Our Almost Diagnosis

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Our private evaluation was today with the child psychologist and occupational therapist. We don't get the official report until the 14th, but she said that her observations, playtime, the information I provided with questionnaires and notes and the interview.....we are looking at ADHD and SPD combination. She said she is not seeing signs of autism, mainly due to the fact he was not in risk range in social behaviors. However, in repetitive behaviors, he is well over the cut off. She explained that SPD sensory-seekers can have a lot of cross-over behaviors into autism-like behaviors.

I'm not sure that this will be the last stop on the diagnosis road for us, but for now I am willing to take a pause, start OT and try some new parenting tactics. While I feel her insistence that AS kids can't be social or share experiences is a bit off base, I do think that has a lot to do with the changes to the DSM.

So that is where we are. While I suppose we are not officially an ASD family, I hope I can stick around...I am finding more help here than in any NT-parenting area.

Autism can look a lot like ADHD and SPD, and I am guessing the opposite is true, also. Whether this diagnosis is right or not, I obviously can't say, other than I have a feeling, like you do, that they are making too many assumptions about social success.

How is your child's pragmatic speech? Did they test that? If so, do you have a breakdown? Momsparky mentioned in another recent thread how pragmatics can look misleadingly good on average but the breakdown could have splintered skills. Pragmatic speech is something that is likely to show up as problematic even if social skills appear good enough.

If I only had a dollar for every person told me why my son DIDNT have ASD, Id be on vacation now! Yes, my son eventually did get a spectrum diagnosis. What does your gut think?

also, my son is EXTREMELY social and always has been. Many people on the spectrum are.

How old is your child, and did the evaluator use the ADOS (autism diagnostic observation schedule)?

Definitely stick around here -- your kid doesn't need to be "officially" ASD at all. If we share some of the same challenges, that's good enough to fit in.

My 14 year old daughter was tested in October 2013 and at first the school psychologist was not seeing it at all, she just wasn't autistic enough to get the diagnosis. I got upset and told her to keep looking, as after reading about aspergers, I knew that this was my daughter for sure. I told her I had been waiting 13 years to find out what made my daughter tick and this was the answer. She ended up using some other forms and then suddenly she was totally testing for aspergers. Her coping skills are that of a two year old and her interpersonal skills are that of a 4 year old, but she is very bright, super well spoken and a great writer and very outgoing and social.

My son is 3, almost 4 (December). I know he does not fall into the area of "classic" autism but when I look at aspergers/high functioning symptoms and behaviors it's like the authors are writing about my boy exactly. I feel like if he is AS (and my gut says yes) no one is going to believe it until he is old enough to be out of typical preschool behavior age range. I told her myself (and in my pages of notes) that it is not so much the individual things he does that worries me - it is the degree to which he does them and how many behaviors and quirks there are. She literally said "he shows joint attention, that isn't something an autistic child ever does" - which is BS. She wasn't condescending per say, I did like her. But I feel like she was quick to dismiss autism simply based on him being talkative.

I also feel as though the ADHD label is an easy write off on any need for therapy or help. She told me point blank that he is too young to medicate (duh) so there isn't much to do for ADHD other than try different parenting and "hold on for the ride". Yes, because I'm sure ignoring the chance to enact real change for him now won't effect him when he is older and has to pay attention and hold still on a daily basis in school. :sarcasm:

I am glad they payed attention to the SPD issues, so that we can get OT. But then again, since SPD "doesn't exist" as an actual diagnosis per the DSM or any other standard, it is hard to get the therapy paid for. If our insurance refuses we are going to have a time of it.

They did not use the ADOS. She used the GARS-3 and didn't even follow the "checklist" for autism during her playtime because she said it was obvious it wasn't needed. :headscratch: No speech test.

One of the support groups I attend is open to parents of children "with autistic spectrum issues," just to make sure it's as open as possible. So, we've got lots and lots of parents here whose children have SPD and ADHD as well as AS, and all kinds of other diagnoses as well. It's like alphabet soup in here. Point is, we all have issues in common and can share strategies that work.

We also had about a half-dozen diagnoses: ADHD, I myself thought it was bipolar, mood disorder, PDD-NOS...we finally went somewhere where they really knew what they were doing, they gave him a battery of tests, a diagnosis of AS and then EXPLAINED why in a way we understood.

A diagnosis is only as good as what you get from it: if they throw letters at you and shrug, go somewhere else. You need a roadmap for interventions for your particular kid; sounds like OT is an excellent place to start, but it sounds like he needs more...and I think your misgivings about the psychologist's statements are spot-on.

Child psychologists are not necessarily equipped to diagnose autism, believe it or not. If you can find a developmental pediatrician, or, even better, a developmental practice or center headed by one that also offers OT, speech therapists, early interventionists and social workers, go there. Definitely get the pragmatics looked at by a speech therapist (your school should have one,) and if nothing shows up now and you're still worried about social skills in a year or two, do it again.