Talk to me about the Autism Evaluation

JL04M

Today my LO had his first visit with a pediatrician (we are Canadian, he goes to a GP for his visits until GP referred him to a pediatrician for reasons below). We had concerns about speech regression, and some odd behaviors.

He said Da-Da a handful of times at 9.5 months, as well as Mama a handful of times at 10 months as well as Bye-bye once. He was then silent until 18 months when he said Da-Da twice, Mama once, and No twice. He is 21 months now and has not spoken since 18 months. He grunts a lot. Grunting is his way of communicating.

He has a few odd behaviors like an how he likes to hold crumpled up paper in his fist for hours, likes certain things a certain way and will tantrum if they are not, really likes to spin and watch the wheels on toy cars, etc...

However, he does interact with people fine, and has decent eye contact. He does point, but only started pointing a month or so ago. 

His pedi said today that he suspects he does have autism, and he will be getting a 2 day evaluation to see if he does or not. 

My mind was kind of going a mile a minute and I was trying to chance my toddler around and keep him from tearing the room apart so I didn't get a chance to ask the pedi all of the questions I would have liked to. I left thinking "Oh, I should have ask this and that..." so could anyone answer me these questions if possible?

1.What can I expect at this 2 day evaluation? (just so I can have a heads up)

 2. Is it possible for someone to be somewhere on the autism spectrum and to have some of the signs of autism but not all?

TIA

Deborah621

I am not sure how the evaluation process differs in Canada, we are in the states. With our son, we had an evaluation at a local Children's hospital that lasted about a half day. One doctor interviewed us and asked us questions and another doctor was working with DS. We were in the room with him the whole time. They evaluated DS in all areas of development, and gave him specific evaluations to test for Autism. Specifically I remember they used the ADOS.

I know a child does not need to have all the signs to get an ASD diagnosis. I feel my son has great eye contact, and can be very engaging and social. He is also very rigid at times, stims, and has pretty much no language.

Good luck as you go through this process, it is very stressful! But it will only help you understand your son better. My son has made a lot of progress since the diagnosis since he is now getting the therapy he needs.

lite-bright

I took DD1 to her district evaluation and speech eval; my DH took her to the formal diagnosis testing. 

Beforehand, we both answered a ton of developmental questions for the necessary paperwork. I sent DD1's baby book along with DH, and he had to answer lots more questions. If you google ADOS (which is one of the tests they used), you'll find some info about what the test is like. That was the one that really put DD1 in the realm of autism.

For her speech eval, they asked her to answer simple questions/point to pictures on a chart; respond to simple commands like "stack these blocks", and see her reaction when handed a toy bear and told he was hungry. A lot of play, but it also had long stretches where she was sitting and being quizzed. 

The district developmental eval covered some of that same territory. A lot of it seemed to be putting a kid in a certain environment with lots of play elements (stairs, climbing area, play kitchen, puzzles) and seeing her reactions. Did she walk up the stairs with alternating feet (gross motor skill), pretend to cook in the kitchen, look to the adults for help or guidance; was her play repetitive, did she try to get an adult to join her, did she get stuck on certain things?

My DD1 didn't have major issues with eye contact until after age 3. She is very affectionate, and begs us to play with her. She has a speech delay and a lot of echolalia, but is still very verbal and chatty. Her language developed on the slow side of normal until about 2.5, when it tipped into the realm of delayed. She doesn't tantrum, toe-walk, or do physical stimming. Most of her deficits are in social interaction with peers -- she wants badly to play and engage, but she misses so much on different levels of communication that it's hard for her to "get" other children and for them to understand her. 

ridesbuttons

I'm Canadian and have gone through some of the process.

Around 18 months with my younger son I had several concerns.  Zero speech, poor eye contact, a propensity to ignore when being called among other things.

I contacted my GP who referred us to a pediatrician for an evaluation.  I also contacted this place: https://www.thefamilyhelpnetwork.ca/home/ which is a local support (free) for a psychologist evaluation.

I had 3 separate visits with the pedi and psychologist: 2 off site (office visits with the pedi) and an in-home visit with the psychologist and case worker.  These were spread out over a couple of months due to scheduling issues.

The office visits were mostly question and answer type visits with the pedi observing DS during that time.  For the psychologist visit I did a lengthy  intake over the phone (half an hour at least) prior to the home visit.  The home visit included more Q&A for me and the psychologist interacting directly with DS2.

At the end of all of this, both parties agreed: no need for ADOS, no autism.

Now, during the 6ish months that I began the process and the follow up visit with the pedi, most of my concerns had more or less resolved.  DS attended speech therpay from the age of 20ish months until over the age of 3 when he 'caught up'.  Likely childhood apraxia of speech.  I engaged private speech therapy as the wait times for government sponsored programs is excessive.

I have wondered since how much of his concerning behaviours was driven by his speech delay and how much is just part of who he is. 

Perhaps not what you were looking for but this is my first-hand experience with the process as far as I got into it.  You can PM me if you want though I don't frequent the boards as much as I used to.

JL04M

Thanks for the info everyone.