AS traits vs AS and developing away from AS ( 5 year old)

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My son has just turned 5 he has just recently been assessed by a speech therapist here in the UK. He has had some issues at nursery integrating with his peers. The nursery hinted at AS around his first year (he was 3/4) his speech was delayed then.
By the time he had the recent assessment his speech had improved dramatically what concerned us was his accent...he tend to speak with a quite unusual and quirky accent with the odd TV inspired quirky phrase. The speech therapist was very definite in that in her experience she had only heard anything similar with children somewhere on the spectrum. Whilst she cannot be definite she thinks he should go for a full assessment. She agrees with us that his accent can change, sometimes it sounds much more natural and local. We have noticed signs of his speech changing (less dramatic) over the last while.

In terms of nursery I was told today that he is making big improvements in his problem areas, he is more prone now to naturally interacting with his peers and showing signs of getting involved in bigger groups-something he normally avoids. They've used a series of strategies that seem to be working well. Outside nursery he seems reasonably capable of playing with his peers-I watched him play an imaginary game for around 20 mins earlier this week with two class mates in the park...he does like playing on his own a lot too. In terms of social interaction, he can be both appropiate and sometimes a tad innapropiate or stiff. We as a family have quite an insular lifestyle so he doesn't get to mix with other kids a lot anyway.

We are concerned though that he can be disruptive at nursery and prone to the odd outburst..today at a local ball activity group he lay down and refused to get up-he's been going for months and never donesuch a thing.
I spoke to his main teacher today about her experience with other AS or related kids and she did say the obvious that she had seen a wide range of children who were AS but B was much less obvious in triggers and had shown signs of affection that were not particularly common in her experience.

Where he clearly doesn't show any AS traits is in motor skills/co-ordination etc...he is pretty adept at ball play and is fast with good balance etc. He doesn't have the specialised interests aspects, he likes a variety of things and can change favourite TV shows/activities etc quite quickly. He is affectionate and has very good eye contact and I would say he is pretty reasonable at interchanging during a conversation. He has a very good imagination and is good at making up stories.

Where he does show more obvious AS traits is in areas such as food, he is fussy and limited in what he eats, obviously the accent, sometimes loudness bothers him but again he is inconsistent in this and the history of lack of integration in groups..with his peers.

I see two big factors, one is he is a very happy wee boy secondly he has always developed and progressed. To give an example sometimes when excited or under stress he would flap his hands or do odd posteur things....he has completely stopped this about 6-12 months ago. As he develops he is less controlling and much more prone to compromise overall.

I of course realise he is young and difficulties with his peers may become more apparent as he gets older but at this stage I see nothing dehabilitating in his personality. Of course we don't know for certain either way whether he will be diagnoised as AS or whatever. However both ourselves and the nursery see a little boy developing and progressing away from some of the issues he had/has.

This brings me to myself, I have some quite obvious AS traits (I was removed from nursery for not integrating) and seeing my son growing up has made me revisit my own history. I was a bit of a loner but always had good friends and above all I developed into someone who is known to be very good at reading people and I was always reasonably sociable but was also sometimes disliked by my peers. Of course like anyone else I have had my times of feeling rejected and have had the odd issue here and there which I could relate to either being AS or pretty close to it. Did I merely develop and learn or did I just have some AS traits?

This of course brings you into much more complex areas in that both NT and AS people can struggle to cope with life and/or relationships for a variety of reasons.

I'd be very interested to hear from forum members about my son specifically and indeed if they could point me in the direction of other factors to look for him in and indeed this notion of developing away from and/or coping with AS....and of course the fine line between having AS traits as opposed to AS because the more I read and the more true life examples I hear about..the more confused I become. I'm also interested in these inconsistances he shows in the traits.

Thanks in advance for any comments.

Some kids are just late bloomers socially. There seem to be a lot of kids who are diagnosed as having AS or being on "mild" end of the spectrum at a very young ages, who it turns out, just weren't given time to develop before a judgement was passed on them. They get "better" as they age between the ages of 2 and 6.

I think children with AS on the other hand, get "worse", and by the time they are 7 the parents are usually having a nervous breakdown.

In other words, the social deficits, the hypersensitivity, and difficulty with change, and the obsessive interests become more apparent, and "melt downs" become more frequent because the child cannot interact or function in the way people expect them to.

Concerning the motor skills issue...while this was observed by Hans Asperger, it did not make it into the moern DSM-IV diagnostic criteria for AS. However it is part of the diagnostic criteria of non-verbal learning disorder, which is very similar...probably frequently identical to AS and possibly what Hans Asperger was originally observing.

I have some motor skills issue but this never prevented me from catching a ball. It just makes it difficult to be particularly acrobatic or agile in my movements...I can't dance, and I can't style my hair behind my back. I took longer than other children to learn how to ride a bike and roller skate/roller blade and of these activities, I'm no more coordinated at than most people's grandmothers, who are more coordinated than me as they can knit.

That would be the case for many of us, the "getting more confused" part. At least, when it comes to ourselves or borderline cases with our kids. I think the way to sort it is relatively simple: what is the goal? What would the label accomplish or not accomplish?

For me, it's just a curiosity, am I AS or am I not? Whatever impairments I had I long ago accommodated outgrew, or simply accepted; if I was ever diagnosable, the case would have been very borderline. But I don't need any answers to unsolved questions in my life and I don't need any services, so it seems acceptable to realize AS is a spectrum that involves multiple traits and genes, and it is quite possible to have AS traits without "being" AS. So, that's kind of the box I've put myself in, and while I do still sometimes play around with the academic exercise of trying to sort which way I truly fall, it is actually irrelevant to my life and I move on.

My son, however, was a different situation. We had services we needed from the school, and we had identified the services long before we had identified the potential for AS. The only way to get the services was to pull a diagnosis off the list, and AS was the one that seemed to fit. Overtime, the AS diagnosis has come into sharper focus, but when we first accepted it when he was 7 it was pretty borderline.

Not every AS child has every AS trait, and even for those they do have large variations can exist. I think what I see most are:

1) Issues reading social cues - this seems to be pretty universal, probably "the" key to diagnosis. This is very difficult to diagnosis in young kids because until a certain age they all have this problem.
2) Theory of mind issues - they have difficulty grasping that world doesn't know what they know, or process information in the way they do. Like number 1, above, age plays a factor in being able to use this for diagnosis, but your son should be at about the age they can do what is called the "Sally" test.
3) An unusual disparity of gifts and burdens - little seems to even keel or "average" in an AS child.

And ... a few other things that I can't think of a simple, one sentence way to summarize. But, that should get you started. Or more confused

One thing that the neuropsycologist told us that I have witnessed in our son is that some kids just develop in "fits and starts". At certain points in time they may appear to be developmentally (emotionally, socially even physically) significantly behind their peers then they have a relatively huge leap in development and appear to be on par with their peers. This pattern may continue where they seem to fall behind then months later seem "normal" again. This may be the case with your son. It is really hard to tell at 5 I think when the signs seem to be so borderline. It may also be that he has some sensory processing issues but isn't really on the spectrum. As Chronos says, it may get "worse", in other words his differences may become more apparent, as he gets older. Or they may not!

When my son was very little, he had a significant language delay. At that time, for many reasons, I was thinking he had autism, but when I was doing my research I looked up the definition of the 2 language disorders that he was diagnosed with. (Developmental Dysphasia particularly) Both of those had a lot of characteristics of autism that made me question if he was indeed, autistic. Speech issues are a big part of autism and it makes sense that the autistic traits that people see in language impaired kids are also traits of those on the autism spectrum, but yet they are two very different things.

I would imagine if you have language issues it would be hard to socialize. My son can communicate, but he can't think fast, he's inflexible and very controlling, and this has a lot to do with how hard it is to formulate a thought and the work that goes into it. If you can't keep up, then you don't get the practice that you need, and may even give up and play by yourself or say things that are inappropriate in the eyes of an NT, but not for your child or those who understand him.

I wonder if your son's willingness to socialize more coorelates with a spike in language comprehension and expression?

Thanks to you all for such detailed and interesting answers.

Chronos-your overview was very helpful.

DW-Mom-I think my view on myself is very similar to your own...my son has merely made me retrace my own steps..I need to be careful I don't read too much into my own experience as some sort of template for him.

The label aspect is fascinating...my own desire for my son growing up was that he could avoid some of the personal pain and darker periods we all go through growing up...I was aware this was an impossibility anyway and it may in some ways dissolve the importance of a label...if he has AS it may be that the hurdles he faces have been better defined....if he is not AS it is not to say some hurdles will not be similar...at best he will face different hurdles. I guess you'd worry about your kids anyway although I'm not dismissing the issues that AS might bring as he develops.

The Theory Of Mind "Sally" test is fascinating to me because even as an adult I think there are a number of ways your logic might lead you to the false answer....I suppose it is important how clear it is made that you need to put yourself into the shoes of the doll.....you might get carried away and want to give the logical answer. If you are driven by logic (i.e the marble can only be in one place) then you might think what Sally thinks is irrelevant....I hope that makes sense.

Bombaloo I think your description is not far off what his development has been like at certain times certainly historically.

MommyJones I possibly wasn't clear enough....his language skills now are pretty good, above average in the descriptive area but he is very clear and understood by peers and adults alike. That wasn't always the case and his confidence obviously has improved. The issue is his accent which is not local or like ours-it is noted by others. I think as well as it has developed it appears quite quirky and as I said heavily influenced by phrases from TV shows. I don't think this is an issue amongst his peers at the moment but it clearly has the potential to be later on.

As parents our biggest issue at this stage is not the interaction with his peers, it is more to do with disruptive and challenging elements of his nature which puts him on the radar of his nursery teachers. and we fear that when he goes to school in August he will resist inteaction and activities he doesn't want to take part in..it is noticeable he is actually quite popular with his nursery friends from last year when they see him (he moved from afternoons to mornings this year). He may choose sometimes not to mix but he does always look for his friends to play with...I am watching very carefully the interaction when he plays but at that age the playing can be quite chaotic anyway.

Thanks again I'd be interested to hear more thoughts......

I recently read something that resonated with me on a grand scale. The link is below the excerpt:

From page 5 of http://www.asknz.net/uploads/2/9/3/7/29 ... ectrum.pdf

If your child is on the spectrum (and it reads to me like he is), he will be labeled eventually. Some of those 'labels' might be far more hurtful than autism ever could be. My opinion is that it would be best to listen to the speech therapist and have your son assessed for ASD. If he grows out of ASD that's great, but ASD isn't something you "grow out of", you simply learn how to function in the world if you're lucky. I have been "quirky" and "eccentric", "weird" and "unique", "cynical" and "unstable", etc. depending on the situation and who was giving me a label. I wish I had known about ASD when I was younger. I have been told to "lighten up" and "not be so intense" and have struggled my entire life with a large variety of things.

My son has an imagination and imaginative play. I think we have to be *very* careful attempting to be specialists by reading a diagnostic criteria. I felt my son had "perfectly fine language skills" and was shocked when the speech path wrote "robotic prosody" on his report. It wasn't until a month later that I heard the robotic prosody for myself.

It is absolutely true that many of the HFA and AS traits do not become an "issue" until a child is six or seven and one cannot dismiss developmental behaviours with "age appropriate". Most of us are going a bit nuts as parents by that time and unfortunately if we wait it means that our kids might miss out on some of the early intervention programs that have popped up around the globe.

P.S. My son was the most popular kid in his preschool too. The thing was he directed all the play because he has a gregarious personality. Not all ASD people are withdrawn and isolate themselves.

Ominous thanks for the comments.

I think it is inevitable we will get him assessed, we have only had a week to digest the news and the full report has not yet arrived back from the speech therapist.

The label will only affect us in the short term, we are the ones currently having to adjust to a change of perspective but the potential of a label doesn't change our wonderful son nor the happiness he has brought us....or the stress.

I am aware of the problems of the amateur AS detective and indeed the problems we have being objective about our own child...indeed since the speech therapist pointed out certain issues his speech seems much worse to me in terms of it being odd. I am also sure you can start to see things in everything once you start looking....in other words you can lose perspective either way...by being over defensive and close to denial or indeed seeing AS in every sentence or movement. We've been aware he has traits, we have been for some time but because we are not experienced we don't know how to define what that means.

The obvious reality would appear that some AS children can appear to be very close to NT behaviour (whatever that is) in certain circumstances and less so in others. That is very interesting.

I do know in our case our wee boy has eradicated the obvious physical postures and gestures he used to show occasionally as a 3-4 year old. That to me is interesting as well.



The flapping example

Hi Benjamin,

My son also doesn't have a lot of the physical characteristics he used to. I think it's worth noting that as many high functioning people learn those behaviours are upsetting or "inappropriate" to NTs in their environments, they develop more "socially acceptable" stims. I chew gum. Lots of gum. I tap my feet. My son rocks in his chair when he's studying. He chews on pencils, etc. Some "stims" can be as simple as touching your own fingertips or feeling of the cloth of your shirt and would likely go unnoticed to even some untrained eyes. The upside is this shows the adaptive ability many of us have as we can and do change some of our behaviours in order to attempt to "fit" in society. I think an underlying issue is this adaptation can be an additional stress because we often have to work to retrain our desire to stim into something more socially "appropriate:.

You strike me as a wonderful and caring dad and I wish more kids had parents like you. I believe you're spot on about perspectives across the board. I was terrified that I was "trying to find something wrong" that didn't exist, to the point that when I got the dx I was a bit surprised. I was sure it might just be that I'd coloured my own view by ticking too many boxes. I think the bottom line is diagnosis isn't a race. If you find you are able to manage and your son is able to thrive without it, I don't think it is particularly important. I can only say I wish I'd known a long time ago. If you have some idea what is going on, then certainly any issues that you face as parents or he faces growing up will be able to be addressed even without having an early diagnosis.

Thanks for being a good dad. It's not an easy job and it's a thankless one generally.

I ran the Theory Of Mind test by junior today and he got it..said the dolly would look in the basket indeed he enjoyed the game so much that he demanded the naughty teddy bear moved lots of Sally's things....every time he said Sally would look where the object was originally.

I'm not going to get carried away because he understands that.

Any comments on AS children losing at games? He absolutely loathes getting beat at any game, he just abandoned one suggesting that he had won having 6 items opposed to dad's ten.

I think that one is called, "being 5 years old." My 10 year old NT daughter still has trouble losing; my AS son actually integrated that skill at an earlier age than she did. Of course, the NT daughter has no trouble re-writing the rules to change the outcome, while my AS son believes rules are rules and while he might misinterpret them and be very stubborn about it, he'll never change them mid-stream just to win. Maybe that forced him into acceptance earlier?

DW a Mom I was actually thinking the other way...that an AS child mild not be that pre-occupied with winning or indeed cheating as junior lapses into quite often when games aren't going his way....

Any comments on the theory of mind aspect...I think he seems quite adept at realising others have different views and feelings about things.

Yep, mine passed that one as well.

Mine also hates losing games still to this day. We work on it a lot. Mine hates losing anything, actually. He believes getting one answer wrong on a math assignment with 50 questions is "losing" as well.

For what it's worth, I frankly don't think that "lacking theory of mind" accurately describes aspies or similar but more severe auties.

The original "theory of mind" tests were done as follows: a child and the child's parent were brought into a room. A ball was put in one of two boxes. The parent left the room. The ball was moved to the other box. The child was asked which box the parent would look in for the ball. It was found that four year olds answered this question more accurately than three year olds, so it was concluded that an ability to put oneself in another's place, labelled "theory of mind", developed between the ages of 3 and 4.

Now, there are a whole bunch of possible confounders in this experiment. First off, it's not clear one has to "put oneself in another's place" to figure out the answer to the question - it really doesn't have anything to do with the popular concept of "empathy". Then there's the fact that young children may think their parents are omniscient and might be able to correctly divine where the ball is, even if they do understand that, say, other toddlers might not know everything. Most importantly, though, it's highly dependent on language and communication skill - the child has to understand a fairly complex question from the experimenter, and then the child has to explain its responses in a way that will be understood by the experimenter. The results may be completely explained by the substantial improvement in language and communication skills between ages 3 and 4.

Now what do we know for sure about classic autistics? They can't speak! And even aspies and high functioning auties have communication deficits - for example, they don't generally incorporate information from facial expressions into the meaning of verbal communication. So again, the association of lack of "theory of mind" with autism spectrum may just be that auties and experimenters don't understand each other all that well.

By the way, the Boston University Child Cognition Center has recently been doing some experiments to try to control for the communication issue, by measuring what children are looking at and for how long as a measure of what they expect, rather than trying to ask them verbally. The results haven't yet been published but my understanding is that they will be soon. The fact that this hadn't been looked into before is in my opinion a measure of just how weak the scientific basis for the whole "theory of mind" thing is.