Special Needs

Is Autism or Autism Spectrum Difficult to Diagnose? (long)

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).
Lilypie Kids Birthday tickers Lilypie Third Birthday tickers

Re: Is Autism or Autism Spectrum Difficult to Diagnose? (long)

  • We're kind of in the same place. My dd is the same age. Some sensory issues, only interest in her peers if the activity is motivating and is content to play independently. She does have more of a receptive delay than expressive but has good verbal and nonverbal communication skills. We have decided to move forward with the Eval from the overdiagnosing clinic. The way I look at it is this. In three years from now, the picture will probably be a little clearer whether she is autistic or not. I would rather look back and say "gee, guess we didn't need as much therapy as we thought" than look back and realize she was autistic after all and we missed three years in that window where the majority of brain development occurs where we could have made some significant changes.
    Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • My DD has SPD with tactile and vestibular issues, and she is very sensory seeking with movement.  She also has ADHD  She jumps, watches TV upside down, twirls, and when she was younger she used to line up toys a lot.  She used to chew on her index fingers, but I'm pretty sure it was teething related because it stopped when she was just over two.  She started putting her hands in her mouth a lot a few months ago, and sure enough, when I was flossing her teeth the other night I noticed two of her six year molars had come in.  This is just to say that sometimes I think there can be a sensory component to something that looks like an anxiety-driven behavior.

    Is the OT only working on eating?  DD's fine motor delays weren't glaringly obvious to us or her teachers because she had developed a lot of coping mechanisms, but vestibular issues can affect fine motor, motor planning, and bilateral coordination.

    When we sought an evaluation my DH and I were definitely concerned about ASD.  Our developmental pedi doesn't believe that she is autistic, and even though she seems to have a number of red flags, the social component doesn't seem to fit her.  She seeks out same-age playmates and will opt to play something she doesn't particularly like rather than play by herself.  Even with the SPD and ADHD diagnoses, DH and I still feel like understanding how DD ticks is a process.  There could be CAPD or an LD in our future. 

    I think that getting as much information as you can about your son so that you can push for the right therapies is a good thing, so I would do the evaluation at the autism center, but like auntie said, you still might not have a definitive answer.
  • Loading the player...
  • -auntie- said:
    Susan_KW said:
    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?  

    ASD can be very difficult to dx in very young children, in very high functioning individuals, and where the presentation is subtle. IMHO, it would be better if kids accessed services they needed around delays and revisited the diagnosis closer to five.
    He will get cut off from therapy at age 3.  We need a medical diagnosis to continue or else pay out of pocket.

    SPD can exist without comorbids, but I don't personally know any such creature. There's almost always ADHD, a mood disorder, speech/fine motor delay associated with SPD. In the case where a child has ASD, the sensory piece is generally subsumed by the DSM-5 diagnostic criteria for Autism Spectrum Disorder rather than giving SPD as a comorbid dx.
    The school district seems to think that it is very unusual to have his level of SPD without something co-morbid.  
    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.

    The stuff in red has more of an ASD feel than straight up sensory to me. Of course, he could just be being a toddler; toddlers are quirky people. But lining things up, bringing order to them, rather than actually playing with them classic. Some kids, do both. LOL, DS got his Hot Wheels out a few weeks ago for old time's sake and then angle parked them along the baseboards in his bedroom. I hadn't seen that in a while

    Tell me about the vocalizations. Does he sort of play with making sounds? Does he repeat words or parts of words? Repeating words or sounds is echolalia. Sometimes it's a typical developmental phase in learning language. Sometimes it's a kind of crutch in processing auditory input and sometimes it's just for fun. The latter can be considered a repetitive behavior aka stimming.
    He makes clicking sounds while playing.  He does repeat words when playing with his sister.  He can be like a little echo, but that is starting to fade away.  

    The finger chewing is a concern. Some clinicians may interpret it as "self injurious behavior" which is a big ASD red flag. Sometimes picking and biting can have an almost OCD-like antecedent where the child nibbles or picks to smooth nails out or make them even. For me, that a kid who isn't 3 would have this level of anxiety is hard. My own kid is anxious by nature; it drives his behavior. It's a burden for him and something we've worked on for years.
    I suspect the finger gnawing (which is new) is related to his 2 year molars (finally) coming in.  He hasn't broken the skin or left any marks. He has also been drooling a lot.  My husband and I think a lot of his food issues might be around his never ending teething.  He doesn't pick at his skin or finger nails.  

    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.

    Unless he was seen by a medical doctor or psychologist from EI, they weren't qualified to offer an opinion on whether he has autism. EI is great because they don't need a dx to help a child.
    The district pyschologist scored the test but didn't administer it.
    Do you feel the eval done in MN was representative of his skills at that point in time? Was he reasonably cooperative? Those scores are really low individually, but together they are what you would expect to see from a child on spectrum with a more classic presentation rather than what would have been labeled PDD-Nos or Aspergers in the past. Some kids with ASD are very passive in terms of self help and life skills- they tend to be late feeding, dressing, toileting, etc. Sometimes adaptive skills are clouded by poor fine motor skills or hypotonia which makes it harder to sort out. 
    In MN they were confident his low scores in receptive language and adaptive skills were because he had no expressive communication skills.  Most of his communication was via throwing himself on the floor and screaming if something didn't go his way or grabbing my hand and leading me to what he wanted.  They thought the scores would go up when he started to communicate with language.  This is what happened when his expressive language came in at 26 months.

    Often these are kids who don't have the inborn drive to be independent; my mother laughs that DS is the only child she ever knew who never uttered the words "I do it myself" as a toddler/preschooler. He did eventually get around to it- he was 17 1/2 and we were working on his Eagle Scout Leadership Service Project at the time.

    No, I hear I do it a lot :)  Then the inevitable scream of frustration when things don't work out the way he wants him too.  Got forbid his granola bar break in half when he takes it out of the wrapper or his lego tower topple over by it's own weight.

    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.  

    How bad is the eating? Is it a refusal to eat anything or is it a matter of a very limited diet? FWIW, both of these can be seen in both kids with SPD and ASD. Many kids on spectrum eat a very limited "white" diet- bread, pasta, milk- maybe cheese or some yogurt.

    He's a white diet kid.  He survives off of grain cheese combinations (grilled cheese, mac and cheese, pizza, quesidilla), various fruit/vegtable/yougurt squeezie pouches, and sunflower spread with bread, and granola bars.  He will occasionally eat a cheese stick.  He will eat almost any type of cake, cupcake, cookie, cracker, or candy.

    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.  

    Winner! Winner! Chicken Dinner! 

    Your SLP nailed it. Many higher functioning kids on spectrum can and do fly below the radar as preschoolers. DS wasn't dx'd until the last week of kindie. We had red shirted him, so he was 6 years and 9 months old. TBH, the behaviors that drove us to the eval were more related to his ADHD and dyslexia than his AS.

    DS has an Aspergers presentation. He spoke early and often, his adaptive skills were age appropriate, he was pretty much OK in terms of gross motor and advanced in fine motor. He had some sensory issues, but nothing huge. He had a lot of anxiety and specific fears. His diet was not as bad as some- he wasn't much into meat, but he'd eat salads and fruit.

    DS always did better with an indulgent adult than peers. Well, until now when his peers are adults. As a LO he was the kid chatting up the teacher or counselor. He was cute and funny and smart, so most thought he was just really bright. His own pedi told me there was nothing wrong with him except that he was "the much loved child of older parents". He had friends in preschool and played well with his peers. He did have some imaginary play and while some of it was fairly scripted, he had a lot of scripts so only a really observant professional would pick up on it.

    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. 

    This would be DS to a tee. He'd happily play alone or with peers, so long as they were playing something he enjoyed. He did sometimes seek out a couple of kids in preschool and kindie but they were real quirky themselves.

     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.

    Young twos parallel play, but by three most kids should be able to interact and share during play. Since he's almost 3, this should be an emerging- but not mastered- skill. Often kids who have been in a day care setting or have older sibs would be a little on the earlier side around this. 
    He plays wonderfully with his sister.  He follows her around like a puppy.  If she is in costume twirlling and singing, I'll look over and he'll have fashioned a hat out of a bin, grabbed a lego tower as a wand, and will be spinning in circles and singing too.  He imitates what she does. It's very cute to watch.  He can share and interact with peers, but he doesn't initiate it.  He needs a slightly older child or adult to initiate the play and keep the play going.

    I asked his OT and ST, they both said he has SPD but that they don't see any autistic signs.  

    They really aren't qualified to make the call. Sometimes it's like the 10 blind men and the elephant when it comes to these kinds of professionals. The SLP sees the speech piece, the OT might see the SPD piece but nobody is taking a more holistic look at all the pieces.
    True.  

    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.  

    Yeah, that has to be tough.

    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.

    Testing fatigue? 

    The test they typically do with kids is ADOS which is a lot like a playdate with an indulgent uncle. It's not hard or even unpleasant unless your child really doesn't like people. I which case he probably is going to get a dx.

    They should also do some scales with you and with his DCP team to parse out behaviors. Ideally, a psych or behaviorist would observe him in his class as well during an unstructured time like snack or recess.
    Yeah I guess testing fatigue is the least of our problems.  It's something his school district has brought up.  Something about not being able to use the same test more than once a year.

    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 overscore risk is usually an issue with the WISC and other IQ tests. He's too young for WISC by about 4 years. I suppose there is a potential for him to learn ADOS from repeating it, but they could supplement with GARS or CARS. A Vineland would be really useful in teasing out his ability to function adaptively which is really important in this. Have any of the SLPs looked at pragmatics or are they focused on receptive/expressive language?
    The school district SLP seems to be focusing on pragmatics.  That would be the area he is delayed in.  Or rather, his ability to communicate beyond simple requests (what I think you mean by pragmatics? ).  Most of what he says is of the I want this variety.  His articulation is mostly very good.  I filled out the Vineland for the county EI but haven't yet been given it for the school district assessment.  

    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.  

    Receptive is usually the stronger of the two so that's good. Since DS has Aspergers and was speaking better than most adults as a preschooler, we only ever did evals around pragmatics and the social use of language until he was approaching middle school and needed SLP support for organizing his writing. 

    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).

    This has to be really hard. The thing is, he's so young that the bar for typical is still so emergent. It could be that he doesn't get a dx now, and you have to revisit things when he's older still. Or you could be seeing the leading edge of some other condition, like ADHD, that won't be diagnosable until he's considerably older. Or it could be that he's a quirky kid with a handful of autistic traits that don't rise to the level of a dx. I have a couple young friends who fit this last description. 

    One of them has GAD, ADHD and major SPD around food- he used to spit up food he thought he'd choke on. He lived on tuna and Wonder Bread for years. One of the feeding clinics finally got traction around this with a hybrid CBT plan but he was about 12 before he could eat most foods. He's doing pretty well these days. He has a brother with ASD and he really seems very like my own DS, but the social communication piece doesn't fit. He had some huge anxiety issues in middle school and early high school, but is thriving in college now. He'll get his BS in 3 years and is applying to grad schools.

    He has a new ST at his therapy and they switched to a more cognitive approach (CBT=Cognitive behavioral therapy and GAD=generalized anxiety disorder?) for feeding therapy. He is doing much better with this approach.  He needs to be pushed into trying stuff.  We are working on licking preferred foods (sunflower spread) from non-preferred foods (pieces of fruit).  The first couple of times results in whole body shudders and trying to scrape the food off his tongue.  But with more exposures he does seem to do better.

    I guess a lot of my confusion is that the developmental psychologist through the EI regional center definitively ruled out any type of ASD diagnosis just a few months ago.  I thought we were safe because of that.  Now the ST through the district is calling that into question since there wasn't a peer to peer component.  I don't think DS has ADHD or anxiety just based on his ability to focus and play independently.  I don't know that a kid with ADHD could do that.  I also don't see anxiety being the issue because I don't usually see fear in his behavior.

    Could non-verbal learning disability cause this?  I was diagnosed with a non-verbal learning by a neuropsych in my 20s.  My spatial abilities are impaired while my verbal abilities are superior.  I guess the discrepancy between them was enough to make the diagnosis. I also have kind of extreme food issues.  And I kinda of gotta keep if then scripts in my head when trying to make small talk - yeah I know.  But no-one appears to have heard of this type of learning disability let alone how to treat it.  What little I've been able to find on it seems imply it is from brain damage and not hereditary (although I suspect my mom and brother have it too).  Do I bring it up at his appointment next week.  I've brought it up with the school district and I mostly get a blank look and a subject change.  So, I don't know if it is a real diagnosis.  This disability messed up my ability to learn higher level math and made primary school kind of suck since I just didn't pick up on non-verbal communication cues very well, but I don't know if it would cause SPD.  Plus, DS doesn't seem to have spatial learning issues going by how much he likes to play with legos and puzzles.  He is also very good at gross motor.  He has this innate ability to catch himself when losing his balance that his older sister is lacking.  Seriously, my older daughter can trip over her own two feet when standing up and not moving. He seems to have a much better ability to know where his body is in space.


    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
  • KH - those are all very good points and I hadn't thought of it that way.  I think part of it is that I'm sick of all the testing.  My daughter just tested out of her IEP so we've been going through extensive testing with both children since moving here.  Both were born prematurely (DD - 31 weeks 0 days, DS 32 weeks 6 days), so it's been a long road of interventions and testing.  I thought we were in the clear with DS since overall (before this age) he was doing so much better than DD.  Now DD appears to be in the clear (she was born earlier and had several brain bleeds), but it is DS that might have life long challenges.  

    mszee - His OT is almost all feeding therapy (as is his ST).  We're running out of time because he turns three in a little over a month (gulp) and then all therapies through EI stop.  So far when they do look at fine motor he usually can accomplish the skill quickly if given one on one instruction.  His OT even commented he appears to be almost a year ahead in his grasping skills (observing him do a puzzle as a reward with accomplishing a feeding therapy goal).  Right now neither fine motor or gross motor appear to be delayed - in fact they are areas of relative strength for him.

    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
  • FYI--kids with ADHD can have great focus and independent play skills. That focus is seen within preferred activities. It's the non-preferred stuff where ADHD kids struggle.
    Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • FYI--kids with ADHD can have great focus and independent play skills. That focus is seen within preferred activities. It's the non-preferred stuff where ADHD kids struggle.
    Definitely true. DD has ADHD Inattentive-type, so she is not disruptive and she doesn't have out of seat behavior in school. She can focus very well when she wants to, but she tends to lose things, forget things, has a harder time listening and following directions than a typical child. She hates stopping in the middle of something because she worries that she won't be able to go back and finish it. ADHD can also affect impulsivity and self-regulation.
  • Having just been through this my DS who has just turned 3 last month when we got his dx. I would peruse it if you believe it will allow you more services. The reason I wanted a dx was I wanted to make sure I was treating the right thing. In my area when he aged out of EI we transferred over to the school system. I have not turned in his dx to the school so he has no iep and the children that do have a iep receive more time with a teacher which is to help them prepare for school. As far as services like OT and SP in my area is not enough. I still opted for private.
    Warning No formatter is installed for the format bbhtml
  • Susan_KWSusan_KW member
    edited October 2013
    I didn't know that people with ADHD could hyper focus on preferred activities. I thought ADD was caused mostly by random misfires in the brain shattering concentration. I didn't realize that concentration could be kept for long periods of time. So, there goes my understanding of ADHD :) 

    But, he can focus on non-preferred activities. He can follow multi-step directions. His auditory processing appears to be developing similar to his sister's. Because she was just tested, I know that she is doing very well (2-3 years above grade level) with her auditory processing. For example, during the testing he came away from a Lego based Thomas the train set (two out of three of his most favorite things!) and sat down and really focused on the flip-board picture portion of the language testing. She'd ask the question, he would pause for 10-15 seconds and point to the answer. He would do the same with repeating non-familiar somewhat complex words when asked. She had to really push to get a ceiling on the test - "show me thinking" and "Does the cowboy prefer to sleep on a bunk or a couch" were the two that did him in. 

    With his sensory issues as bad as they are, I think if this was being driven by ADHD, he would have a severe case of ADHD? I don't see him being able to focus on a language test as long as he did on that test if he had severe ADHD. 

    The reason I'm so psyched about the Legos and puzzles is because in a few years (if he keeps up his development) he'll be better at it than me. My 5 year old will soon be better at puzzles than me. When it comes to trying to visualize where a puzzle piece should go, she IS better than me. My spatial reasoning ability is bad, really really bad. I see them being able to create complicated Lego structures and do puzzles without having to painstakingly manually rotate each piece and think they might have escaped my learning disability! 

    I know non-verbal learning disabilities are often seen in autism. Because of that I sometimes wonder if I'm on the spectrum. But, I can still feel empathy and sympathize with others. I have the ability to connect with others and to have close friendships and relationships! But, I do have difficulty perceiving subtle visual cues in conversation. Not so subtle cues come through loud and clear :) 


    But, at any rate, it doesn't sound like I should mention that I have a non-verbal learning disability at DS's medical autism screening, since it's not recognized as a true diagnosis in itself. 

     Yes, CA, does differentiate between medical and educational autism diagnosis. Or so I hear, but I'm not sure why it would matter other than it can be taken away if he doesn't re-qualify in 3 years? CA does developmental delay differently than most other states. I think it is optional under federal guidelines? We ran into this because DD's IEP was a developmental delay qualification. CA doesn't recognize that designation, thus necessitating a full re-evaluation for her once we moved here. They do have it nominally but it is somehow different than most other states and can only be used up to age 4.5. Or at least that was how the pre-school intake person explained it to me. They have to re-qualify almost every pre-schooler who comes in from out of state since most of them are qualified under developmental delay.
    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
  • And I need to redo that response on a PC. Apparently thebump doesn't recognize line breaks from an iPad. Sorry if my last response is incomprehensible!
    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
  • It's my understanding that sensory issues are often co-morbid with ADHD, but the degree of one isn't necessarily indicative of the degree of the other. We just had a meeting with DD's teacher, and right now her fine motor issues are her biggest challenge in the classroom (which are related to her particular sensory issues). I'm not saying that your DS has ADHD, but there's a lot more to it than just not being able to pay attention.
  • It's interesting the two questions that proved difficult for your DS. They would require abstract reasoning which is an area where some on spectrum struggle. But he's not quite 3, so I don't know that it's something he would demonstrate yet. I kind of side eye the cowboy question; do kids know much about cowboys these days? Back in the day, cowboys were heros and all over TV and movie screens but that ship has sailed. It kind of reminds me of the brouhaha over an old SAT question about yachting terms being potentially discriminatory for those who are not upper class white people.

    For what it's worth, I don't think he has any idea what a cowboy or bunk is :)  He said couch - maybe because he knows what a couch is.  He did point to the thinking man a couple of times - not because I think he knows what thinking looks like, but because it was the only person in the group of six objects.  Then he got distracted by there being a tower (his tower obsession has moved beyond legos to anything tower looking) and started jumping up and down saying "there a tower, there a tower". Either way, I think he'd passed the older two/young three year old level some time back in the test!

    With his sensory issues as bad as they are, I think if this was being driven by ADHD, he would have a severe case of ADHD? I don't see him being able to focus on a language test as long as he did on that test if he had severe ADHD. 

    Hard to say. ADHD isn't usually even considered until 5 or 6. ADHD looks different based on which presentation a person has- hyperactive, inattentive, impulsive, combined type as well as how impacted they are. It looks different across the lifespan. My mother's was always pretty much something she used in positive ways- she was high energy and very creative- but as she's getting older (75) she's struggling more with organizational stuff and her poor health lately has prevented her burning off her energy so she's not in a good place. DS's ADHD used to be all about the impulsivity/inattentiveness as a kid, but as a young adult the impulsivity is gone and the executive function deficits remain the challenge.

    When a person has multiple differences comorbid, they won't all necessarily be at a similar level. DS's ASD is relatively mild, his LD issues were significant, his SPD is largely out grown and his ADHD is sort of middle of the road.

    Another couple of years of waiting for answers (if there are any that need to be found) will be hard. 

    Maybe his SPD is from an immature nervous system from being a preemie.  His impulse control is much better than it was a few months ago. Maybe all this sensory craziness will end on its own. I guess it could be the answer.

    I know, I'm grasping at straws.  I'll update on thursday if I know anything more.

    I still think it's relevant and worth mentioning, especially given that you feel this runs in your family.

    Then I'll mention it. 
    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
  • mrszee2b said:
    It's my understanding that sensory issues are often co-morbid with ADHD, but the degree of one isn't necessarily indicative of the degree of the other. We just had a meeting with DD's teacher, and right now her fine motor issues are her biggest challenge in the classroom (which are related to her particular sensory issues). I'm not saying that your DS has ADHD, but there's a lot more to it than just not being able to pay attention.
    I understand.  I'lll ask about what to look for relating to ADHD at his appointment on thursday.
    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
  • Susan_KWSusan_KW member
    edited October 2013
    Auntie - Yes he does latch on to one thing or the other every couple of months. In September he was all about bridges. Now, he is into towers. He gets excited when he sees them and mostly wants Legos to build a "big big tower". We were skyping with Grandma & Grandpa today and he wanted the Legos so he could build a "big big tower" to show them :) He is getting better at building them too - he is stacking and cross linking two columns together when he builds them now so that they don't topple over as easily when he carries them around. I'm aware of the link between autism and prematurity. I had thought the risk was more for micro-preemies. DS weighed almost 5 pounds when he was born. One more knock against the little guy I guess. DS was an amazingly chill baby. I could put him in his carrier and he'd sleep for hours. I'd put him down in his crib and he would roll over and go to sleep! He was the complete opposite of his big sister.
    Lilypie Kids Birthday tickers Lilypie Third Birthday tickers
This discussion has been closed.
Choose Another Board
Search Boards
"
"