Need timing advice: ASD screening/diagnosis (long)

Assembly_Reqd

I know at some point we will get Nate into KKI for and ASD appointment. I am having a quandry as to the "when", especially when I see that children as young as 18 months are getting ABA therapy. Part of me doesn't want to miss out on important therapy time if he does get some sort of dx, but the other part of me thinks we should wait for two reasons.

1.) He is already getting therapies in the areas of his delays; PT, OT, SP, VT & ASL instruction.

2.) I think he may get an ASD dx as he stands right now and am thinking a bit more maturity and therapy could parse out some of those "red flags"

Besides the fact that his is totally behind with gross motor(not walking) and speech skills (1 word) there are three behaviors that are concerning to me as well:

1. He can entertain himself extremely well. He can play for up to an hour by himself without me hearing a peep from him. (playing with different toys appropriately) If I am in the room reading or watching the bbob tube, he will "check-in" every so often by coming over to the couch. Maybe I am just lucky to get a kid who does this and should consider myself blessed, but this behavior concerns me for some reason.

2. Another thing he does is guides my hands to "help" him do things. When we toss the ball back and forth he eventually gets himself into my lap and uses my hands to pick up and bounce the ball. He will also grab my hands to sign the word 'more' instead of just signing it himself. Auntie has mentioned seeing this behavior before in HoH and Deaf children who also get an ASD diagnosis.

3. His eye contact sorta sucks, but then again, my eye contact skills (and DH's) kinda suck too. I can get eye contant from him at least once a day, but he is not really an eye contact 'seeker' if you get what I am saying.

These are the positives in his court: he has always ate and slept like a champ, he transitions well, he never tantrums(yet) and all around seems to be a very laid back kinda guy.

Part of me just wants to stop the "wondering" and "know". Another part of me doesn't want to jump the gun. I guess what I am asking is if waiting (until age 2.5-3-ish) would really hurt or if I should just bite the bullet and get an appointment?

Thanks if you got this far and thanks for any advice you can give!

 

houndbaby

Those 3 behaviors described my ds to a T before therapy. My ds is also a great eater and sleeper, no tantrums, really just an all around kind, loving, laid back kid. I think that part is just who he is. We made an appointment to see a dev pedi a few months after my ds turned 2 and we had taken care of hearing (tubes) and tested vision. It took us several months to get in to see a dev. pedi for evaluation. We were already in all of the therapies we needed and by the time we got in for an evaluation my son was a totally different kid than when we had originally scheduled it. He was diagnosed with mild autism. Whether to make an appt at 18 months is up to you, if you are already getting all the services and therapies that you want/need you can wait on it. If you need the diagnoses to get more services, go ahead and schedule an appt.

CrazeyJaneyR

Why don't you ask what getting a DX would do to his current therapy schedule to see if any major changes would be made and how a DX might help him.

For your own peace of mind I would get the evaluation.  For his sake too. Early intervention is key, that's all I hear these days. My guy is 19 months old - hell yeah I got him DX - I wanted the opinion of a professional - no matter how well I know my son, people schooled in ASD know about his condition, and their opinion and DX will guide me to helping him. The sooner the better, IMO. I don't see how it could do anythin but help.

 

I felt a huge sense of relief after my son was DX. The wondering was killing me, and I felt like he needed more help. Now I know he does, and I can start getting him the help he needs. 

Assembly_Reqd

Thanks so far everyone for your input! To answer some of Auntie's points..

I will be going back to work "full time" for about a 6-8 month period of time starting some time in Oct. I have been looking at daycares and part of me wonders if I would make a different choice based on a diagnosis. I am excited that he would be in a daycare with NT children becasue then I can get caregiver input on his behaviors. Right now he goes to the school for the deaf Mon & Fri mornings for 2.5 hours with hoh/deaf kids as well as some hearing sibs thrown in. If I had a dx, that would change things and I would not go back to work and search out an appropriate therapy program here for T-W-Th's.

Auntie brought up a good point about me "needing" a dx. I want to stop the wondering, but I see now with a dx I will just add another "wondering" to my list regarding Nate's future.

For the "parent as a tool" stuff. I will usually tell him/sign "your turn" to him or tell him "you do it" and make my hands unavailable. He will usually then do whatever he was wanting me to do by himself.

My whole quandry was that I didn't want to "miss out" on some therapies that could help him more if they were started earlier (brain development window). I keep hearing all the "early intervention is the key" type stuff and it is making me sort of anxious.

Justinlove

I wish we all had that magic crystal ball that could see into the future

I can't tell you what to do, but I do want to give you some "feel goods" about daycare.  LA has absolutely THRIVED at daycare.  She adores her peers and teachers and she tries to do the things they do.  She interacts with them and I really believe that daycare has done MORE for her than therapies have.  Obviously not every kid is like this, but for her daycare has been awesome. 

We really debated if I would SAH or work after LA's birth.  The plan had always been for me to SAH, but the economy took a turn and I have a very secure job that I would not have been able to get back if I left (in fact, my school system--the second largest in our state, has not hired a teacher since LA's birth).  At the time, I was upset about going back to work, but now realize that it was a blessing in disguise as I know LA would not be as far along as she is now without that daily interaction with neurotypical peers.

JenGK

Z's been receiving services since before he was 2, and we don't have an official diagnosis yet (other than apraxia and SPD).  We did take him to see Dr. Greenspan before he passed away, who said he wasn't on the spectrum, but we didn't go too much further than that.  Only now, when he is four and we have to make a kindergarten decision next year, are we taking him for an official evaluation.  Right now, the only thing that could change with a diagnosis is an opportunity to be placed in a mini-MIPA class (autism-only thru the public school).  Right now he is in a self-contained non-cat class and we are happy with that - but it would be nice to have the option to switch if we need it.  He also gets speech, OT, social skills and Floortime each week. 

It took me a long time to get to a place where I was OK with functioning without a  diagnosis, and now I'm glad we waited.  I was able to hand the doc a huge stack of therapy notes and provider evals, teacher observations, school testing, etc.  I think he's in a much better place to make an accurate diagnosis than if we had gone in two years ago.  We've had the parent interview, and I bring in Z for observation and testing this coming Thursday.