We're going down the autism assessment process for the second time in 3 months. Various professionals have mentioned multiple red flags (I'll get into specifics in the next paragraph) while others have somewhat definitively ruled autism out. I don't know whether we should keep going down this assessment route or just throw in the towel and say he's quirky. Is it very difficult to diagnose at 2.5/3? Can somewhat extreme sensory issues exists without a co-morbid diagnosis?
As background, I have a 33 month old little boy who has some sensory issues, ok a lot of sensory issues. The little guy spins, head bangs, refuses to eat most foods, likes to count objects and line up objects, gnaws his fingers (all 8 of them) when stressed, makes little vocalizations to name a few. He was also speech delayed (didn't start talking until 26 months), but has mostly caught up speech wise.
He has been receiving EI services since he was 20 months when he scored 1st percentile for a composite language score and 3% percentile for adaptive skills. We recently moved to another state and had to re-start the assessment process. In our previous state (MN) his EI team did not think he was autistic.
We moved to CA and his new service coordinator was really alarmed by his sensory issues and scheduled an autism screening with the developmental psychologist. The screening came back that he was not autistic or on the spectrum, but that he did have sensory issues (especially around food) that impacted his day to day life. We started twice a week speech therapy and OT to primarily work on his abysmal eating.
Fast forward to now. We are re-entering the evaluation process for special education through the school district since he'll turn 3 in December. Once again autism is being raised - this time by the speech therapist who evaluated him. She suggested a full assessment done because of the red flags she saw while evaluating him (spinning, head banging, vocalizations, finger chewing, etc). She mentioned that higher functioning kids can do wonderfully one on one with adults or older children and fly under the radar. They needed to observe him with peers so they are going to observe him at his pre-school. As an aside - I asked his pre-school teacher how he plays and she said he plays wonderfully alone and is great at entertaining himself, but if peers come by he'll play with them too. He doesn't seek out peers to play with. The classroom ranges from young 2s - older 3s.
I don't remember my daughter initiating play with peers at 2, but maybe I'm remembering wrong. Is parallel play still the norm at an older 2? From what I observe on the play ground at play dates most of the other kids his age aren't doing self-initiated peer play yet either.
I asked his OT and ST, they both said he has SPD but that they don't see any autistic signs.
I don't know what to think anymore. Each time autism is raised as a possibility it's like being punched. This maybe he has autism, no he doesn't, well maybe he does is emotionally wrenching. I don't know what to think anymore.
Our pediatrician wrote a referral to the local autism assessment center. The EI developmental psych discouraged me from having it done this past summer. She said that 1) it would be the same test she gave and 2) they tend to overdiagnose. With this latest autism concern through the school district, I went ahead and scheduled the evaluation for next week (they had a cancellation, otherwise the earliest appt would have been next year). I'm torn on whether to pursue this further. I also worry there might be some testing fatigue.
Since July he has had a developmental psych eval, 3 speech evals, 1 OT eval. He is scheduled to have another pysch eval and cognitive eval with the school district in early November. Add to that a 4 hour full developmental eval by the hospital next week. Do they use the same tests? Is he too young to overscore on them from familiarity.
The most recent speech eval took a long time since he scored divergently on two tests (Rosetti showed delay, another one did not). She broke out a third test that involved a bunch of flipboards of pictures. I think he did well on it. He showed his receptive language is far far beyond his expressive language.
Gah, this is just so nerve wracking and confusing. I honestly think he is fine. I think he will outgrow the sensory issues (well maybe not the picky eating). But he doesn't head bang, crash into me/others, run out into the street, try to off himself at the playground (leap from high surfaces) nearly as much as he did over the summer. He's suddenly almost afraid of heights. He seems so much more regulated and to have a self preservation instinct now. Now if I scream stop he'll race away and come to screeching halt right at the edge of the side walk. This is a lot better than running into the parking lot like he used to (albeit still nerve wracking).