Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

If you don't mind me asking, what treatment is available for mild ASD? Other than socialization therapy (people might not be interested in hearing you talk about earthworms/LEGOs/Trains/insects/spaceships/human body all the time), I'm not sure what else he needs. I think my position is that the teacher's concerns are more of "let's test to rule it out", and less "these are the problems I see and let's get on them now". IF he was having serious issues I would be first in line to try to get some more testing done. Since the only issues are likes to talk about a few topics, and has a handful of friends at school... I'm not seeing the problem I guess?

op

have you ever heard the saying little kids, little problems, big kids, big problems? social issues become much more important, nuanced and complicated as kids age, and he will need to keep up. Even things like understanding from tone of voice when to do something a certain way or understanding customs and mores - don't underestimate the huge import of that stuff. It will also be harder for him to make friends as his issues become more noticeable, meaning as the other kids advance more socially. How do you know its "mild" also? The fact that you had a speech delay is a little worrying because most kids with HFA or Aspies do not have speech issues - so you will want to rule out the other comorbidities. Also, kids with autism are more likely to have seizures - like a lot more - LDs, ADHD, etc etc etc so you want to be watching for that stuff. Just all things you will want to know about.

My son has never had seizures, but thanks for the tip. I get what you're saying but I'm not seeing it with him.

Thanks for the advice!

My son had speech issues because of a physical problem with his tongue, so I'm not sure if that's related to ASD. Of course it might be.

I am still not very concerned about him. I don't think I'm going to do anything until the fall at the earliest. But I think it's good to know that there are long wait lists so I might want to put myself on one of those.

OP

Anonymous wrote:Really appreciate the advice so far. To be clear we are going to test next fall if issues continue.

Op

I would see a developmental pediatrician b/c you can get insurance coverage vs. a neuropsych evaluation, but check with your insurance. I'd get on a waitlist at Kennedy Krieger and Childrens and just take the first appointment that comes up and cancel the other. They look at the whole picture and a lot things can be the source for the behavior you described.

The early intervention services don't really diagnose kids. Your kid may not have qualified for speech services, but it doesn't mean that he doesn't have some expressive or receptive speech issues going on.

Anonymous wrote:

Anonymous wrote:I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

If you don't mind me asking, what treatment is available for mild ASD? Other than socialization therapy (people might not be interested in hearing you talk about earthworms/LEGOs/Trains/insects/spaceships/human body all the time), I'm not sure what else he needs. I think my position is that the teacher's concerns are more of "let's test to rule it out", and less "these are the problems I see and let's get on them now". IF he was having serious issues I would be first in line to try to get some more testing done. Since the only issues are likes to talk about a few topics, and has a handful of friends at school... I'm not seeing the problem I guess?

op

have you ever heard the saying little kids, little problems, big kids, big problems? social issues become much more important, nuanced and complicated as kids age, and he will need to keep up. Even things like understanding from tone of voice when to do something a certain way or understanding customs and mores - don't underestimate the huge import of that stuff. It will also be harder for him to make friends as his issues become more noticeable, meaning as the other kids advance more socially. How do you know its "mild" also? The fact that you had a speech delay is a little worrying because most kids with HFA or Aspies do not have speech issues - so you will want to rule out the other comorbidities. Also, kids with autism are more likely to have seizures - like a lot more - LDs, ADHD, etc etc etc so you want to be watching for that stuff. Just all things you will want to know about.

Anonymous wrote:

Anonymous wrote:I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

If you don't mind me asking, what treatment is available for mild ASD? Other than socialization therapy (people might not be interested in hearing you talk about earthworms/LEGOs/Trains/insects/spaceships/human body all the time), I'm not sure what else he needs. I think my position is that the teacher's concerns are more of "let's test to rule it out", and less "these are the problems I see and let's get on them now". IF he was having serious issues I would be first in line to try to get some more testing done. Since the only issues are likes to talk about a few topics, and has a handful of friends at school... I'm not seeing the problem I guess?

op

People underestimate what kind of supports are needed for kids with "mild ASD" because they usually do not have academic issues. My son does not and excels academically but he gets 20 hrs of Sp Ed support for social communication issues and 8 hr a month for social skills classes, pragmatic speech therapy and OT for fine motor issues - currently typing speed. The Sp Ed support means that there is a Sp Ed teacher in the classroom to help with any issues that may come up. DS has always been fully mainstreamed at his current school which is the only school he has ever attended with the bonus that he started at the school with the mostly same group of kids since prek4... but there are over 100 kids in his class so plenty of kids to be friends with.

I want my kid to have friends including a best friend at school, not bullied or picked on, be a full participant and not a kid out by himself in the sidelines and to love going to school. He gets all that with the supports he has.

It is difficult to provide high level academics with social supports. There is exactly one school, Auburn, in this area that integrates a social skills curriculum with high level differentiation.

IF your son has ASD, it is better to know sooner. Finding a school willing and able to provide the social supports (and the social curriculum) that a child with mild ASD needs is hard. Better to start looking now.

Anonymous wrote:

Anonymous wrote:I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

If you don't mind me asking, what treatment is available for mild ASD? Other than socialization therapy (people might not be interested in hearing you talk about earthworms/LEGOs/Trains/insects/spaceships/human body all the time), I'm not sure what else he needs. I think my position is that the teacher's concerns are more of "let's test to rule it out", and less "these are the problems I see and let's get on them now". IF he was having serious issues I would be first in line to try to get some more testing done. Since the only issues are likes to talk about a few topics, and has a handful of friends at school... I'm not seeing the problem I guess?

op

Depends on the issues - often speech therapists are used to help develop pragmatic conversation skills. That's possible in a school setting if there is a documented disability. Otherwise you might get some informal social skills group work if the school psychologist hs some time, or the classroom teacher will try to help model better interactions. But if it's ASD then you would typically need to do much more direct instruction with a child to see a difference, not just modeling.

Anonymous wrote:

Anonymous wrote:I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

If you don't mind me asking, what treatment is available for mild ASD? Other than socialization therapy (people might not be interested in hearing you talk about earthworms/LEGOs/Trains/insects/spaceships/human body all the time), I'm not sure what else he needs. I think my position is that the teacher's concerns are more of "let's test to rule it out", and less "these are the problems I see and let's get on them now". IF he was having serious issues I would be first in line to try to get some more testing done. Since the only issues are likes to talk about a few topics, and has a handful of friends at school... I'm not seeing the problem I guess?

op

And btw I think it's a credit to the school that they're willing to screen in the first place.

Anonymous wrote:I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

If you don't mind me asking, what treatment is available for mild ASD? Other than socialization therapy (people might not be interested in hearing you talk about earthworms/LEGOs/Trains/insects/spaceships/human body all the time), I'm not sure what else he needs. I think my position is that the teacher's concerns are more of "let's test to rule it out", and less "these are the problems I see and let's get on them now". IF he was having serious issues I would be first in line to try to get some more testing done. Since the only issues are likes to talk about a few topics, and has a handful of friends at school... I'm not seeing the problem I guess?

op

I would do ADOS/ADI-R which only tests for ASD and is the gold standard. 4 is too young for a Neuropsych eval.

My son had zero issues until he entered prek and his teacher pointed out that there maybe issues. DS was diagnosed with ASD/Asperger's at 4 and got an IEP.

He is doing great in 3rd grade at a language immersion school. Has lots of friends and loves school.

If it turns out that your son has ASD, better to find out now and get him help rather than later.

Really appreciate the advice so far. To be clear we are going to test next fall if issues continue.

Op

Anonymous wrote:

Anonymous wrote:You should consider a full neuropsych testing. A lot of things could be going on, not necessarily HFA. Neuropsych testing uses many different types of tests, so it is more reliable than just the Bayley test alone. Some of these problems won't become fully apparent until 1st grade, but if you can catch them earlier, you can start intervention earlier, which will lead to better outcomes.

Socialization training may or may not help, because the most effective training is tailored to the child's diagnosis and individual profile.

Neuropsych testing isn't done on 4 year olds, is it? Plus it costs thousands of dollars.

Also, I'm not sure there's a ton of evidence on the importance of early interventions here, where there do not seem to be any severe issues and the mom's gut feeling is that things are ok.

It's not unreasonable to "wait and see" if the kid seems to be functioning.

I will say that Montessori might not be the best environment for a shy kid who needs more support, however.

PP here. I agree it is not unreasonable to wait. You can do neuropsych testing on a four year old, but you are right, the results are not as reliable as if done later.

I am thinking about my own experience where the preschool identified some issues, but we felt everything was okay and did not react. As soon as first grade started, a lot of issues became obvious, and in retrospect, we thought maybe that preschool teacher was right. We now wish we had done things differently, but you may be right that it would not have made a difference.

Anonymous wrote:You should consider a full neuropsych testing. A lot of things could be going on, not necessarily HFA. Neuropsych testing uses many different types of tests, so it is more reliable than just the Bayley test alone. Some of these problems won't become fully apparent until 1st grade, but if you can catch them earlier, you can start intervention earlier, which will lead to better outcomes.

Socialization training may or may not help, because the most effective training is tailored to the child's diagnosis and individual profile.

Neuropsych testing isn't done on 4 year olds, is it? Plus it costs thousands of dollars.

Also, I'm not sure there's a ton of evidence on the importance of early interventions here, where there do not seem to be any severe issues and the mom's gut feeling is that things are ok.

It's not unreasonable to "wait and see" if the kid seems to be functioning.

I will say that Montessori might not be the best environment for a shy kid who needs more support, however.

Also the Bayley test is only good for children up to 42 months of age.

You should consider a full neuropsych testing. A lot of things could be going on, not necessarily HFA. Neuropsych testing uses many different types of tests, so it is more reliable than just the Bayley test alone. Some of these problems won't become fully apparent until 1st grade, but if you can catch them earlier, you can start intervention earlier, which will lead to better outcomes.

Socialization training may or may not help, because the most effective training is tailored to the child's diagnosis and individual profile.

It's a Montessori school so the teacher will be the same until kindergarten. He changes teachers in 2018 when he begins 1st grade. Teacher pushed for eval for reasons stated above. It is more of a "just in case" testing which Id be all for but my gut is telling me to slow down.

Am very curious about other diagnosis he might have, but I think they would only be testing him for ASD. Could they suggest some other diagnosis? Is the Bayley test inappropriate for ASD diagnosis?

Op