is autism always just an opinion prior to age 2? — The Bump
Special Needs

is autism always just an opinion prior to age 2?

went to see the speech pathologist and another pedi and they both said that my lo is not showing any autism red flags and that he doesn't seem autistic at all.  I am not trying to get people to agree or disagree with the diagnosis, nor am I shopping around for a diagnosis, I am just confused about what makes a child autistic at this age when so many professionals disagree on the label.

my lo is speech delayed and shy, sometimes joining other kids and doing parallel play, and sometimes playing with a toy alone, usually slow to warm up to new people.  He points and babbles, engages with us all the time.  Never thought he had autism until we met with the neurologist, there he was just playing with toys, not interacting with us or the dr.  But at the speech pathologist, he was happy and engaging with us and the speech pathologist, bringing us toys, etc.  From my experience, it seems like the Drs. look at the child at one moment in time and give the diagnosis or opinion.

I am getting my child speech services and once again am not trying to get anyone to say my lo is completely fine, just wondering how common it is to get conflicting information.

Re: is autism always just an opinion prior to age 2?

  • Very common in our experience.  DS's pediatrician SWEARS he's been over-diagnosed with PDD-NOS.  The psych evaluator made it seem like she wasn't quite ready to say Autism so was giving him PDD-NOS for now.  Special Instruction therapist #1 said "probably not"; Special Instruction therapist #2 says "maybe, not sure".  

    *sigh*  Me, personally, right now I'm not sure.  I mostly notice his speech and social delays but I don't know how much of that is his own personality and how much is disorder.  

     Good luck! 

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  • imagemalcivar:

    Very common in our experience.  DS's pediatrician SWEARS he's been over-diagnosed with PDD-NOS.  The psych evaluator made it seem like she wasn't quite ready to say Autism so was giving him PDD-NOS for now.  Special Instruction therapist #1 said "probably not"; Special Instruction therapist #2 says "maybe, not sure".  

    *sigh*  Me, personally, right now I'm not sure.  I mostly notice his speech and social delays but I don't know how much of that is his own personality and how much is disorder.  

     Good luck! 

    wow, it sounds like we are completely in the same boat.  How can you move forward with the diagnosis and accept it when so many people say it's not the case?  are you just moving forward with services and not paying attention to the label?  I know they say denial is common with this diagnosis, but so is late speech and social "quirks" in toddlers.  Does it come down to when and how speech develops?  If it is autism, will speech not come as it would in a child without autism?  I guess my post should have been titled "until speech develops, is autism an opinion?"
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  •  I don't know the exact age but I think autism is really 'an opinion' until that point when you can factor out toddler quirks.  I'm not sure with DS. I definitely think that his social delays are more than just quirkiness but as for anything else, it really hinges on his speech and how it develops.  Right now he's still labelling the world and not really using it to communicate his needs and wants but if that kicks in, it'll be interesting to see how everything else develops.  

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  • imagemalcivar:

     I don't know the exact age but I think autism is really 'an opinion' until that point when you can factor out toddler quirks.  I'm not sure with DS. I definitely think that his social delays are more than just quirkiness but as for anything else, it really hinges on his speech and how it develops.  Right now he's still labelling the world and not really using it to communicate his needs and wants but if that kicks in, it'll be interesting to see how everything else develops.  

    my lo, 21 months, always points and make sounds to get what he wants, but also only labels words - points to and says: banana, hat, bum, etc. 

    do you know how you or your h were socially at this age?  I know that they always say that people use these similarities to deny labels, but my parents said that whenever they took me to easter egg hunts and they told the kids to go everyone ran up to get the eggs and I would just stand there like a deer caught in the headlights - at every easter egg hunt, I don't remember this, but it is definitely socially awkward and behind.  They said that this is one of the many examples of how I acted, I am not trying to deny the label, but I was also speech delayed as a child so I most certainly would have been diagnosed with autism had they been diagnosing it then.

  • According to my MIL, DS is EXACTLY like DH was at this age.  Me, on the other hand, was quite the gabber, little social butterfly, which is funny considering how downright shy I am now as an adult.  
     
    Guess we'll just have to wait and see how our kids develop.  
     
    While his ped disagrees w/ the dx, she has always been of the mind that getting him services can do nothing but help in the long run.  Not sure if she's just hedging her bets or if this is truly her philosophy.  I'm just glad she's never been an interfering factor in us getting svcs for DS. 
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  • Well, for me I had EI say motor problem and speech delay (age 2); private SLP say orla motor dyspraxia but not autism (age 2-4); OT say dyspraxia but not sure about autism (age 2-current); Dr. Greenspan (autism expert) say no autism but SPD/motor planning issues (age 2); dev pedi #2 say maybe autism but too young to tell (age 4); school psych say moderate to severe autism (age 4.5); SPED preschool teacher say SPD (age 3-4) and suspected autism (age 4.5 -- it was the same teacher); summer camp SLP/OT/psych say SPD/motor planning and maybe autism but too early to tell (age 3).  Obviously, no one but the docs are qualified to diagnose.  These conversations all took place in the context of just talking about what we were seeing and what type of therapy plan to develop.  Bottom line -- get therapy and worry about a label later.  Regardless of whether Z has autism, a social communication disorder, or some other issue, he needs speech and OT to reach his full potential.  Therapists look at what a child's specific deficits are and develop a plan accordingly.  Therapy is not like having an ear infection, where they say red ear means antibiotic at (weight x per pound book dose).

    And it is possible to have delayed speech, develop speech, and still be on the spectrum.  As Auntie said, there are tests, but many of them are for kids when they are closer to school age.

    Zachary, 8.31.2007 * * * Adam, 3.24.2010<BR>

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  • we got a conclusive PDD-NOS shortly before DD's 2nd birthday... that said, this was from a pediatric specialist that was part of an autism center affiliated with MGH... I suspect she'd seen enough autism cases in her professional career that she could probably diagnose in utero (obviously kidding there, just trying to stress the point that practice made perfect, in her case.)
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  • My DD was diagnosed with autism at age 18 months.  But, she was also diagnosed with a seizure disorder at 12 months which caused severe delays.  I don't agree 100% with the autism diagnosis, but I am actually glad she got it because it opened the doors to ABA which she has greatly benefited from.  Her neurologist doesn't agree with the autism diagnosis either, but he feels the same way I do.  I won't be surprised if as she gets older she still has the diagnosis, but I'm not sure yet because of her delays from the seizures.

    Her diagnosis was from a developmental neuropsychologist at Children's Hospital in Boston.

     

  • In our experience, regular pedi said no way autism, but didn't interfere with referrals at 2.5 yo, SLP said no autism at 2.5 yo, developmental pedi said no way autism at 2.5 and again no autism at 3 yo. EI psych labeled autism at 2.5yo and school psych labeled HFA at 3 yo. So, yeah, confusing. That didn't stop me from getting all possible services for DS. It can't hurt. However, the fact that the dev pedi said no autism twice, even after DS went through her intensive 3 month intervention program at UCLA, so she had a ton of data on him. She has a 30 year experience with ASD. It's her specialty. Don't know, DS has issues, that's all I know now that he is 6. He is awesome, but he has issues and needs support at school. So, I'm no longer interested in thinking about the label
  • To offer you a different perspective, my friend who had a child that was delayed since birth. At his 15 month appointment, her pedi said don't worry, all kids develop at a different rate. She got the same message at his 18 and 24 month visits. 4 years later, he's been diagnosed with epilepsy and she kicks herself everyday that she listened to the doctor's advice that he was fine and didn't seek help for him earlier.

    I would rather my child be overdiagnosed, receive help then find out that he was fine vs not believing a diagnosis and waiting it out until he was older. Early intervention is so critical for kids with autism or other delays, so get him whatever therapy they feel will help with his autism and worry about the label later.

    I'm quite surprised your slp is already labeling him before really working with him for a while. My slp said she'd need a good 3 months of interacting with him before she'd feel comfortable with any label or diagnosis.

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  • image-auntie-:

    You seem to be having difficulty seeing the bigger picture. Your posts are never about the merits of ESDM vs Floortime of ABA; you never ask for suggestions around managing challenging behavior at Target or the dentist. You have a laser focus on you vs the professionals on parsing the dx..

    She does ask all of these questions on 12-24. (yes I lurk) It's like a virtual MCHAT over there. You can guess what kind of "helpful" answers she is getting too.

    I encourage you to ask those questions over here and also participate in the discussions. Many mommies here a going through the same thing with challenging behaviors. Some mommies also have "typical" children and will be able to answer your questions better.

    WAY 2 Cool 4 School


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