How do you help a friend who in denial that her twins are totally ASD?

[Anonymous]

Can I just chime in with an answer that might help op and the whole situation

Op - what you want by intervening is for the kids to get therapy yes? (No other good reason to do so)
The kids don’t necessarily need a specific dx to get therapy. Mine has has ot for years with no specific dx (he has adhd but we had ot from before that). He also had play therapy (bc he had no impulse control and rampaged around). The only treatment for asd is therapy. So why don’t you talk to your friend and say look you don’t need an eval to just do therapy. Do all the things bc it’s an insurance policy.
You can say this very strongly and it will help the kids and is a win win. Just more expensive for her but maybe she doesn’t care.
I have always thrown therapy at my kid assuming he has all the things bc there is disagreement about his dx. Worst case scenario they need less and she pulls back (this happened to us recently once we put him on meds). So that’s how you can intervene

[Anonymous]

Anonymous wrote:A friend of mine was in complete denial over her son's autism. It was obvious to everyone, He was flapping, the whole 9. Well she finally got the memo and got the kid the help he needed. He's now at Columbia. He's still a little weird but functional enough to be at an Ivy League university. I think it's the existing stigma and shame that prevent parents from wanting to see what's right in front of them.

Wow I mean I wonder where the shame comes from? Maybe by close friends labeling their child as weird?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

ALL adults have a duty of care towards ALL children. Sometimes it's worth jeopardizing a friendship when a child's wellbeing is at stake. The worst that can happen is the loss of the friendship. I agree that teachers will generally not say a word until it is past time, otherwise they can lose their jobs. And to people who don't know this, early intervention is KEY to helping children with ASD, ADHD and related issues, so there is some urgency to the diagnosis and treatment.


I have spoken my mind to certain people, OP, when confronted with similar situations. It went well, because I am a research scientist who has done a lot of work on ADHD and autism, and I myself have a child with HFA/ADHD, and therefore I have some standing and I know how to talk about it. The people I spoke to are still my friends, and all but one sought care. The one who didn't has a father in terrible denial, who shouted at the psychiatrist when the mother made an appointment and who has systematically shut down any attempt to get his child help. It's sad. Now the child is "homeschooled", because all the schools they've attended "did not support" the child, according to the parents. This illustrates that after saying your piece clearly, you're done. You can't keep insisting. We still socialize with this family.

Just out of curiosity, what do you recommend as early intervention for ADHD?

It depends on the exact diagnosis and whether learning disabilities or other issues are suspected. For severe cases:
Since psychiatrists are loathe to medicate very young children unless all other avenues have been explored, parents have to accommodate their child has much as possible by changing the environment to give them as much time as possible before medication becomes inevitable. This usually means finding a preschool that can cater to other students' safety and wellbeing while corralling a hyperactive child; or for inattentive ADHD, finding a structured environment where the child doesn't get lost in the shuffle and can be encouraged to participate. Usually, both types of children have to be taught explicitly how to socialize appropriately. Social skills groups organized by psychologists' practices can be very helpful. Parental education is critical! The home environment has to play to the child's strength, and lead to positive reinforcement for things they do well, with firm boundaries and checks and balances to increase self-regulation. In elementary, medication is usually the best line of defense, because it allows the child's brain to focus just enough so that they can absorb rules, avoid learning gaps and have enough observational skills and body/mind control to make friends.

ADHD is often comorbid with learning disabilities (dyslexia, dyscalculia) or other disorders (anxiety, ASD) and these need to be addressed as well. The school can offer services and accommodations, such as scribing, dictation, preferential seating, repeated directions, use of a calculator, pull-out help for writing and scaffolding of writing tasks, group speech therapy, extra time on tests, etc, if parents request a 504 or an IEP and provide the neuropsychological report as evidence. This is crucial for school success, and goes hand-in-hand with stimulant use. Patients with severe ADHD need both school accommodations and stimulants to avoid school failure and depression.

[Anonymous]

Anonymous wrote:

Anonymous wrote:A friend of mine was in complete denial over her son's autism. It was obvious to everyone, He was flapping, the whole 9. Well she finally got the memo and got the kid the help he needed. He's now at Columbia. He's still a little weird but functional enough to be at an Ivy League university. I think it's the existing stigma and shame that prevent parents from wanting to see what's right in front of them.

Wow I mean I wonder where the shame comes from? Maybe by close friends labeling their child as weird?

Some people are just weird. If you can't accept that, maybe it's you who needs the therapy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:A friend of mine was in complete denial over her son's autism. It was obvious to everyone, He was flapping, the whole 9. Well she finally got the memo and got the kid the help he needed. He's now at Columbia. He's still a little weird but functional enough to be at an Ivy League university. I think it's the existing stigma and shame that prevent parents from wanting to see what's right in front of them.

Wow I mean I wonder where the shame comes from? Maybe by close friends labeling their child as weird?

Ha! My son has Asperger's and he is WEIRD. I say this with love. It's a totally acceptable term, when all the other alternatives are... offensive.

[Anonymous]

Anonymous wrote:Can I just chime in with an answer that might help op and the whole situation

Op - what you want by intervening is for the kids to get therapy yes? (No other good reason to do so)
The kids don’t necessarily need a specific dx to get therapy. Mine has has ot for years with no specific dx (he has adhd but we had ot from before that). He also had play therapy (bc he had no impulse control and rampaged around). The only treatment for asd is therapy. So why don’t you talk to your friend and say look you don’t need an eval to just do therapy. Do all the things bc it’s an insurance policy.
You can say this very strongly and it will help the kids and is a win win. Just more expensive for her but maybe she doesn’t care.
I have always thrown therapy at my kid assuming he has all the things bc there is disagreement about his dx. Worst case scenario they need less and she pulls back (this happened to us recently once we put him on meds). So that’s how you can intervene

Thanks for the feedback, it's helpful. Unfortunately I said something to that effect, like "some kids just need therapy to master some skills" framing it as a net positive; she genuinely didn't see a need for any supplementary help, as if it would be some huge redundancy and complete waste of time. It was at that point I realized the denial was thick and that it ran deep. Without revealing too much info, her girls had preexisting medical problems for which they received care and it seems since that has resolved she doesn't want to revisit the issue of them needing anymore "help." Finances are also an issue. I'm also of the type that will throw everything at my kid in hopes that something sticks/works; she is more of the opposite, low intervention approach. But I appreciate the constructive reply.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Can I just chime in with an answer that might help op and the whole situation

Op - what you want by intervening is for the kids to get therapy yes? (No other good reason to do so)
The kids don’t necessarily need a specific dx to get therapy. Mine has has ot for years with no specific dx (he has adhd but we had ot from before that). He also had play therapy (bc he had no impulse control and rampaged around). The only treatment for asd is therapy. So why don’t you talk to your friend and say look you don’t need an eval to just do therapy. Do all the things bc it’s an insurance policy.
You can say this very strongly and it will help the kids and is a win win. Just more expensive for her but maybe she doesn’t care.
I have always thrown therapy at my kid assuming he has all the things bc there is disagreement about his dx. Worst case scenario they need less and she pulls back (this happened to us recently once we put him on meds). So that’s how you can intervene

Thanks for the feedback, it's helpful. Unfortunately I said something to that effect, like "some kids just need therapy to master some skills" framing it as a net positive; she genuinely didn't see a need for any supplementary help, as if it would be some huge redundancy and complete waste of time. It was at that point I realized the denial was thick and that it ran deep. Without revealing too much info, her girls had preexisting medical problems for which they received care and it seems since that has resolved she doesn't want to revisit the issue of them needing anymore "help." Finances are also an issue. I'm also of the type that will throw everything at my kid in hopes that something sticks/works; she is more of the opposite, low intervention approach. But I appreciate the constructive reply.

I think if she feels this way then she is def not going to be receptive to getting them evaluated. Therapy is way easier to do than evaluation for someone with overall anxiety.
Op I don’t think that beyond encouraging therapy there is much you can or should do. She needs to feel Hope though. She is prob scared! We are all scared for our kids a lot if not all of the time. The best gift you can give her is hope. Like saying ‘I spoke to someone recently who said ot or speech therapy was so wonderful for their child and now the kid is making more friends and so happy in school’. She just needs to feel motivated by hope

[Anonymous]

Anonymous wrote:Honestly, it took us forever to get an ASD diagnosis, and I really wish our kids' teachers would have brought this up. We had suspicions but were always dismissed by our ped, and our DS is very adept at masking, so it was hard to know because he is our first, and we didn't know that much about HFA and how it presents. I'm still actually very angry at the teachers at our fantastic preschool who SHOULD have brought this up. We didn't get a diagnosis until 4th grade.

+1 I had a toddler gymnastics teacher point out some things that led to her getting diagnosed with HFA, and thus treatment started right away. I was angry at the teacher at the time, but now I am grateful that she did.

[Anonymous]

Anonymous wrote:Maybe you could monetize this, OP. Follow people around on the playground, present a diagnosis, and then tell them they owe you $100.

Brilliant. Thanks for the laugh.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This seems like more of an eccentric twin thing than an autism spectrum thing.

Honestly OP, you are out of your lane, and thought I suppose you mean well you are not informed, you opinion is not wanted, and knowing this woman "for a year" is negligible.

See, the thing is, my opinion IS wanted. It was asked for, repeatedly, actually. And to reiterate: I never told my friend that I thought her kids were autistic. Nor did I bring it up without being asked. I simply told her that it SOUNDED LIKE the teacher was suggesting she thought the girls were on the spectrum based on the comments she made. The teacher suggested they be evaluated and I, upon being asked, told MY FRIEND it would be a useful exercise in getting more info if in fact the teacher doesn't know what the f she's talking about. Therapy and an evaluation can only help a child, IN MY OPINION. Prior to this convo with the teacher, I had always thought the girls were ASD and was actually surprised they were admitted into the school in the first place. And no, I never said any of this to her. But after talking with her it's become apparent to me how utterly in denial she is and it's truly to the detriment of her kids. But I get it, we can't face what we're not ready to see.

So yeah, continue on with the belief that I'm a piece of shit busybody non-friend who offers unsolicited diagnoses that I'm unqualified to give because I dared to ask a question on an ANONYMOUS FORUM.

And for the record, we don't even live in the DMV area, so the idea that I'm divulging protected info and compromising their privacy is off-base.

You are a busybody and you told her that it was ASD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The responses to this query seem a bit unhinged. This woman is absolutely my friend and I've spent enough time with her and her children to be confident about "my diagnosis." We've been friends for almost a year and I regularly see her for playdates and to get out of the house. I never mentioned anything to her until she brought it up TO ME after the preschool teacher mentioned it; in the back of my mind I always knew it would come up and when the teacher mentioned it I was surprised by her complete denial.

I'm sorry, but the other adults around a child DO have a duty to them, to a certain extent. I'm not going to mention it to her unless she brings it up first but I was a little surprised when this other preschool apparently had no issue with them and their obvious developmental disorder. I just got the vibe that the school wanted their money and would flag the issue later, after the check cleared.

You seem really up there on your own supply. We are criticizing you because you are ridiculously self-confident, and aren't appearing to approach this at all like a real friend would. Has she confided in you about concerns other than what the teacher mentioned? Have you asked generally about how her twins are enjoying preschool and what they respond to the most? What do you actually know about your "friend's" access to resources and professionals? None of our responses have been unhinged.

Yes, we had a conversation on the phone for almost 2 hours about it. I never said shit, just said that if it were my son I would want to pursue an evaluation just to get data and then decide how to proceed, to see it as a sort of "Second opinion" from the preschool teacher.

But whatever, interpret me however you'd like, it's ultimately irrelevant to the question since the big answer here has been "shut up and do nothing." So, noted.

Read your post. You did say it and then you are publicly criticizing her for not doing what you say. Imagine if she see's this. I hope she dumps you as a friend.

Opinions of most preschool teachers are useless.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The responses to this query seem a bit unhinged. This woman is absolutely my friend and I've spent enough time with her and her children to be confident about "my diagnosis." We've been friends for almost a year and I regularly see her for playdates and to get out of the house. I never mentioned anything to her until she brought it up TO ME after the preschool teacher mentioned it; in the back of my mind I always knew it would come up and when the teacher mentioned it I was surprised by her complete denial.

I'm sorry, but the other adults around a child DO have a duty to them, to a certain extent. I'm not going to mention it to her unless she brings it up first but I was a little surprised when this other preschool apparently had no issue with them and their obvious developmental disorder. I just got the vibe that the school wanted their money and would flag the issue later, after the check cleared.

You’re being really really unkind about these children and that’s driving the comments. You refer to them as “humping” playground equipment and as having an “obvious developmental disorder” and just generally sound incredibly full of dislike and distaste for these poor kids. It’s disturbing. Look, they’re 4. They’ll go to kindergarten in a year and the teacher will have to bring it up if necessary. Kids with developmental disorders that impair their development to the point they can’t function are placed in special education. So, why don’t you just leave it? It’s a slow hard path for some people. They’re not missing out on much. If they are autistic, there’s no cure. So calm down.

If there's no cure then why do some kids "recover" and go on to become indistinguishable to their NT peers? You're clearly of the camp that nothing can be done, which is just factually wrong. Do you think ABA is useless? Everyone here is so defensive and projecting their own shit here it's sad.

If kids recover, they were inaccurately diagnosed. ABA is good for some stuff but not for other stuff. You aren't saying any read flags that these kids should get ABA. We tried it and it was a huge waste of time and money despite having a lovely provider. Some kids have delays. Some kids catch up. Some kids surpass their peers later on. Some kids develop more issues. Its just how it goes.

[Anonymous]

Anonymous wrote:So a child can show all the textbook "symptoms" of autism but no one can notice it or talk about it without being "out of their lane" because the adults in the room are too triggered. Got it. The only people who know .001% of the situation are the people commenting here. These kids are textbook but even credentialed professionals should just shut up about it and mind their own business. Makes sense.

So, as a stranger who never met these kids, you can accurately diagnose them as textbook? Wow, that is amazing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This seems like more of an eccentric twin thing than an autism spectrum thing.

Honestly OP, you are out of your lane, and thought I suppose you mean well you are not informed, you opinion is not wanted, and knowing this woman "for a year" is negligible.

See, the thing is, my opinion IS wanted. It was asked for, repeatedly, actually. And to reiterate: I never told my friend that I thought her kids were autistic. Nor did I bring it up without being asked. I simply told her that it SOUNDED LIKE the teacher was suggesting she thought the girls were on the spectrum based on the comments she made. The teacher suggested they be evaluated and I, upon being asked, told MY FRIEND it would be a useful exercise in getting more info if in fact the teacher doesn't know what the f she's talking about. Therapy and an evaluation can only help a child, IN MY OPINION. Prior to this convo with the teacher, I had always thought the girls were ASD and was actually surprised they were admitted into the school in the first place. And no, I never said any of this to her. But after talking with her it's become apparent to me how utterly in denial she is and it's truly to the detriment of her kids. But I get it, we can't face what we're not ready to see.

So yeah, continue on with the belief that I'm a piece of shit busybody non-friend who offers unsolicited diagnoses that I'm unqualified to give because I dared to ask a question on an ANONYMOUS FORUM.

And for the record, we don't even live in the DMV area, so the idea that I'm divulging protected info and compromising their privacy is off-base.

You are a busybody and you told her that it was ASD.

Someone's reading comprehension seems a bit remedial.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The responses to this query seem a bit unhinged. This woman is absolutely my friend and I've spent enough time with her and her children to be confident about "my diagnosis." We've been friends for almost a year and I regularly see her for playdates and to get out of the house. I never mentioned anything to her until she brought it up TO ME after the preschool teacher mentioned it; in the back of my mind I always knew it would come up and when the teacher mentioned it I was surprised by her complete denial.

I'm sorry, but the other adults around a child DO have a duty to them, to a certain extent. I'm not going to mention it to her unless she brings it up first but I was a little surprised when this other preschool apparently had no issue with them and their obvious developmental disorder. I just got the vibe that the school wanted their money and would flag the issue later, after the check cleared.

You’re being really really unkind about these children and that’s driving the comments. You refer to them as “humping” playground equipment and as having an “obvious developmental disorder” and just generally sound incredibly full of dislike and distaste for these poor kids. It’s disturbing. Look, they’re 4. They’ll go to kindergarten in a year and the teacher will have to bring it up if necessary. Kids with developmental disorders that impair their development to the point they can’t function are placed in special education. So, why don’t you just leave it? It’s a slow hard path for some people. They’re not missing out on much. If they are autistic, there’s no cure. So calm down.

If there's no cure then why do some kids "recover" and go on to become indistinguishable to their NT peers? You're clearly of the camp that nothing can be done, which is just factually wrong. Do you think ABA is useless? Everyone here is so defensive and projecting their own shit here it's sad.

A diagnosis may not always be set in stone at a very early age. Some kids may have delays that present as ASD especially receptive language delays, but they grow out of it with time and intervention. Clinicians do not have crystal balls so they will advise parents based on the diagnosis of the moment.