Anonymous wrote:

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

I was told to stay away from it for my MERLD child by the professionals who saw him.

Now, we DID have a Functional Behavior Assessment done and put in some school supports that modified his behavior there. But full-on ABA is wicked expensive, very time consuming (12 to 15 to 25 hours a week) and doesn't increase receptive language. And the expressive language it produces is often very scripted -- I've witnessed that firsthand with kids who have had intensive ABA.

Really, most MERLD kids don't need ABA. A good behavior support plan, a speech therapist and parents who understand modeling and recasting goes a long way. We saved that ABA money and went on fabulous vacations that truly sparked his conversational language.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Not so. There are many genes with identified links to autism. Many of them are linked to MERLD. My son's 1 deletion related to autism is also related to language disorders like MERLD. In fact, of the children with autism who had it every single one had multiple deletions unlike my child. Many experts have told us MERLD and a few have said autism. I don't care. Autism has gotten us great services and it is well known kids with autism have receptive and expressive delays often. It is also supposed to be standard protocol (as per Wright's law) to make sure kids with HFA get speech and language services. As long as your child gets the speech and language services and other needed interventions I would not get hung up on HFA vs. MERLD since both involve the same delays.

I am not expecting an onslaught of angry MERLD parents. This is my 2 cents and many will probably disagree.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

No, I am not the OP, and no, I am not scared of an autism diagnosis. My 11 year old son has severe ADHD, which given his family and birth history is not surprising, and he *may* additionally be barely on the cusp of Asperger's. I pursued the ADHD label in order to get school services and medication for him. A formal label for Asperger's will not get him the services he needs, so having spent 3.2K on a full neuropsych already, plus daily meds (2K annually), I don't think I need to spend one more cent on an evaluation for Asperger's right now. The psychologist told me the test might come back inconclusive, since he wasn't a clear-cut case.

And, PP, you're quite rude and ignorant.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

No, I am not the OP, and no, I am not scared of an autism diagnosis. My 11 year old son has severe ADHD, which given his family and birth history is not surprising, and he *may* additionally be barely on the cusp of Asperger's. I pursued the ADHD label in order to get school services and medication for him. A formal label for Asperger's will not get him the services he needs, so having spent 3.2K on a full neuropsych already, plus daily meds (2K annually), I don't think I need to spend one more cent on an evaluation for Asperger's right now. The psychologist told me the test might come back inconclusive, since he wasn't a clear-cut case.

And, PP, you're quite rude and ignorant.

Anonymous wrote:

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

I honestly don't get this. If MERLD is a language disorder then why would you need behavioral interventions like ABA which are supposed to help remedy social weaknesses? At some point if you say the child has MERLD and social communication deficits and ADHD it's seems really hard to distinguish from and ASD. I fully understand feeling like teachers and administrators are making inappropriate or uninformed judgments about your child, and also the desire to have an accurate diagnosis. BTDT. But I can't understand why if your child looks to be having autism like symptoms you would not get them fully evaluated.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Anonymous wrote:To the uninformed person who keeps insisting ABA isn't appropriate for a child with MERLD, you really are full of it. ABA is for behavior and people who are certified are of course qualified to deal with MERLD as well as autism. If you want to get someone who specialize in speech you get a speech therapist. DUH.

http://bacb.com/bcba-requirements/

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

FYI, I am
Not the OP


MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:MERLD is only relevant for the preschool age at this point mainly b/c speech delays b/f school age often resolve: http://www.asha.org/public/speech/disorders/Preschool-Language-Disorders/

Past preschool age, children will be given a differential diagnosis according to the latest DSM V in which MERLD does not exist. This could include a language disorder, communication disorder (autism is one, but there are others), and/or ADHD.

MERLD is still relevant for kids after preschool age as it can and often continues into elementary school if not life long. Many kids learn to adapt and cope but the residual effects are still present. It really doesn't matter if it is called a language disorder or MERLD but MERLD is a specific type of language disorder identifying concerns with both expressive and receptive language. For most MERLD kids without other diagnosis, it is called a language disorder but it makes it difficult to say language disorder without identifying receptive and expressive language. A language disorder could mean anything from receptive, expressive, both, apraxia, stuttering and many more. Most parents find it easier to continue to call it MERLD regardless of the official diagnosis if their kids still struggle with receptive and expressive language.

Not all kids with language disorders have communication disorders (including autism) or ADHD/ADD or a learning disorder. Some do, but many do not.

PP, kids can continue to have expressive and receptive language delays into elementary and beyond. However, in the latest DSM V published in 2013, the characteristics of MERLD fall under different diagnoses.

I have two kids who were diagnosed with MERLD as preschoolers by developmental pediatricians. Both have had full educational after age 6 and have received differential diagnoses, neither of which were autism. So either people are living in ignorance that there age 6+ have MERLD or they don't want to do full educational testing b/c they are avoiding a diagnosis.

We have not done full testing. It is not recommended for our child right now. Our developmental ped did some basic testing (including IQ) and did not feel more was warranted. Its not a good idea to keep testing kids over and over again. Not all kids have academic or other issues. You do a full evaluation to understand what is going on, but for some kids, the parents and professionals have a good handle on it, so it is not the best idea in less new issues crop up later. You keep insisting how important it is, and it is important and a good idea for many but not all. OP child is not 6. If your kids have dual or multiple diagnosis and you need to better understand it, it makes sense. You may have had a misdiagnosis of MERLD, but some of our kids actually have MERLD (or what ever you want to call it).

Also, the diagnosis are always ever changing. That doesn't mean even if clinically it falls under different diagnosis, that its not an appropriate term for some of our kids. By us just saying language disorder, you have no clue what is going on. If I say more specific, then you'd understand better.

Yes, it's evident that you haven't had a full educational diagnosis. The diagnoses aren't ever changing. The DSM is updated every few years based on review of the clinical evidence. DSM 4 was published in 2000. DSM 5 published in 2013.

I didn't say that all kids with MERLD end up with academic or other issues--that's your interpretation probably b/c you had a child initially diagnosed with autism. What I said was that a preschooler diagnosed with MERLD
--issues could resolve or could include
--language disorder AND/OR
--communication disorder AND/OR
--ADHD

Could doesn't mean will. An itemized list with commas ending with and/or in a sentence means these are possibilities. There are others.

(So it's great if your young child shows no social or educational issues at the moment. It would probably behoove you have a full educational evaluation b/f he finally leaves the tiny private that he currently attends, especially if he's transitioning to public.)

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

FYI, I am
Not the OP


MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

FYI, I am
Not the OP


MERLD can be an early catch-all when the symptoms don't quite add up to an autism or ADHD diagnosis. What people need to understand is that you don't observe young children and older children with the same battery of tests, and that therefore MERLD diagnoses are more frequent in younger children, and ASD/ADHD/etc diagnoses are more frequent in older children. MERLD is a symptomatic observation. It does NOT mean a 100% risk of Autism diagnosis down the road, but it certainly increases the likehood.

My son was diagnosed with MERLD as a preschooler, then was given a full neuropsych in late elementary and diagnosed with severe ADHD, inattentive type. We refused the additional tests for Asperger's, but we know he has always had Aspie tendencies, and that Aspie tendencies run in my husband's family.

if you refused diagnostic tests how can you speak definitively about it?

You really want to know?
1. Because I'm a research scientist who has read quite a bit of primary research literature on the subject, as well as observed my husband, and his family, closely.
3. Because we talked to several psychiatrists, psychologists and developmental pediatricians over the years, and they all said that yes, DS had tendencies, but even if more tests were done, they still might not lead to a definitive diagnosis. He's on the cusp, and it could go both ways, and it doesn't really matter anyway since we know he has tendencies, know how to manage them, and it's the ADHD which is really burdensome right now.

He has accommodations at school as well as medication for the ADHD, and that is what matters.

Is this the OP? I don't think you necessarily need a definitive diagnosis at the moment. If he has accommodations at school, are they working? And despite what PP mentioned, you can certainly do ABA or behavioral therapy with a child diagnosed with MERLD. I'm also really surprised that you're medicating so early. I would exhaust behavioral options first. If you are medicating, it may be trial and error.

P.S. I find it hilarious that you've been "observing" your husband and his family closely. The only genetic link they've found to autism is older fathers. Plus, as a research scientist, you're probably just as socially awkward as he and his kin are, you just don't realize it.

Bottom line, expressive and receptive delays can cause problems for a kid whether or not they're on the spectrum. Keep treating the symptoms. If you want a more definitive diagnosis wait until your kid is at least age 6 and then get an educational evaluation.