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Kids With Special Needs and Disabilities
How do they diagnose an autism spectrum disorder
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Anonymous
| What about a child who is completely verbal, very smart but prefers to play alone at the age of 5. Does that earn an asd diagnosis today? If not, what diagnosis could it potentially earn? |
Anonymous
| I think there is a big difference between an otherwise normal 5 yr old who prefers to play alone and a child on the spectrum. Is your child able to interact w/ his/her peers and just prefers not to? I used to nanny for a boy like this and while he was able to play with other kids, he liked playing by himself. When I would ask him why, he would say that he doesn't like to play what the other kids play. I am an introvert and remember retreating to my room as a kid and playing w/ my stuffed animals and crayons after playing with other kids. It tired me out. |
Anonymous
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That almost describes my child, when he was four years old. And he did not get an ASD diagnosis. He got a diagnosis of ADHD at Childrens Hosp with a developmental ped. Then he got a diagnosis of social anxiety from a psychologist. Then he got a diagnosis of sensory regulatory disorder from Dr. Greenspan. In my opinion, he's got them all - adhd, social anxiety, and sensory issues.
I bet everyone has their own opinion. DH works with autistic children. And he says that autistic children have difficulty with that intimate exchange with others. A nonverbal child who has language delay might still not be ASD if she can engage in gestural exchanges intimately with another person....a wink and a smile from a caregiver yielding a smile or exuberance or some positive reaction frequently from a child. It's the affect they seem to have difficulty with, reading that affect even in their loved ones faces and responding because of that affect. Not playing with other children can be due to sensory overload and not autism (though most ASD children have sensory issues too). When we did OT and got a handle on his sensory issues, we found he did indeed want to play with other kids and was able to play with them one on one. |
Anonymous
| A lay person cannot make this diagnosis and shouldn't try. the truism is that if you are concerned, you should get an evaluation. A good evaluation will include long checklists for you and your DC's teacher, at least one office visit (there are scales that are used to diagnose ASDs) and ideally a classroom visit. Its very easy for parents to rationalize away what they see, and to miss critical signs. |
Anonymous
OP here. I'm actually not trying to rationalize anything. Quite the opposite. I've been down the dev ped route, I've been the Greenspan route, I've been down many other routes all in the hopeless search to get a name for this middle ground I'm in. Some doctors really do label any kid with the kind of social delay that mine has as having aspergers or PDD. Others look at how amazingly lively and engaged my child is in a quiet smaller setting and say, "No WAY is she on the spectrum." I'm confused by the lack of clarity on this issue. I think these kids in the middle are a mystery. And I think its a real disservice to parents. |
Anonymous
| 20:27 again. I'm sorry, i didn't mean to say you were in denial. I went through the same run around with my child. One so called expert said he couldn't have an ASD because he related so well to him. yeah, one on one with an adult. It is so frustrating. What I found was that as my son got older, it became increasingly obvious that he was, indeed, on the spectrum. The gap between him and the other children (not just social, he's actually quite social) just grew larger and larger. You'll really know for certain in a few years. Until then, all you can do is treat the symptoms you see (which it sounds like you are). |
Anonymous
| One more thing, Greenspan won't give you a name, especially an ASD. |
Anonymous
Can I ask..where were the gaps most obvious? With my DD, she really gets sensory overload in big settings. When we have a party at home, she'll retreat to her room and tell me flat out, there are too many people here and I'd rather play alone. But most of her differences involves this (sensory overload) and social. |
Anonymous
OP I don't blame you for feeling frustrated with those 'in between kids'. My kid is an inbetween kid and he's not ASD. He's got motor planning issues, sensory issues, and is behind socially. Kids who can relate one on one but not in a group setting are not ASD in my opinion. It just means they get sensory overload and can't relate in group settings. Get an ASD one on one and you still will have a hard time getting a nice gestural or intimate exchange with him going. This is for those who are truly ASD. |
Anonymous
I totally feel your frustration. Not being able to get an answer is incredibly frustrating. We, too, have seen the specialist, do the therapy, etc. We also participate in research, mostly because I'm hopeful they'll see something someone hasn't seen before which will help me better understand what's going on and how to help my kids. I've found the evaluation teams very helpful and informative. Have you thought about participating? Someone recently posted about an NIMH study involving ASD and developmental delays. Two of our kids went through it and it was a very positive experience for them. You might think about it. They can definitely tell you how they diagnose autism and, importantly, it's free.
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Anonymous
| I have a 5 yo boy who is similar but with a PDD diagnosis. I'm not sure how valid it is, though. I work in a school where a lot of children have auditory processing disorders and one of the truisms there is that girls are diagnosed much later than boys. The boys are diagnosed in preschool, the girls in upper elementary. Girls tend to present in such a way that it doesn't get picked up. Possibly something like that is going on. |
Anonymous
| I notice the gap between my son and other children mostly in school settings. Also, sometimes when I see other children -- in a store of a restaurant -- it hits me how different they are than my son. |
Anonymous
| Haven't read all the posts. A dev ped is the best way to go IMO. What was the early history like? Often with autism spectrum you see things like delayed pointing, delayed/lack of or poor pretend play, late to turn to name, late to use the terms "mom" and "dad", late to wave bye bye, motor planning issues, pincer grasp delays, poor social conversation abilities, etc. Also those on the spectrum can be either hyper-responsive early on (easily over stimulated) or hypo-responsive (the easy baby who rarely cries and seems passive). Echolalia is another concern. Those are just some of the big red flags early on and you only need a few to start to suspect ASD. |
Anonymous
Read the earlier posts. this is not at all the situation the OP is in. |
Anonymous
OP: There is no "disease" ASD...there is huge variation. Thus the emphasis on a "spectrum" -- and a message to you that there is no clarity....there is a massive gray area because we are all somewhere on there. I kindly and sympathetically suggest you think about why you want clarity here. Are you really trying to ask "Is there something wrong with my child?" That is a different question than a diagnosis....particularly one as vague as ASD. ASD tells me nothing. I listen to aspergers people unable to function in public...and to label a small child as having asperger's because he does not engage well in large groups is a disservice to that child. The lack of clarity is because there is a lack of clarity. There is no dividing line....many children have autism-like traits and will grow up to be happy, productive members of society. Think about your child and what it is that you think might prevent him from having a happy productive life. Many of these children who have these traits might be helped with gentle interventions...others might be better off if we celebrate and accept differences. We are all wired differently. What you describe here, at least, is a "personality" and not a disorder. When some aspect of your child's personality begins to interfere with his social development, then you could address that. My $0.02. |