4 year old new autism diagnosis

[Anonymous]

I have a 4 year old boy that has apraxia of speech, and a new autism diagnosis (by developmental pediatrician & also through ADOS test). He has been doing speech therapies through public & private to work on his speech, and the new autism diagnosis is kind of thrown me off. I always know that he has some social delay, but I thought that it is mainly due to his language delay. His pediatrician/daycare teachers(teach him for 1 year)/speech therapist through public & private/family members & friends are all surprised with his new diagnosis because he is so happy, social & interactive. Anyways, now I am confused if he truly has apraxia of speech or not, or his speech delay due to his autism spectrum. And, even the ADOS test doctors tell me that he has a lot of good qualities that hide his autism symptoms, and that is why a lot of people don't think that he is on the spectrum. They say it is difficult to say if he has mild or moderate autism, and he is recommended ABA therapies.

Please tell me something about ABA therapies since it is all new to me. And with autism diagnosis, anyone has experiences if insurance will cover it or not? And, I also want to understand what does that mean he has a lot of good qualities that hide his current autism symptoms, does that mean he will outgrow it or if I don't do anything, the symptoms will show up more obviously when he gets older?

Thank you!

[Anonymous]

Depends on the ABA. It's discrete trial training typically and teaches a child skills.

It does not teach natural language.

ADOS overdiagnoses language delayed children with autism. Did you know that?

[Anonymous]

Anonymous wrote:
Depends on the ABA. It's discrete trial training typically and teaches a child skills.

It does not teach natural language.

ADOS overdiagnoses language delayed children with autism. Did you know that?

Give it a rest, lady. Some kids have autism. You do this every. Single. Time.

[Anonymous]

OP where did you get tested?
I am on the journey to figure things out so far I’ve bee. Given a “maybe ASD” we don’t know yet. It seems weird he can “mask” his ASD if ASD is based on behaviors...

He is still so young everything is an unknown right now. The good thing is insurance will cover more w the dx.

ABA is recommended but reviews vary.

[Anonymous]

Anonymous wrote:OP where did you get tested?
I am on the journey to figure things out so far I’ve bee. Given a “maybe ASD” we don’t know yet. It seems weird he can “mask” his ASD if ASD is based on behaviors...

He is still so young everything is an unknown right now. The good thing is insurance will cover more w the dx.

ABA is recommended but reviews vary.

Ugh wish you could edit once hitting go.

I mean did they explain about the “masking” ASD? That’s very confusing.

[Anonymous]

Anonymous wrote:
Depends on the ABA. It's discrete trial training typically and teaches a child skills.

It does not teach natural language.

ADOS overdiagnoses language delayed children with autism. Did you know that?

Not OP, what do you mean ADOS overdiagnoses ASD? We are taking it in a. Few weeks and they told me it’s supposed to be for nonverbal kids too. Is it not?

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Depends on the ABA. It's discrete trial training typically and teaches a child skills.

It does not teach natural language.

ADOS overdiagnoses language delayed children with autism. Did you know that?

Not OP, what do you mean ADOS overdiagnoses ASD? We are taking it in a. Few weeks and they told me it’s supposed to be for nonverbal kids too. Is it not?

Kids, especially with receptive language issues can have similar traits to ASD. Usually by age 4, kids can continue to have severe language issues and are often labeled ASD, when in a few years a lot of the concerns - social, eye contact, following directions, etc. are resolved once the receptive and expressive language start to come in. At that age its still a bit hard to tell but by 5-6 it is very clear. Its basically a checklist and very subjective.

I did not find ABA at all helpful for language. We had a sweet ABA therapist who tried to work on language but it was not very good when compared to the SLP who specialized in language. ABA is good for actual skills and behavioral issues but not for language, or that was our experience. We didn't have any behavioral issues so it was a bit of a waste for us and we dropped it for more speech.

If you try ABA, interview the therapists to find a good fit. I probably talked to 8-10. Make sure you work with the actual therapist vs. an aide with a therapist overseeing.

[Anonymous]

Anonymous wrote:I have a 4 year old boy that has apraxia of speech, and a new autism diagnosis (by developmental pediatrician & also through ADOS test). He has been doing speech therapies through public & private to work on his speech, and the new autism diagnosis is kind of thrown me off. I always know that he has some social delay, but I thought that it is mainly due to his language delay. His pediatrician/daycare teachers(teach him for 1 year)/speech therapist through public & private/family members & friends are all surprised with his new diagnosis because he is so happy, social & interactive. Anyways, now I am confused if he truly has apraxia of speech or not, or his speech delay due to his autism spectrum. And, even the ADOS test doctors tell me that he has a lot of good qualities that hide his autism symptoms, and that is why a lot of people don't think that he is on the spectrum. They say it is difficult to say if he has mild or moderate autism, and he is recommended ABA therapies.

Please tell me something about ABA therapies since it is all new to me. And with autism diagnosis, anyone has experiences if insurance will cover it or not? And, I also want to understand what does that mean he has a lot of good qualities that hide his current autism symptoms, does that mean he will outgrow it or if I don't do anything, the symptoms will show up more obviously when he gets older?

Thank you!

I'd get a second opinion except if your insurance pays for speech due to ASD vs. language disorder.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Depends on the ABA. It's discrete trial training typically and teaches a child skills.

It does not teach natural language.

ADOS overdiagnoses language delayed children with autism. Did you know that?

Not OP, what do you mean ADOS overdiagnoses ASD? We are taking it in a. Few weeks and they told me it’s supposed to be for nonverbal kids too. Is it not?

NP. It is absolutely for nonverbal kids, too. You select the specific tasks based on the language ability of the child (or adult). It assess quality of communication and social interaction with or without language.

If you have questions, please ask the person giving the ADOS. They know more about it than any parent posting here.

[Anonymous]

Children can absolutely have ASD and apraxia of speech. One doesn’t preclude the other.

[Anonymous]

Anonymous wrote:
Kids, especially with receptive language issues can have similar traits to ASD. Usually by age 4, kids can continue to have severe language issues and are often labeled ASD, when in a few years a lot of the concerns - social, eye contact, following directions, etc. are resolved once the receptive and expressive language start to come in. At that age its still a bit hard to tell but by 5-6 it is very clear. Its basically a checklist and very subjective.

Yes. OP, no one here can know if the ASD diagnosis is correct, or whether your child will outgrow the ASD symptoms or perhaps just learn to mask/compensate for them as he develops.

As for ABA, call your insurance to see what is covered. Coverage and the process (some plans will require preauthorization for ABA, some will only cover ABA from in network providers) will vary.

[Anonymous]

Anonymous wrote:Children can absolutely have ASD and apraxia of speech. One doesn’t preclude the other.

Not only does one not preclude the other, apraxia and ASD often go hand in hand. The frequency of CAS among kids with ASD is much higher than in the general population.

https://leader.pubs.asha.org/doi/10.1044/leader.RIB1.20092015.18

[Anonymous]

Op as a fellow parent of a 4yo who presents similarly, I’m following. We have an appointment in April and might walk out with an ASD diagnosis. Interested to learn more about ABA therapy and the other questions you posed.

[Anonymous]

Anonymous wrote:Op as a fellow parent of a 4yo who presents similarly, I’m following. We have an appointment in April and might walk out with an ASD diagnosis. Interested to learn more about ABA therapy and the other questions you posed.

Wow PP, same exact situation here! Following too. As far as insurance coverage for ABA, many states have mandates for that (I'm in FL and it's mandated coverage) but BCBS Federal only covers ABA with an autism diagnosis-frustrating for me as my dd has been recommended it due to her diagnosed delay in potty training, but it isn't covered as we don't have a diagnosis yet and have had a long wait for the eval.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Depends on the ABA. It's discrete trial training typically and teaches a child skills.

It does not teach natural language.

ADOS overdiagnoses language delayed children with autism. Did you know that?

Not OP, what do you mean ADOS overdiagnoses ASD? We are taking it in a. Few weeks and they told me it’s supposed to be for nonverbal kids too. Is it not?

https://www.spectrumnews.org/news/autism-tests-struggle-to-balance-accuracy-and-speed/

Google "ADOS sensitivity and specificity." What you find is the ADOS is very good about correctly identifying that SOMETHING is wrong, but over-identifies ASD as the cause.


Based on the cutoff scores that yield the highest accuracy, or ability to identify autism, the SRS diagnosed children with autism with an accuracy of 94 percent, and the SCQ with an accuracy of 80 percent when compared with the clinical diagnoses. By contrast, the ADI-R accurately diagnosed 98 percent of the children, and the ADOS was 100 percent accurate, the study found.

All of the tests were less specific, however, meaning that they did less well at distinguishing autism from other developmental disorders. The SRS diagnosed 33 of 44 children with other developmental disabilities as having autism and the SCQ misdiagnosed 45 of 50 children. The ADI-R also wrongly diagnosed 33 of 48 children with other developmental disabilities as having autism. The ADOS fared best, misdiagnosing 16 of 57 children.



This is one of many, many articles on the ADOS. So many people here want to use it as a stand-alone test. It's not. Add to that this desire to label everything ASD, partly fueled by the money cycle -- want therapy?? Insurance will only pay for the ASD label -- and you quickly find out as a parent that you need to really focus on what your child needs and not get sucked into the ASD frenzy going on these days.