. At this age, it isn't so much the social communication issues (parallel play is still considered OK) but the repetitive behaviors and obsessive interests that got DS diagnosed with ASD.

DS is 8 now and was also diagnosed with ADHD, combined type, at 7 through a full neuropsych eval but the ASD/Asperger's type diagnosis at 4 was spot on.

Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:You posted before. Please get him checked out for seizures. Other than that none of what you are noting sounds like and ASD. And ASD is a deficit in social communication skills that causes at least significant interferes with functioning. You already had one complete evaluation that cleared him. But there are types of epilepsy that can look like regressive autism.

Yes, I did post before, and yes, I am working to tease out possible medical issues -- it's a slow going process. I think my anxiety is growing the longer it's taking to figure out the sleep issues -- and as my anxiety grows, my mind reaches for the worst possible scenario. Not to suggest that ASD is the end of the world. But still. And yes, I know this is not healthy.

what are the sleep issues? This does not sound like ASD to me or even like there is any issue at all. Sorry to be dismissive but -he likes cars? he likes certain kinds of pretend play? What exactly is the concern here.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The only thing that sounds remotely concerning is the not responding to his name. Otherwise, it seems age appropriate to have a favorite toy, especially since it sounds like he's playing with it appropriately.

How are his interactions with peers? His expressive and receptive language?

OP here. He understands everything, speaks well, has big vocabulary, great articulation, etc. but his speech is not quite conversational. For example, I will ask, "how was school today?" he might respond, "it was great mom." if I follow up with "what did you do?" I hear crickets. He is able to tell us when he's mad, or frustrated, etc. sometimes before a tantrum, sometimes after.

Most of his time around other children is at daycare, but as far as I know, his peer interactions are fine. He has a best friend at daycare that he loves and gets very excited to see outside of daycare on the rare occasion, but beyond that, has few consistent play dates. On the playground, he always seek out and find one kid that he will follow around and imitate. BUT, he's known to be pushy and territorial sometimes too, say, when we visit the train display at our local bookstore.

I forgot to mention in my original post that he often repeats phrases he hears from his favorite cartoons. Sometimes we'll ask him where he heard [whatever statement he made] and he will tell us which cartoon.

This all sounds like normal 3 year old behavior. He sounds on track socially. I just don't see any signs of an asd here. It is your anxiety most likely.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The only thing that sounds remotely concerning is the not responding to his name. Otherwise, it seems age appropriate to have a favorite toy, especially since it sounds like he's playing with it appropriately.

How are his interactions with peers? His expressive and receptive language?

OP here. He understands everything, speaks well, has big vocabulary, great articulation, etc. but his speech is not quite conversational. For example, I will ask, "how was school today?" he might respond, "it was great mom." if I follow up with "what did you do?" I hear crickets. He is able to tell us when he's mad, or frustrated, etc. sometimes before a tantrum, sometimes after.

Most of his time around other children is at daycare, but as far as I know, his peer interactions are fine. He has a best friend at daycare that he loves and gets very excited to see outside of daycare on the rare occasion, but beyond that, has few consistent play dates. On the playground, he always seek out and find one kid that he will follow around and imitate. BUT, he's known to be pushy and territorial sometimes too, say, when we visit the train display at our local bookstore.

I forgot to mention in my original post that he often repeats phrases he hears from his favorite cartoons. Sometimes we'll ask him where he heard [whatever statement he made] and he will tell us which cartoon.

All of that sounds totally nor,al for 3 year olds.

Asking "what did you do" is too broad of a question for 3 year olds, and even much older kids. Try asking, "which center did you go to" or "who did you drive cars with" or "what did you have for snack" or something that is narrow enough for a young child to understand.

[Anonymous]

All of that is very normal. My son is not autistic and is also obsessed with cars, demands we play in a certain way etc. My best friend's son is autistic and nothing you describes sounds like him.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The only thing that sounds remotely concerning is the not responding to his name. Otherwise, it seems age appropriate to have a favorite toy, especially since it sounds like he's playing with it appropriately.

How are his interactions with peers? His expressive and receptive language?

OP here. He understands everything, speaks well, has big vocabulary, great articulation, etc. but his speech is not quite conversational. For example, I will ask, "how was school today?" he might respond, "it was great mom." if I follow up with "what did you do?" I hear crickets. He is able to tell us when he's mad, or frustrated, etc. sometimes before a tantrum, sometimes after.

Most of his time around other children is at daycare, but as far as I know, his peer interactions are fine. He has a best friend at daycare that he loves and gets very excited to see outside of daycare on the rare occasion, but beyond that, has few consistent play dates. On the playground, he always seek out and find one kid that he will follow around and imitate. BUT, he's known to be pushy and territorial sometimes too, say, when we visit the train display at our local bookstore.

I forgot to mention in my original post that he often repeats phrases he hears from his favorite cartoons. Sometimes we'll ask him where he heard [whatever statement he made] and he will tell us which cartoon.

That sounds like an expressive language disorder and/or receptive.

His behavior sounds pretty normal for his age. His language does not. I'd have him evaluated by a speech clinic and see what they say.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The only thing that sounds remotely concerning is the not responding to his name. Otherwise, it seems age appropriate to have a favorite toy, especially since it sounds like he's playing with it appropriately.

How are his interactions with peers? His expressive and receptive language?

OP here. He understands everything, speaks well, has big vocabulary, great articulation, etc. but his speech is not quite conversational. For example, I will ask, "how was school today?" he might respond, "it was great mom." if I follow up with "what did you do?" I hear crickets. He is able to tell us when he's mad, or frustrated, etc. sometimes before a tantrum, sometimes after.

Most of his time around other children is at daycare, but as far as I know, his peer interactions are fine. He has a best friend at daycare that he loves and gets very excited to see outside of daycare on the rare occasion, but beyond that, has few consistent play dates. On the playground, he always seek out and find one kid that he will follow around and imitate. BUT, he's known to be pushy and territorial sometimes too, say, when we visit the train display at our local bookstore.

I forgot to mention in my original post that he often repeats phrases he hears from his favorite cartoons. Sometimes we'll ask him where he heard [whatever statement he made] and he will tell us which cartoon.

That sounds like an expressive language disorder and/or receptive.

His behavior sounds pretty normal for his age. His language does not. I'd have him evaluated by a speech clinic and see what they say.

I don't think so. He is 3.5. Most of them quote their favorite shows and have a hard time responding to open ended questions like that.

[Anonymous]

^^ also, he has been - see her original post - and no issues were noted.