Testing Results

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Hi Y'all....I've been missing for a bit. We've been quite busy here - we managed to move up L's neuropsych eval, managed to get in for a private OT/Sensory assessment, and started to line up a Behavioral Intervention Specialist with a local non-profit autism group.

So, we did get L's results from the neuropsych eval. Primary diagnosis is Asperger's, which is what we thought - and what the school district keeps denying. She does also have co-morbid diagnoses of dysgraphia, General Anxiety Disorder, NOS, Mood Disorder, NOS, and the neuropsych did say that she also has significant ADHD type behaviors, but did not give that diagnosis as technicially its either Autism/Asperger's or ADHD under DSM-IV. She does appear to have "face blindness" as well - it was a bit odd in that she can identify emotions, but cannot accurately read emotions on peoples faces and perceive what her behaviors are doing to others. It makes perfect sense to me, as the thing that we keep hearing is that she doesn't have empathy towards others - I think that would be a hard thing to comprehend, if you weren't able to accurately judge how someone is feeling by looking at their face. She also has some executive functioning delays. IQ testing went fairly well - overall IQ is 119? I think - the really interesting part of it was her verbal IQ, which was 140 - the results said that with the split between her verbal IQ and visual spatial IQ, the combined score didn't mean much and that the subsets need to be consulted in order to get an accurate read on her performance. It also noted that the gap between the two scores was quite rare - occurring in less than 1% of the popluation?

So - I'm open to suggestions on how to best get the school system to help here. I'm hopeful that now that we've done the outside assessment and have an Asperger's diagnosis, they will begin to get off the she has a "conduct disorder", she has bi-poloar disorder kick. The neuropsych said that she DID NOT see any of the typical things that normally go along with childhood bi-polar disorder or a conduct-type disorder. In her opinion, L has issues only when she's overwhelmed or stressed - but once the stress is put aside (her example was with challenging tests), L re-groups and goes on to work on the next item. The neuropsych's comment was that with conduct-type disorders, the child will typically be defiant and refuse to continue at all with any further testing.

School has been ROUGH so far this year. Out of the 3.5 days she's had so far, she's been sent home twice. Once for a verbal outburst at the teacher and leaving the room to go into the hall to cool down w/out permission and today for an fight on the playground w/three boys. The school is continuing to push for a placement in an EI room (which the neuropsych says will be a BAD idea for L), although, they are now arranging a meeting with the Autism team to hopefully begin exploring additional resources.

Last edited by gardengirl414 on 15 Sep 2010, 10:06 pm, edited 1 time in total.

Hi GardenGirl -

Sounds like similar IQ results - DS' verbal is 130 and processing speed is 88. The "scatter" (wide disparity) between the two is rare within the population, but supposedly not rare for Aspies, His overall is 112, but as with your daughter because of the wide range, the average isn't really of value. He also has sever executive dysfunction.

For us the NeuroPsych has given DS a BP dx because his special interests aren't special enough, he has shared interest (so long as you are sharing his special interest) and his rocking isn't enough to be stimming. I have a bunch of others who think that DS is just so smart that he answered questions as he was supposed to during testing and they clinically see Aspergers.

The pediatric neurologist told me that until I provided supports appropriate for an Aspie, we would not help the meltdowns. We have started focusing on these interventions and it has been impactful for him (we have seen a reduction in meltdowns).

That said, we did move him into an ED classroom. The good news is there are 10 kids with 3 adults. the bad news is some of his peers have conduct disorders. Over time, as he gets older, this will be a problem. Right now the behavior modeling in the class is ok. We have yet to figure out what will be appropriate for him.

We have started some supports, as we are learning different things about what she needs. We have been actively working to get on track with her sensory issues - they seem to have gotten worse in the past 6-8 months, so we've started using noise reducing headphones, making sure she is getting the sensory inputs that help (spinning/swinging). Can you give some suggestions on the types of interventions that you have used? The one thing that does seem to help is to avoid confrontations with DD - it's like beating your head against a wall and serves absolutely no purpose - it just makes the situation worse. Of course, at school, absolute compliance is expected, as well as not doing anything that might disrupt the other children (pacing, for example, or stretching on the floor while everyone is seated on the floor for reading circle) - which I understand perfectly....but it doesn't help DD to not be able to do some of the things that help her cope with the situation.

You've expressed one of my biggest concerns - being in a room with others who have conduct disorders. I'm afraid that it will take a bad situation and make it even worse.

I was just looking through the district's "classifications" - it seems odd, but they have Asperger's specifically called out as being "different" from their designation of autistic spectrum disorder. This is the language that they have: Autism and Differential Diagnosis in DMS-R: "Autistic Spectrum Disorder should be distinguished from Asperger's Syndrome. As opposed to ASD, this disorder does not involve major deficits or delays in language or cognitive development." That seems very odd to me - is it possible that Asperger's doesn't technically qualify as ASD under the educational guidelines? I really hope that I am misinterpreting this......

i think they are making a distinction because the aspergers criteria specifically require that there is no significant language delay or cognitive impairment. that means the child should have near normal language thus will not require the supports that a non-verbal or delayed child would. it also means that the child is average or above average intelligence and not requiring supports that a cognitively impaired child would. so an aspergers child typically has different needs than a child with kanners or classic autism.

altho, they are wrong in trying to separate aspergers out from asd, as aspergers IS an asd. their use of the terminology is incorrect, but i assume its just how they classify things, either aspergers or asd where asd is everything else on the spectrum.

The supports I am referring to:

Allowing the pacing or rocking or whatever

Not requiring absolute compliance, if a demand is not working for DS, he is redirected to another appropriate activity. For my DS, once he is "checked out" of a task, because of completion OR he has decided he can't do it, he needs to be engaged by an adult who can then either provide him assistance with the current task or redirect him to another appropriate task. He is not required to do what everyone else is doing.

I never realized how bothered he is by change. He thinks he likes change, however, he reacts badly to it. At this point, the teacher will call me at home if she is going to be absent because the district subs aren't trained to work with my type of child, and I keep him home. They address any changes in advance and work with him on it.

He still has meltdowns, in his class, it's not the end of the world as it is in a mainstream class. To a certain extent this is helpful. It helps to have adults know exactly how to handle and for other kids to have the issues too.

There is no way that these accomodations could be made in a class of 34. It is just not realistic. We have a class of 10 with a teacher and two aids. Because of the low ratio, the conduct disorder kids aren't a problem for DS.....YET. However, when it comes to middle school (next year), this is a huge concern. In addition, once DS figures out how to aviod meltdowns, this class is not academically stimulating at all. He is basically making up his own work to be interested. (he sometimes does thier worksheets to prove comprehension, but then he will choose a research topic and look up facts.).

I don't know where you live but where we are the district did not recognize Asperger's as Autism because they said it doesn't require interventions. Yes, that's right NO interventions or supports.

Needless to say, my daughter is now in a private school and is doing much better. The schools did want to classify her ED due to her anxiety but I absolutely would NOT allow it. Eventhough it would provide for a smaller class size for her, the problems as mentioned above would be encountered. PLUS, she is NOT Emotionally Disturbed and was only having anxiety because her NEUROLOGICAL differences were not being taken into account!

Sorry, this is a sensitive subject for me. I hate the way the schools will let our kids fall between the cracks simply because they are too bright to "fail" academically. I hate to sound like a pessimist but simply having a neuropsych eval and dx was not enough for us to convnce the school to address my daughter's difficulties at school. I hope your experience is better than ours.

Mama_to_Grace, you sound about as bitter as me about the public school. I am so glad the private school is working out well.

I don't think children with some ASDs can get an accurate IQ test due to the differences in learning and ADHD type issues.

Same case here, as we learned yesterday. Our "choices" are moving to the EI room in another school - or petitioning the district to begin with the AS "educational" assessment, which will take a month and allow the current situation to continue - which is definately NOT good for DD - she has not been able to stay at school a full day as of yet. If (and that's a big IF) she is found to be AS (if she meets the EDUCATIONAL criteria, not the "medical" diagnosis that we have), then our choice is to place her in the resource room within her current school - the class they have there is for children who have lower IQ's, or delays in learning, but are otherwise functioning well. Really, that's not much of an option for her either.

We looked at the EI room today....the teacher is wonderful, the environment is more in line with what she needs. The other children in the room, however, all do seem to have other delays outside of the emotional issues by which they've been classified. Speech issues (which I'm sure will be difficult to understand for DD with the 139 verbal IQ and her somewhat blunt nature.......), cognitive functioning issues.......I am also very, very concerned that she will not get the academic challenges that she needs.

Somehow, this has just gone from bad to worse......

The one good thing that I noticed is that DD seems to be doing better.....I took her off Ritalin yesterday and both DH and I have noticed a big drop in her irritability - she still has frustration and does still get upset, but it is WAY better than it was 2 days ago when she was taking the Ritalin. Contrary to her P-Doc's opinion (the last one - we started with a new P-doc at the beginning of this summer), I have been concerned for some time that it is contributing to her irritability. We first really started noticing a big increase in behavioral problems last spring when the P-Doc recommended adding more Ritalin in the afternoon (DD has a tendancy to overload in the afternoon), which we did. It didn't seem to help much, and we noticed the irritability (Doc says that the increase in dose has nothing to do with the behavior change - of course, this doc also said she was bi-polar, was "rapidly cycling'" and wanted to then start lithium, which I vetoed). I stopped giving her the afternoon dose after 2 weeks - but, the behavior remained.

So, to get to my question - has anyone experienced their child being OK on Ritalin and the later start having issues with side effects/irritability?? It seems odd that it would suddenly start causing issues? But, I suppose, your body chemistry would be different as you get older/start heading into adolescence (she's now eight)?? I will talk to her new psych tomorrow during her "meds" appointment - but I'm not holding my breath. This one mumbles and bumbles and drives me NUTS!