Reply to can you have multiple diagnoses? say ADD, Language disorder and Auditory Processing disorder

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[quote=Anonymous]OP, my child has auditory processing problems, a language disorder, and ADD/Inattentive, but most definitely is NOT autistic  or on the autistic spectrum in any way.  The way you describe how your nephew's verbal expressive weaknesses make social interaction hard for him is much more consistent with Mixed Expressive/Receptive Language Disorder (MERLD) than autism, IMO.  The lack of expressive narrative imaginative play is exactly like my child.  That lack of play, IME, has not only social impacts, but later language impacts.  For example, if you do not have a lot of imaginative verbally narrated play as a child, you are not practicing expressive speech as much nor are you learning how to organize a story, etc.  So, at a later age, when these skills are expected, the child is not at a normal developmental point.

IME, a very good speech/langauge assessment can tease out the underlying language problems, but schools are not really well qualified to do this.  Nor is a developmental pediatrician or psychiatrist or psychologist.  These all give just the most general overviews of language development.

Who gave the PDD-NOS diagnosis?  Did that come from the school system?  Schools are reluctant to code for anything more specific than PDD below age 7 (slightly later in some states) unless the diagnosis is very obvious.  This is because the skills needed to clearly diagnose a language disorder (like reading and writing) are not even expected to develop until the 6-8 age window.  Similarly, with ADD, a child generally can't even be tested for ADD reliably before age 6, because the testing relies on skills that the average child won't have until 6 or later.

Has your sister had your nephew evaluated with a full speech and language assessment and full neuropsych (it might be a bit early for the neuropsych, but definitely could be done by age 7) outside of the school system?  If not, this should definitely be done.  Most neuropsychs can make the differential diagnosis between autism and MERLD and ADD, but it will help if there is the fuller speech/language assessment from a SL pathologist to consider while making the diagnosis.

IME, schools are not that well qualified to differentiate between more functional autism and moderate to severe language problems.  They are also often motivated to steer toward the autism diagnosis because many school systems have autism programs whereas they don't have programs for those with serious language disorders.  [/quote]

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