Recap of Greenspan Appt. — The Bump
Special Needs

Recap of Greenspan Appt.

We met with Dr. Greenspan starting at just after 9 this morning for close to 2 hours.  I'd already filled out a bunch of paperwork with Zach's history, and spoke with his nurse for an hour about the issues I was seeing.  When he came into the room, Zach was enthralled with him and ran up to hug him.  I shortly learned that Dr. G is recovering from a broken hip, and that he couldn't even really handle that, so I had to run interference when Zach tried to run up to him (which he did a couple of times).

He then observed Jason and I interacting separately with Zach and gave us ideas based on Floortime on how to better engage with him for extended periods of time.  We then had a long conversation about what he could do for us, what his diagnosis of Zach is, and his therapy plan.

Bottom line is that he believes that Zach has SPD/motor planning deficiencies, but that he is not on the spectrum.  He said that Zach is way too warm and engaged with/interested in people -- including Dr. G -- to have a ASD diagnosis.  He did recommend an extensive course of therapy to address his sensory/motor planning issues and to help with having consistent, extended interactions.  The only thing he suggested that I'm hesitant about implementing is a GF/CF diet.

After a break, we went over to DIRS, which is a Floortime-based therapy center.  We met with one of the director, who did another observation of Zach, talked with us about our concerns, gave us a primer on Floortime, and showed us how to start to implement Dr. G's therapy plan.  (Zach really liked him -- he got hugs during the session).  He agreed with Dr. G's belief that Zach is not on the spectrum, commenting that his interest in people and warmth was a strength that we should play off of.  We're probably going to start seeing an OT there, since Zach responds better to center-based therapy than home therapy.  He had a great time playing with all their toys and equipment.  The trampoline was a big hit -- I'm thinking I need to get a small one for may basement.  We met the therapist, and Zach engaged more with her than he has in weeks of meeting with our county OT at home. 

It's nice to finally have some answers and a comprehensive plan going forward. 

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


Re: Recap of Greenspan Appt.

  • SPD is not that bad of a diagnosis. and you are getting it early . Have you been to the spd site yet, so much information there.


    Please check out my blog. I have three spd kids. 

  • Sounds like it was a pretty good appointment - you certainly learned a lot!
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  • That sounds great.  Congrats on having a good plan in place.
  • Auntie, I sort of thought the same thing about ruling out ASD based on warmth or engagement, but then again, who am I to question Dr. Greenspan? :)

    And interesting information about GFCF diets... I haven't gone down that road with DD, but my instincts tell me that it won't really benefit her, and your information validates my thinking on the issue.

    OP, Sounds like a very productive appointment, which is all that matters!

    A sister is a little bit of childhood that can never be lost. ~Marion C. Garrett
    image7_0002 A ~ 2.7.06 S ~ 9.2.07
  • Thanks for your thoughts, and I'd be interested in hearing the gossip.  I'm always opening to revisiting the actual diagnosis if needs be, but the plan that he suggested makes sense to me.  My description of his reason for excluding ASD was probably too generalized -- beyond just warmth, he pointed to his problem solving abilities (including asking us for help when he needs it to solve a problem he can't on his own), his ability to engage in pretend play and to properly use toys, interest in playing with other kids, and some other things (this part of the conversation was happening while Zach was getting grumpy because it was nap time, so I'm waiting to get the report).  Overall, the thing I want to do is to get treatment for his issues, regardless of what the diagnosis is (though I admit I was relieved to hear that he didn't think he was autistic).

    I admit that I do have some hestitation to go full -force into getting lots of therapy at this center that I imagine he has financial ties to.  But I think that Zach needs to have center-based OT sensory therapy, regardless of where it happens, in addition to follow-up sensory diet work at home.  (There is a woman a bit closer to my house who does the same kind of SPD work).  I also need to find someone who does oral work -- as both his SLP and Dr. G agree that he had oral motor planning issues that we need to work on before we'll get fully developed speech.

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

  • My JM was not dx on the spectrum till he was five years old, he was dx as SPD till that time, the thing is much of the therapy is the same. So start the therapy and wait and see. JM is in mainstream school as he has been in therapy since he was one year of age. Get him the help that he needs and all will be fine.
  • I would personally go with what the doctor says.  If you start reading so many posts on line and internet searches, I find that you will go crazy, your mind won't know what to think, etc.  I personally think the whole autism with a little on the spectrum, a lot on the spectrum, etc. is just too much -- meaning I truly do not know what to make of the whole thing.  I tend to run into a lot of people and professionals who think it's also getting way out of line with the whole spectrum role but that is my two cents.  Do what is best for him now and do what the doctor suggests and play off of the spd diagnosis now and see what happen later as he grows.  That is all you can do now.  I would not go with an autism dx yet.  JMO.

  • DIR/Floortime didn't originate for children with autism, as Greenspan's initial area of interest was typically developing infants.  My point being that his model of interacting with children is not strictly for children with autism.  Sounds like instead of calling it autism (what does that REALLY mean these days?  so many children get this diagnosis and they are all so different), he is labeling the overt symptoms.  SPD and motor planning deficits are much more descriptive than autism.  Anyway, just wanted to throw this out there in response to the concerns auntie presented.  I don't care if this man is 149, he has seen a lot and knows far more than I ever will.  I completely respect his assessment and opinions.  And lastly, maybe I am naive, but he has clients and speaking jobs coming out of his ears, I don't think he is referring this one child to a specific program for monetary gains.  Maybe I am wrong
  • I agree with the age factor as well in regards to the poster who commented on him being 149 or whatever :)  He has tons of experience and is a professional here.  I know many professionals could be wrong but I doubt it in this case.  I am sure he is not entirely ruling out autism overall but he may certainly be just ruling it out now at his age which I find completely appropriate.
  • I haven't read all the above comments yet... whew there's a lot!! 

    I am so glad you got a thorough eval and glad it went well. I still can't believe that you meet with THE Greenspan for this eval. And who's to argue with that? I mean he's seen how many kids on/off the spectrum. I really respect his opinions, but.... 

     I jumped a little when he said that his engagement is too warm for a Dx of autism. In 2 hours, my son would do the same thing (maybe, I wasnt there) but when you see him with other kids there are subtle but evident things that scream inappropriateness. He is very warm to adults, situationally. 

    I certainly hope that what he told you is the case. 2 is SUCH a hard age....  just remember the therapy/help/supports are much more important than a label.  

    Does your son have some obsessive things he does... or not? That's one thing I would have a hard time pinning under SPD.  


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