My pediatrician is wrong about this, right?
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Last month my DD had her two year well visit. I voiced my concerns that my child had autism specifically due to the fact she has a receptive language delay, does not always responds to her name/ignores instructions, and also has some red flags like stimming/other sensory behaviors.
At that point, she stopped checking her out and asked me to get her to interact with me while she observed her for 5 minutes (which worked out well since my kid was hella pissed off and screaming since she loathes going to the pedi). I had some toys in my bag to keep her entertained (specifically, a toy phone and a few toy tea cups since both my kids love pretend tea parties). We played for a few minutes and then I sang a few songs like row your boat/wheels on the bus.
She said that while she respected my opinion as a parent she doesn't feel she has autism since she is very social, engaged and interactive with me (and even reported she got a lot of eye contact from her). She believes her symptoms are due to an immature nervous system causing auditory processing difficulties. She did give me the neuro referral to be evaluated for autism and even called on my behalf to get me an earlier appointment which was amazingly nice and supportive.
It's not unheard of that a child with autism is engaged, interactive, and enjoys initiating play with a parent right? I'm right and she's wrong on this, correct? I know I have some legitimate concerns and am doing the right things for her but I feel lately everyone is second guessing my gut feeling as a parent.
Re: My pediatrician is wrong about this, right?
I had no idea giving a cup to mom she "pretend" poured liquid to was an advanced play skill--my son learned it at 1.5 when I put him in daycare part time for socialization and my DD picked it up from DS at around the same age.
Ironically enough, one of my OT's first comments was "poor functional play" when I asked her to write up something regarding DD on the paperwork the children's hospital sent over in preparation for her eval. lol.
I thought PPD-Nos kiddos technically fell on the autism spectrum--I thought it was another classification like Asperger's. If I got a PPD-Nos dx, would that help me obtain more services via my school district/insurance provider like an ASD dx would?
Please don't assume I was attempting to get random moms on the internet to diagnose my child and that I want to take their advice over my pedi. My pedi said "your child doesn't have autism since she is so interactive and engaged with you while she's playing. The kids on the spectrum that are my patients don't do this." I thought that was an inaccurate statement so I was just clarifying I shouldn't take that judgment as fact.
I definitely don't think her pretend play is a learned script--she will brush a doll's hair, walk her in the stroller, feed them a bottle, food on a spoon from a toy container, if she has a doll with her while she's having a snack she tries to share her food, etc. Her older sibling doesn't have too much an interest in dolls (especially to that degree) so she didn't learn it from him and she's at home with me so she didn't learn it from other children at daycare. Her OT has seen her pretend play with dolls but DD definitely has limited interest in interacting with her in play so she really only gets a small window. I didn't think that this kind of play would discredit a diagnosis though since from what I understand kids vary greatly on the spectrum. She certainly has a number of other behaviors that are consistent with kids with autism.
I am definitely aware that I may not get a dx/all my questions answered. I've already gotten the shpeel from my OT of "I know I'm not qualified to diagnose autism but I don't think she presents with enough to get a definitive diagnosis. be prepared to get the developmental delay label with a referral to come back in 6 months."
I do know with my district, the diagnosis would help with services I would want for her. I also realize that specialists I'd want for her may not take insurance though I do know for a fact the developmental pedi does--I am going to the neurodevelopmental center at our children's hospital staffed with a neuro/developmental pedi/SLP/OT and I've been through who/what is covered. Wouldn't services like aba/floortime (after EI ends--she gets it currently through them) have to be provided though if she has a dx? I know many specialists wouldn't necessarily be covered regardless--but therapies she would receive on a regular basis would, no?
He did not have the level of pretend play you are describing at 2. That level came probably some where between 3 and 4 and is pretty limited and scripted compared to his peers.,
DS 09/2008
Auntie--you really need to give a course on how to quote selected parts of text. LOL.
No family history at all of autism. No one even kind of quirky/socially awkward--both sides of the family are full of salespeople, HR, nurses, etc. I had apraxia as a kid so there's some neurological issue (perhaps with some SPD/inattentive adhd tendencies though never formally dx) and likely have some uncles who had it as well since a few have some mildly noticeable speech issue.
I'd really lean towards inattentive adhd as the potential root issue especially since I know some traits overlap--but she is very weak socially. She has a small list of people in my family she likes and ignores everyone else in the world who attempts to talk to her--wont respond to her name, wave hi or bye to anyone besides her small group of preferred people. When strangers say hi to her, she cries. She has zero interest in her peers with the exception of her sibling who she likely has an unhealthy attachment to. lol. She makes no eye contact with her therapists who she's had for a while unless they're engaging her in some sort of preferred play, like singing a song with gestures like row your boat/doing something silly to make her laugh.
That really sucks regarding the insurance but good info to know. Is medicaid any more helpful? My state has a program that allows families who make 250% of the federal poverty limit pay a monthly premium to buy into medicaid as their secondary insurance to cover what their employer sponsored insurance doesn't cover. Wondering if it's worth applying for that.
Sorry for all the questions--I do appreciate the responses!
Girls on the spectrum are way under diagnosed. They just don't present like the boys do for the most part. My DD is very social, will initiate play with other kids (just on her terms lol) is very engaged with me and DH and she definitely has autism.
She also loves showing affection and says I love you all the time. Just look at the criteria for autism. Does she have a language delay? Does she have social issues? DD will engage with kids but not at the same level of her peers. She also insists on very structured play (ie, the barbies have scripts to follow and if her playmate doesn't follow there will be issues lol). Third, does your DD have any repetitive activities?
DD was officially diagnosed about 1 1/2 years after we really started voicing concerns to her doctor.
Definitely an expressive language delay. I say frequently she has a receptive language delay--but there's really no way to measure what she knows (besides the expressive language she has which is limited). If you ask her to draw a circle on a piece of paper, she will grab a crayon properly between her pointer/middle finger (which she was never taught but figured out on her own at 16 months) and draw a circle. Ask her to identify a picture of a circle in a book? She wouldn't point to one. She's very self directed and has zero interest of showing off knowledge like most kids would.
Definitely social issues but no to the repetitive play. On the contrary--she has limited focus unless it's her preferred activity.
Most of the people involved in her life say she's a mystery and they've never worked with any child like her. I'm holding onto some hope that the neuro will be able to offer insight so we can identify ways to help her more--I'm not holding my breath though.
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Luckily, my apraxia was resolved with therapy by my school-provided SLP so no private therapy here. I would have been royally screwed if I needed additional therapy since I was raised by a poor single dad. lol.
I have heard great things about one of the local universities here that has a SLP graduate program (though the wait list is about 6-12 months to get in). My friend's daughter had her apraxia considered resolved by 1st grade (and she wasn't diagnosed until 4) and had nothing but great things to say. She paid $800 a year so not cheap but nothing like paying OOP hourly to a private SLP. That's our tentative game plan (after based on what we find out from the neuro/our insurance carrier of course).
In terms of medicaid we currently have a HMO so we're always jumping through hoops anyways. What's a few more? lol. I will definitely check this out and see if it's worth it in my area.
Yes. both of my children have sensory issues and they're the total opposite. both seekers--though my son is hyperactive and my daughter is lazy and lethargic. I think he's the best thing for her since he's such a ball of energy and she looks up to him so much. lol. My sensory profile as a kid was closer to my DD--I had hypotonia as well and had lots of gross motor delays, low arousal level, poor attention, etc. I'm still failrly uncoordinated even as an adult.
My son had lots of symptoms of apraxia and we started him on therapy at 1.5. Whether it resolved since we started therapy for it so young or he was misdiagnosed I don't really know but he's doing really well now. As horrible as it sounds when we started seeing delays with my DD I was hoping it was apraxia since it's something I know (even though it really sucks), kwim? This autism thing is throwing me for a loop.