sorry about the typos! It should be Note that....

This is from Tony Attwood, the Asperberger's specialist. Note that it takes 80 of the symptoms to get an actual Asperger's Diagnosis. There are lots and lots of self-diagnosed people who misunderstand that they have some Asperger's traits, but not actual Asperger's. Then their are clinicians simply not following the guidelines strictly. Not that a totally NT will have at least 10 autism traits.

http://parentingaspergers.com/blog/parents-issues/tony-attwood-on-aspergers-syndrome/

The 100 Piece Autism Spectrum Jigsaw Puzzle
Tony talked about the diagnosis process as being a jigsaw puzzle, here’s what he said about making a diagnosis:
“It’s almost like having a mental check-list that you’re identifying. Now, all the characteristics of Asperger’s exist in the ordinary population. A typical person who is not perfect at reading body language, doesn’t have hundreds of friends, who may not like the noise when you note down on the blackboard, etcetera. So, what makes the condition significant is not a unique characteristic but the strength and dominance and effect of certain characteristics. So we’re doing a check-list of them. Now I say that it’s like completing a 100-piece jigsaw puzzle and there are certain essential social relatedness bits and pieces. But 80 or more pieces of the 100-piece jigsaw puzzle makes the diagnosis.
I’ve never met anyone with all 100, but I’ve never met a typical person with less than 10. So basically, I’m counting them up through the assessment, but the issue then incurs if it’s 80 or more to be diagnosed, what do you do with someone who got say, 70 to 80 pieces? So more than the ordinary population, but not quite enough to confirm the diagnosis. They’re in a grey area, what we call sub-clinical, but may still benefit from some of the strategies for the fragments that they have. So that sort of person I would say they have fragments of Asperger’s syndrome and need help for the fragments they have.”

We also do private OT for which we pay out of pocket with no insurance reimbursement. Twice a week at $145/session. You do the math.

Anonymous wrote:I don't know but it looks to me like some parents are accepting an Aspergers diagnosis so they can get the help they need for services.

I don't know anyone who wants services if they are NOT NEEDED. Sigh...

I don't know but it looks to me like some parents are accepting an Aspergers diagnosis so they can get the help they need for services.

- He wandered around the classroom not playing with other children or participating or engaged with what was going on.

- Was obsessed with fans and doors. Elevators are a recent development.

- Needs a lot of one-on-one direction and prompting from teachers.

- low tone. Could not navigate play ground equipment and always slow and lagging behind whenever the class was going somewhere.

- high IQ. and excels in Chinese and way above age level in English and Math but cannot manage to dress, feed, or toilet without assistance - developmentally way behind in self-care skills for his age.

- finger postures, jumps up and down and flaps his arms when excited. Runs around in circles. He no longer does these things due to OT or maturity - not sure.

- lacked give and take in conversations. Tended to lecture.

Anonymous wrote:PP. 2:07, I'm curious how many Asperger's kids you know? You seem to have very definite ideas about what constitutes AS behaviors vs behaviors that are NT.
While I agree that diagnosing is "tricky" for some kids (not mine, however, DS has been described as "classic" Asperger's even with the great eye contact), I trust my developmental pediatrician who's seen hundreds of Aspies, each one unique, rather than stuff I've read in books.

DS has social reciprocity at school and home. Thanks to his IEP - has improved greatly and hopefully continues to progress with age. Has conversations with give and take in a variety of subjects and not only elevators, his obsession, in both English and Chinese for which I thank his social skills group, speech therapist and teachers.

So then what are his "classic" symptoms?

PP. 2:07, I'm curious how many Asperger's kids you know? You seem to have very definite ideas about what constitutes AS behaviors vs behaviors that are NT.
While I agree that diagnosing is "tricky" for some kids (not mine, however, DS has been described as "classic" Asperger's even with the great eye contact), I trust my developmental pediatrician who's seen hundreds of Aspies, each one unique, rather than stuff I've read in books.

DS has social reciprocity at school and home. Thanks to his IEP - has improved greatly and hopefully continues to progress with age. Has conversations with give and take in a variety of subjects and not only elevators, his obsession, in both English and Chinese for which I thank his social skills group, speech therapist and teachers.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PP, parents are not making that distinction, neuropsychologists are. A group of them actually who authored the book, "Misdiagnosis." These neuropsychologists studied the difference between Aspergers children and Gifted Non-Aspergers children and their obsessions.

Maybe it's time to look at the reality that some children have indeed been misdiagnosed.

I never said that children haven't been misdiagnosed. I only said it is BS that children with AS won't engage with others who share their obsessions. I live in that world, I have a son with Aspergers, I know plenty of parents of children with Aspergers. One has a child who is obsessed with trains (which is why I came up with that example) and shares his obsession with other kids with AS who love trains. He isn't all that gifted but he absolutely has AS and absolutely engages in reciprocal friendships over this special interest.

I realize you have this issue you keep promoting and I am not going to argue with you about your underlying point. but there is this mistaken search for the holy grail factor that distinguishes kids with AS and the fact is that the diagnosis is always multifactural and no two kids with AS are alike. i remember thinking my DS couldn't possibly have an ASD because he didn't line up his toys. I had read somewhere that this was "the" distinction. There is no "the" distinction.

Personally, I've never found neuropsychs to be that good with ASDs -- they tend to focus on the minutia and miss the big picture. I'm sure there are some that get it, but obviously not teh ones who wrote this book.

Engage may not mean the same as having social reciprocity. Aspergers children may not be as inclined to entertain another's opinions or viewpoints even if it is pertaining to their obsession. They may simply enjoy discussing theirs. That's engagement but that's not social reciprocity. Social reciprocity is listening, hearing, replying, and having a discussion that may not be your choice to talk about. And the authors of this book state that Aspergers children who are engaging in social reciprocity with others over their obsession are not likely to have Aspergers to begin with. They may have been misdiagnosed. That doesn't sound like BS to me but you're definitely allowed to hold a different opinion. And lining up toys is a symptom of autism and not one of the criteria in the DSM, just like hand flapping is also a symptom. Doesn't mean a child has ASD, as there are kids who flap and line up toys and they're not ASD at all.

My 4 yr old DS does this and does it all the time. He still has Asperger's. His cousins are the same way but my brother refuses to get them evaluated and like you, insists their social deficits, obsessions and repetitive behaviors come from being "gifted." So they get no help or support or services that address these issues. I suppose it doesn't matter much at this point, they function well at school, get excellent grades, etc. But I've seen this played out with an older relative with a teen - he was fine in the earlier grades but had major problems in high school. Not as many supports and help at that point - the interventions just aren't as affective when they're older.

Anonymous wrote:

Anonymous wrote:PP, parents are not making that distinction, neuropsychologists are. A group of them actually who authored the book, "Misdiagnosis." These neuropsychologists studied the difference between Aspergers children and Gifted Non-Aspergers children and their obsessions.

Maybe it's time to look at the reality that some children have indeed been misdiagnosed.

I never said that children haven't been misdiagnosed. I only said it is BS that children with AS won't engage with others who share their obsessions. I live in that world, I have a son with Aspergers, I know plenty of parents of children with Aspergers. One has a child who is obsessed with trains (which is why I came up with that example) and shares his obsession with other kids with AS who love trains. He isn't all that gifted but he absolutely has AS and absolutely engages in reciprocal friendships over this special interest.

I realize you have this issue you keep promoting and I am not going to argue with you about your underlying point. but there is this mistaken search for the holy grail factor that distinguishes kids with AS and the fact is that the diagnosis is always multifactural and no two kids with AS are alike. i remember thinking my DS couldn't possibly have an ASD because he didn't line up his toys. I had read somewhere that this was "the" distinction. There is no "the" distinction.

Personally, I've never found neuropsychs to be that good with ASDs -- they tend to focus on the minutia and miss the big picture. I'm sure there are some that get it, but obviously not teh ones who wrote this book.

Engage may not mean the same as having social reciprocity. Aspergers children may not be as inclined to entertain another's opinions or viewpoints even if it is pertaining to their obsession. They may simply enjoy discussing theirs. That's engagement but that's not social reciprocity. Social reciprocity is listening, hearing, replying, and having a discussion that may not be your choice to talk about. And the authors of this book state that Aspergers children who are engaging in social reciprocity with others over their obsession are not likely to have Aspergers to begin with. They may have been misdiagnosed. That doesn't sound like BS to me but you're definitely allowed to hold a different opinion. And lining up toys is a symptom of autism and not one of the criteria in the DSM, just like hand flapping is also a symptom. Doesn't mean a child has ASD, as there are kids who flap and line up toys and they're not ASD at all.

PP. I am the person who posted about her don not getting the AS diagnosis from the Dev. Ped. I agree with you 100%. My older DS was recently diagnosed with ADHD. For years, we kept trying to work on his attention and impulsivity. But, because he is so bright, we kept putting off getting him help. Finally, this year things came to a head socially, and we had to seek help. I feel very strongly that his younger brother, who is getting lots of support is being treated so much better, not just as a behavior problem, and his issues are Much more pronounced than his older brother's. As I said, though we do not have an AS diagnosis, I will continue to advocate for my sons so that they can succeed in school and in life.

Anonymous wrote:PP, parents are not making that distinction, neuropsychologists are. A group of them actually who authored the book, "Misdiagnosis." These neuropsychologists studied the difference between Aspergers children and Gifted Non-Aspergers children and their obsessions.

Maybe it's time to look at the reality that some children have indeed been misdiagnosed.

I'm the poster with the 4 yr old who got three separate evaluations that all concluded DS has Asperger's. He also is "gifted" according to his WIPPSI score which I don't particularly care about b/c he's 4 and is a rising kindergartener. He has deficits in social communication, obsessive interests and repetitive behaviors which affects his life at home and school and will make life harder for him as he is growing up. We are treating the deficits and getting supports and services at school for him.

I don't care if he's misdiagnosed or if his problems stem from being gifted b/c he obviously needs help to function and to make school a happy enjoyable experience.

IRL, I get a lot of flak from relatives who insist he can't possibly have AS b/c he relates well to them, has good eye contact, yadi, yada. In almost every case, the person has an agenda. One relative refused to get either of his kids evaluated even though the school thought there maybe issues: Kids weren't playing with other children, had obsessive interests, etc. They are both in a gifted program with the same issues. The other relative waited until their child was 16 and having major problems in high school before seeking help.

Many kids with ADHD and/or Asperger's are "gifted" - but their social, attention, and other issues stem from having ADHD, AS, etc. and not from being "gifted." These kids deserve support and help, too.

Anonymous wrote:PP, parents are not making that distinction, neuropsychologists are. A group of them actually who authored the book, "Misdiagnosis." These neuropsychologists studied the difference between Aspergers children and Gifted Non-Aspergers children and their obsessions.

Maybe it's time to look at the reality that some children have indeed been misdiagnosed.

I never said that children haven't been misdiagnosed. I only said it is BS that children with AS won't engage with others who share their obsessions. I live in that world, I have a son with Aspergers, I know plenty of parents of children with Aspergers. One has a child who is obsessed with trains (which is why I came up with that example) and shares his obsession with other kids with AS who love trains. He isn't all that gifted but he absolutely has AS and absolutely engages in reciprocal friendships over this special interest.

I realize you have this issue you keep promoting and I am not going to argue with you about your underlying point. but there is this mistaken search for the holy grail factor that distinguishes kids with AS and the fact is that the diagnosis is always multifactural and no two kids with AS are alike. i remember thinking my DS couldn't possibly have an ASD because he didn't line up his toys. I had read somewhere that this was "the" distinction. There is no "the" distinction.

Personally, I've never found neuropsychs to be that good with ASDs -- they tend to focus on the minutia and miss the big picture. I'm sure there are some that get it, but obviously not teh ones who wrote this book.

Anonymous wrote:

Anonymous wrote:Interesting reads. My DS (now 6) was evaluated in preschool by FCPS child find. Both FCPS, and the play therapist we had been working with felt that there was a strong chance he had Asperger Syndrome. From what I knew as an educator myself, I tended to agree. We saw a Developmental Pediatrician, who in addition to looking at all the evaluation pieces from the county (which involved some cog. testing, speect/hearing, 90 min observation by the psych, long questionnaires for teachers and parents) met with us alone, and met with ds (who at that visit remained almost entirely under the chair). Though she felt he had some Asperger characteristics, she felt he did not have AS. Her reasons were that ds 1) had a strong desire for joint attention/sharing his ideas and 2)Had a strong amount of expression in his voice and his face... He has STRONG obsessions. He has been on Egypt for many months now, every single drawing/school paper that came home had some egypt theme to it. Every day at recess he plays "Egypt". He has major attention issues, poor eye contact as well. I am not sure how it will pan out, I still think very possibly he has AS, but I think sometimes, it is hard to tell when they are little? He has had a good year with an IEP, and one in place for 1st.

These do not rule out Aspergers!

I am the poster of the above. I felt that the Dev. Ped we saw had very concrete examples of why she felt he did not meet the DSM criteria, at least when she evaluated him (at 5). I am not sure I can express all she said in that regard. But, she was definitely all about looking at the DSM criteria, we chatted a bunch about the new DSM, etc. I was very surprised that DS did as well as he did socially this year. He has a lot of friends, a few good ones. He is very well liked and accepted in his class. I think that a lot of this has to do with the fact that he makes up really cool games, and the kids like them. His teachers were amazing with finding ways to use his interests to help him learn. His rigidity improved 10000 fold. The structure of a school day seemed to really help him. I will be curious to see how things are going as he gets older though, when his intense interests (assuming he still has them) are not quite as socially acceptable. What has really improved for him this year is his reaction when someone does not want to play his games or share his ideas. He will either join their game, or continue on his own. It used to be meltdowns when things did not go his way. As I said though, I would not be surprised if eventually he does end up with an AS diagnosis, and truth be told, I am looking for him to continue to get the support he needs, however that may be.

PP, parents are not making that distinction, neuropsychologists are. A group of them actually who authored the book, "Misdiagnosis." These neuropsychologists studied the difference between Aspergers children and Gifted Non-Aspergers children and their obsessions.

Maybe it's time to look at the reality that some children have indeed been misdiagnosed.