How do you know if they're on the spectrum??

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Hi, I have been struggling for a year now trying to figure out my three year old daughter. When she started preschool last year her teachers were concerned about her hearing and described her as being in her own little world. She is slow to move, too. I had her evaluated but they did not see any red flags.

Fast forward a year: My question is can a child have Asperbergers or be on the spectrum if they have only a few signs or do they have to have the major ones?

My concerns for my daughter are as follows:
- not terrific eye contact
- has gotten nervous lately around new people, hand goes in the mouth, doesn't talk or make eye contact until she warms up, then she's fine
- at times, hyper-focuses on what she's doing, oblivious to others around her
- clumsy gross motor (had her evaluated and they said she's fine, will just reach milestones later)
- at times speaks in a very high pitched voice

But when I look up kids on the spectrum she does not exhibit temper tantrums, she transitions well, does not need a routine, is not "obsessed" with a subject, toy or hobby.
She plays very well with her sis ter and friends, back and forth play. However I notice that when we go on a playdate to a new house or enviornment she is content to play on her own, she gets so wrapped up in the new toys.

I've just been reading a lot about Aspergers, Add (inattentive) which ran through her teacher's head, and also SPD. They all seem to overlap and it's confusing. I don't know what to do.
She starts school tomorrow and I'm so anxious for her.
Any thoughts would be greatly appreciated!

The evaluator (6 months ago) said she scored advanced on the cognitive portion and that she was very imaginative which may explain her being in her own little world. Yet I have a feeling something is not quite right. She starts preschool this week and I'm anxious as to how she will do and if I should say anything to her teachers.
Any advice would be appreciated- thank you!

Have you looked at the diagnostic criteria?

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects


(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."


Truth is handing out advice on whether kids qualify to be on the spectrum is beyond most of us as it takes a psychiatrist 14 years to learn to do it.

None of us are qualified to diagnose your child, especially not from a single forum post. However, I would give it some time as she is only 3 and has had very limited experiences with other people. You did take her to a specialist who seems to think everything is fine and so you are taking appropriate steps. Look over the diagnostic criteria so that you know what to watch for, but remember that not everything that looks like autism is autism. Sometimes it's just a quirk or a phase the child is going through while learning how to interact with the world around them.

is very hard to get an aspergers diagnosis at that age, My son was always a bit off, but not dramatically so until he was older, which is the case with most kids who get diagnosed with Aspergers. It usually becomes clear when the social and emotional development surpass the childs ability. SO, a 3 or 4yo playing imaginatively to the point of blocking out the world isnt that odd. But a 7yo doing it is.

I always knew my son was different, a little off, but it wasnt until he was close to 6 that i KNEW we had to figure it out. And my son is also super intelligent, and I got a lot of people telling me its casue he is so much smarter then the kids his age. And yes, he is and was, but that was a part of his Aspergers!

she is still young, you are mom and know best. If I had a dollar for every professional who told me my son was fine, no issues no ASD, Id be rich!! !

From what I understand its devlopmental, so signs will become more apparent as she gets older. My 4yo daughter has only in the last year developed her special interest in snails. This also comes and goes as they are seasonal so in the winter she doesnt seem to obsessed, but as soon as they come out in the spring shes mad on them! It may be that your daughter shows more signs in the next year or her special interest has not been discovered yet! Also I have noticed in my daughter that a lot of the things a 3yo does which are considered acceptable and "normal" she still does and it now seems odd as she is that much older (nearly 5). For example the conversational problems, a 3yo would not be expected to hold a perfectly 2 way conversation on the adults topic of choice, but at nearly 5 its more noticable that she cant.

You may also want to look at what and how you are bringing her up. I realised I was unknowingly giving quite specific commands for my daughter to go and comfort a crying child in public places such as soft play areas. This taught her some empathy and what is expected in that kind of situation. We also have books about emotions and we would often discuss facial expressions of characters in books. This all came years before we had any idea she had AS so in a way we were hiding the signs by teaching her things we hadnt really noticed she struggled with.

When looking into a diagnosis I have found that some of the signs can be open to interpretationand are difficult to recognise, I had got a few of them wrong and assumed she didnt have communication problems as she is so chatty and confident, people kept telling me girls dont have autism and shes too chatty, autistic kids dont talk, which I now know is nonsense! However on closer inspection conversations are stunted and rehearsed, many things she says are directly quoted from tv or books! Little quirks like that can go un-noticed as you will be o used to them, but when you take a step back you might realise they are a sign of AS! Also my daughter can seem quite imaginative to others, but I know her well enough to realise she is repeating these games, she will play the same so called imaginative game over and over in different ways and it is entirely based on real life events, so in a way its not coming from her, its just re-enacting her own life!

I would keep at it if you are concerned, keep an eye on her behaviour even if its left for another year or so. You can always go back and get her checked out again. If she had a diagnosis for one thing it could change over time aswell. Even Drs can get it wrong sometimes and as its been said above, your her mother and you know her better than anyone!

Have you read any books about real life accounts of living with AS rather than factual books with lists of the signs? I found reading "Aspergers In Pink" really helpful, it could have been written about my life! It takes you through the diagnosis journey and highlights problems along the way and how the family overcame them. The little girl in the book now has her own blog too I also watched the movie "Temple Grandin" which was a really lovely film.

Good luck, hope you get some answers soon

A previous poster quoted the diagnostic criteria. I would focus on this:

"The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning."

It sounds like your daughter is not significantly impaired in her functioning, in her home environment. Which means, in layman's terms, she is reasonably happy, and she is growing and developing her skills at her own pace. (From what you say, her learning of pre-academics is ahead of the "average", while her gross motor and social skills may be behind that "average".) As long as she continues to be happy, and continues to grow and develop, it is not in my opinion important or worthwhile to worry about a diagnosis. A diagnosis is a tool to help you get the things you need when your daughter is no longer happy/is no longer developing and growing as a person.

Which is not to say she does not have autism. My child was happy, growing, and developing until society decided he belonged in a room full of loud, unpredictable 5 year olds for 6 hours a day. (Othwerwise known as, he started attending all-day kindergarten when he turned 5). It then became clear his individual profile of strengths and weaknesses did cause significant impairments in his functioning at school. (Which led us to pursue a diagnosis, and we got it.) On the other hand, this child's younger NT sibling would seem on the surface to have been considerably less verbal, more shy/withdrawn, and less social that his brother. The difference was, he adapted quickly and easily to school.

So what do I advise you to do now? You can do the things you'd do for an NT child. If you feel she lacks gross motor skills and social skills, give her more opportunity to develop both. Go to the playground with her more often and encourage her to climb and run, kick around a ball in the back yard with her, invite a potential friend into your home, etc. to give her opportunities and experience with movement and other kids her age.

As far as what to tell the teacher, I would stay away from mentioning suspected diagnoses. They may not mean much to the teacher, and they are speculation anyway. But in just starting school, there should be a lot of parent/teacher communication, no one will find it odd that you are worried about your daughter starting school! I'd send a note or email asking how the first day went, how the first week went, and go from there.

I think that in many instances it would be hard to tell if a 3yr old had an ASD. Looking back, my daughter had signs, but not the big developmental markers that we're told to look out for (walking talking, toileting, etc), but her reactions to sensory discomfort. She was almost 5 before it dawned on me that she might have an ASD. This only happened because I was comparing her conversation skills with those of her classmates. It came as a complete shock, in fact. Prior to that age, there was really very lttle difference that I could see in her social skills.