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vmiguy
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29 Mar 2012, 11:55 am

Hello, I am new to the group. My son Joshua is 3 1/2 years old and I believe he is on the spectrum, maybe an aspie. Its been a roller coaster ride, we had him in IEP since he was nearly 2 yrs for speech therapy and therapists with 30 years of experience and an appt with a development ped had to reassure me several times that my son did not have autism. They said his main obstacle will be to manage his sensory issues and learn to self-regulate. However, his recent behavior has made me doubt that diagnosis. From what I understand aspergers can be very difficult to detect until they turn 5-7 years.

His recent behavior which has made me think he may have aspergers:
-REPETITION: Repeating the same question over and over (sometimes dozen times);in some case even after I had answered it
-OVERREACTION/ABNORMAL REACTIONS: Overreacts/or does not react at all when routine is broken-for example, I made chocolate milk for him this morning as usual but instead of handing it to him I place it on the table and he had a huge fit because I didn't had it to him; his older brother had to give it to him
-CLUMSY: Has always been very clumsly/uncoordinated-lots of spilled milk, falls down alot when he is running; has always been very hyperactive
-WRAPPING IN BLANKET: Loves to wrap himself up and roll around on his blanket while sucking his thumb (stimming?)
-TOE WALKER: Occassionally tip toes; this past weekend he shocked me by doing a beeline tip toe across the front yard
-FACIAL EXPRESSIONS: Lack of understanding of facial expressions; when I smile at my 4 month old daughter she reacts and smiles back--this was the kicker that really made me realize--Joshua has never responded back with a smile if I smile at him; in fact what I noticed this weekend when I smile is he stranglely looked at me and instead got angry almost as if he didnt know how to react
-LANGUAGE: He speaks age appropriate, however has always talked LOUD; often have to tell him to use an inside voice
-EYE CONTACT: Will often "get in your face" when talking; eye contact is good now although when he was 9 months he had limited eye contact which was our first "red flag"
-KISSING/HUGGING: would give a sideways kiss and light hug; has to be on his terms; if you hug him tight he will go bonkers; overreacts when tickled
-FEBRILE SEIZURES: history of seizures (every 4-5 months with a high temp) since he was one year old
-FIDGETY-has always had problems sitting down for prolonged periods

I'm sure I've missed some things but I would appreciate anyones input. I am considering getting him looked at again. I believe he may be on the spectrum. The only thing that makes me lean towards Aspergers is that his language appears to be okay.

Thank you,
Frank



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29 Mar 2012, 2:20 pm

Don't worry about a specific ASD diagnosis right now. Just "He may be on the spectrum" is enough at age three, just so long as it gets him the accommodations he needs. There's not too much difference between the different ASD diagnoses anyway... This early on, I guess it's just a matter of teaching him useful stuff, like how to communicate effectively. I guess if you needed a diagnosis you could just have Asperger's or PDD-NOS on his record. Sometimes a diagnosis is more what you get so you can get the help you need than anything else. (PDD-NOS is atypical autism, and is simply used whenever a kid doesn't fit into a specific category, or, like with your son, is simply too young for the traits to have become particularly well-defined.)

He's three years old--that means he hasn't really hit the big social demand milestones yet, at age six (beginning of school) and twelve (beginning of complex relationships at puberty). So, for now, you probably won't know how things will turn out for him. Maybe he'll need more tutoring on social interaction as he gets older; maybe he'll learn on his own; maybe he'll turn out to have more trouble with something else, like those sensory problems you've mentioned.

You have the IEP; you have access to the therapists; so the best thing to do is just to look at him on an individual level and see what he needs help with--what frustrates him, what is difficult for him to understand, what things overload and overwhelm him. That's pretty much what you'd do with any kid with autism. Autism is so diverse--no such thing as a one-size-fits-all approach. If you had a specific diagnosis, that wouldn't change the fact that his personality and his cognitive style are unique to him, and that you'll have to find out what he needs individually, just as you have been doing.


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anon151
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29 Mar 2012, 2:20 pm

My son was diagnosed with Aspergers at age 7 with many of the same behaviors you have listed for your son with the exception of the seizures and the affection issues. He wasn't a loud talker but he "mazed" in his conversations. His vocabulary has always been years ahead of his peers. It took several evaluations until the doctors and counselors diagnosed him with Asperger's.

Life was difficult for him until his teen years but with the counseling and assistance in school he has been able to overcome most of his Aspergers behaviors. I know every case is different but he has even said he embraces his Aspergers because it makes him different and his brain is wired so he almost has a photographic memory. My best advise is to find a Doc that is involved with Aspergers children and get their opinion/diagnosis. My son exhibited the same symptoms when he was in Pre-School as he did when he was diagnosed so I don't think it is too early.

There are differing levels of Aspergers just as there is different levels of Autism. We never hid the fact that he had Aspergers from him and never let Aspergers be an excuse for anything. A lot of repetition on rewiring his thinking process when it came to social interactions and "quirky" behaviors. If he does have Aspergers get working on it right away as your son will have an easier time in school and life.



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29 Mar 2012, 5:44 pm

Acceptance is the best cure.


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29 Mar 2012, 7:37 pm

CockneyRebel wrote:
Acceptance is the best cure.
Should go without saying, but lord knows there are too many "professionals" out there who think that being "normal" is better than being happy. You may well have to tangle with the school system and the therapists when they won't let your son be himself, when they try to push normalcy at the expense of learning and simple childhood fun. But parents are tough that way. You mess with a kid, and the parents will pretty much bite your head off. It's a reflex--it'll kick in when you need it. Until then, probably a good idea to learn about the school system you'll probably be up against. Talk to other parents, and to older special needs students if you can find them; they'll know it best.


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29 Mar 2012, 7:39 pm

my nearly three year old keeps popping up with "symptoms" like that... but will then cry when another kid hurts themselves... so empathy seems to be working far more than mine ever did.
I've been told that he's too young to be diagnosed with a social problem because he's still working all of that out anyway. I live in hope :D



vmiguy
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30 Mar 2012, 2:45 pm

thank you so much everyone for your replies. I went ahead and made an appt with a general pediatrician as a first step to getting an appt with a developmental ped. I'll keep everyone posted to how it goes. One funny comment about my son. The other night we were talking about God and I was telling him how he made everything and then he asked me:

"who made God"? And when I told him he is in all of us, he asked me how I can "get him out".

His older brother just looked at him and said: "its complicated Joshua"

Frank



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30 Mar 2012, 5:16 pm

[Moved from General Autism Discussion to Parents' Discussion]


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30 Mar 2012, 7:22 pm

I think it's a good idea to get him evaluated so that you can get all the services you can from the school system. I just had my son evaluated 2 weeks ago and according to the school, he is mild on the spectrum but according to the neurologist, he only has some autistic traits.

My son turned 3 in January and his biggest issue is language. He understands most, not all of what you say and speaks like a 2 year old. Since we started forcing him to speak 3.5 weeks ago, he started speaking like a 2 yo. Before that, he hardly spoke. He does a lot of echolalia. He has started developing a "google" thing recently where you say a sentence and he thinks he should reply so he finds a phrase he memorized with one of the words in your original sentence, and replies with that.

I hope to get him in school for the summer session and then start September. Hopefully we will get the necessary therapies also. I think the school will be good for him.



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30 Mar 2012, 9:12 pm

bnky wrote:
my nearly three year old keeps popping up with "symptoms" like that... but will then cry when another kid hurts themselves... so empathy seems to be working far more than mine ever did.
I've been told that he's too young to be diagnosed with a social problem because he's still working all of that out anyway. I live in hope :D


my son has aspergers and has what I believeis empathy. he can notice when a child is upset and he will go comfort them, that was one of the reasons I didnt think aspergers. My nephew with Aspergers used to save his money and go to the pet store to buy the fish that were alone in tanks casue he felt bad for them. My son can be very caring and tries obsessively to get someone to be happy, but he has NO IDEA when he is casueing someone to be upste. he has no idea that other people might not want or like what he likes.

Dr Tony Attwood explained it that they have some extent of empathy, but its not typical.


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30 Mar 2012, 11:52 pm

Oohhh, dear, that old "empathy" thing again...

Okay, let me tell you first of all: Yes, we are capable of compassion. Just as capable as neurotypicals. There are autistic people out there who are so sensitive that they'll cry at the mere thought of someone being hurt. There are autistic people who are so afraid of hurting someone that they withdraw socially.

The "empathy" that the professionals are talking about is not the ability to care about other people. We do care; scientifically, it's been shown that autistic people have codes of ethics as strong as a neurotypical's (though we are more likely to use logic rather than emotion to make ethical choices). It's also been shown that autistic children show attachment to their parents that is pretty much identical to the attachment that neurotypical children show to their parents.

The difference with autistic people and empathy is that we don't "catch" or "copy" emotions from other people. So, if we are in a crowd of cheering people, we do not automatically want to cheer ourselves. Or, if we are at a funeral, we do not automatically feel sad because other people feel sad (though of course if we loved the person who has died, we might feel very sad even when other people are not sad.) We don't mimic facial expressions that we see. There's some evidence that the parts of our brains called "mirror neurons"--the ones that are triggered by other people--don't work as well, which means that when we see someone else do something, it doesn't automatically trigger those same movement centers in our own minds.

There are exceptions to this, though. Some autistic people are extremely sensitive to other people and rather than being oblivious to others' emotions, they are overwhelmed by them and tend to withdraw just to protect themselves from that extreme stress. For the majority of people, though, it's a matter of not automatically understanding emotion: A lot of neurotypical people understand emotion because because they saw someone make a facial expression, mirrored that facial expression in their own minds, and triggered the emotion. Instead, we might look at someone's face, think back about what we know about that facial expression, and understand intellectually, "That person is happy," or "That person feels angry," etc.

But as far as caring about other people, wanting to help them, or generally being pro-social, there's very little difference between autistic people and NTs. The only difference I have seen is a slight trend in the autistic people toward wanting to help others in material ways; for example, to do volunteer work, give someone something useful, or try to solve a problem for someone, rather than the tendency for NTs which seems to want to be to comfort someone, empathize with them, or try to help them feel better.

One last thing: To help someone, you have to know they are in trouble. While we have as strong a desire to help others as anyone might, we do have trouble understanding when someone is in distress. It takes us longer to read faces, and we miss subtle cues that NTs grasp easily. We don't understand many social signals that would be loud and clear to NT viewers. So, when it comes to compassion, you have to ask what a person does with the information they have. If we don't know someone needs help, then not helping them has nothing to do with a lack of compassion, and everything to do with a simple communication gap.


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31 Mar 2012, 6:44 am

Callista wrote:
Oohhh, dear, that old "empathy" thing again...

Okay, let me tell you first of all: Yes, we are capable of compassion. Just as capable as neurotypicals. There are autistic people out there who are so sensitive that they'll cry at the mere thought of someone being hurt. There are autistic people who are so afraid of hurting someone that they withdraw socially.

The "empathy" that the professionals are talking about is not the ability to care about other people. We do care; scientifically, it's been shown that autistic people have codes of ethics as strong as a neurotypical's (though we are more likely to use logic rather than emotion to make ethical choices). It's also been shown that autistic children show attachment to their parents that is pretty much identical to the attachment that neurotypical children show to their parents.

The difference with autistic people and empathy is that we don't "catch" or "copy" emotions from other people. So, if we are in a crowd of cheering people, we do not automatically want to cheer ourselves. Or, if we are at a funeral, we do not automatically feel sad because other people feel sad (though of course if we loved the person who has died, we might feel very sad even when other people are not sad.) We don't mimic facial expressions that we see. There's some evidence that the parts of our brains called "mirror neurons"--the ones that are triggered by other people--don't work as well, which means that when we see someone else do something, it doesn't automatically trigger those same movement centers in our own minds.

There are exceptions to this, though. Some autistic people are extremely sensitive to other people and rather than being oblivious to others' emotions, they are overwhelmed by them and tend to withdraw just to protect themselves from that extreme stress. For the majority of people, though, it's a matter of not automatically understanding emotion: A lot of neurotypical people understand emotion because because they saw someone make a facial expression, mirrored that facial expression in their own minds, and triggered the emotion. Instead, we might look at someone's face, think back about what we know about that facial expression, and understand intellectually, "That person is happy," or "That person feels angry," etc.

But as far as caring about other people, wanting to help them, or generally being pro-social, there's very little difference between autistic people and NTs. The only difference I have seen is a slight trend in the autistic people toward wanting to help others in material ways; for example, to do volunteer work, give someone something useful, or try to solve a problem for someone, rather than the tendency for NTs which seems to want to be to comfort someone, empathize with them, or try to help them feel better.

One last thing: To help someone, you have to know they are in trouble. While we have as strong a desire to help others as anyone might, we do have trouble understanding when someone is in distress. It takes us longer to read faces, and we miss subtle cues that NTs grasp easily. We don't understand many social signals that would be loud and clear to NT viewers. So, when it comes to compassion, you have to ask what a person does with the information they have. If we don't know someone needs help, then not helping them has nothing to do with a lack of compassion, and everything to do with a simple communication gap.


thank you soooooo much for this!! ! It makes perfect sence the way you put it! I find interesting that my son will go to great lengths to comfort a kid that gets repromandedby a parent, or a kid that fell and gets hurt...BUT if HE is the reason a kid is crying he is totally and completely oblivious. A professional recently told me that my son has the ability inthe 3rd person to understand and use the info, but not yet the 1st person, if that makes any sence to anyone!

thanks for sharing this! My son can be the most caring and compassionate kid in the world!


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M-, who would be 6 1/2, my forever angel baby
E- 1 year old!! !


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31 Mar 2012, 9:39 am

Its hard to diagnose Asperger's at a young age but has he been tested for what they are calling HFA (high functioning autism)?
My son was diagnosed with Asperger's right after he turned 6 and it took them a while to test him. It was some of the answers he gave the the psychiatrist that made her diagnose him. Outwardly he appeared typical, maybe a bit hyper. However the older he has gotten the more obvious it is. My daughter was more severe, no language, no responding, no pointing, clapping, waving.....all the typical signs of classic autism and she was diagnosed right before her 3rd birthday. I was diagnosed after her then my son, then my now 19 year old daughter. My 21 year old daughter has auditory and sensory processing disorder. Your son could just have sensory processing disorder but I think its too young for this doctor to tell you its definitely NOT autism.
The most important thing is that he gets the therapy he needs. I also always recommend swimming lessons if you can find a gentle program. Kids that are sensitive should not be in a program that is for more typical kids. The program I put my kids in was for typical and for handicapped kids. They just moved them around in the water until the got accustomed to the way the water felt before they put their head under the water. I think the water helps kids a lot with sensory problems. My daughter has the same types of problems your son does. You MUST do things in a certain way and say things in a certain way or she gets very upset.
Is your son getting Occupational Therapy? If not Id do things at home or try to find a program for him. Also look up PECS cards....I just download images from google and use them. My kids respond better to pictures than words. I always have to tell my husband...."less talking". If you show my kids a PECS card they "listen" and understand better.

Also a lot of typical kids have febrile seizures as well. What is called absence seizures is more common in kids with autism but still not a diagnostic criteria.



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31 Mar 2012, 10:39 am

My son was tested with the ADOS at 32 months and we were told he was not autistic, just very strong willed. After major problems at two preschools he was tested again at age 5 and diagnosed with AS. I might recommend waiting six months or a year so that the social delays are more clear.

If your son recently turned 3, then you probably just transitioned from early intervention services to the school district. Are they still providing speech and OT, or do you feel you need a diagnosis to get help? In that case seeking a dx sooner makes sense.



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31 Mar 2012, 10:39 am

LOL, Callista, I was just about to jump on this one - I think everybody knows how much I hate the E-word in relation to the spectrum. I know this very misconception was one thing that kept us from accepting my son's initial diagnosis.

Clinicians need to find a different word: there is a specific meaning here that is being lost by using a term that has multiple meanings. I like the term "mindblind," but perhaps that is too poetic...



vmiguy
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03 Apr 2012, 9:55 am

Thank you Zette and everyone for the input. As you stated he finished his IEP after he turned three this past Oct and the therapists reassured me several times that he did not have autism but sensory problems and that he would just have to learn how to self-regulate.

When I brought up the sensory issues to his pediatrician (about 6 months ago) he told me: you know sensory processing issues are "code" for autism...the therapists tell me he can have sensory issues but not be autistic, not sure what to believe....

In any case, based on my recent observations I want him reevaluated by a developmental pediatrician, he will be about 3 1/2 at the time and my guess is it will still be too early for any real distiction between NT or ASD (although I have my concerns), I will have him reevaluated every 6 months thereafter.