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I recently took my son (6 years old) to a child psychologist who specializes in assessments for children. She tested him for about 7-8 hours (broken up throughout the week) and we received a neuropsych evaluation 15 pages long.

I took him to the specialist because I thought he may have Aspergers or ADHD. Well, she concluded that he has some characteristics of NLD, but nothing severe enough to warrant an official diagnosis. I think his verbal IQ and Performance IQ spread was 12 or 13 points.

My son has good eye contact, pretty good social skills and is very, very bright. I thought he may have Aspergers because as a young child he was obessessed with fans, lined toys up sometimes (not anymore) and was an early talker and reader.

Also, although he is well behaved in school, we have had a hard time at home with tantrums (getting better since I read the Explosive Child book). Also, he can be very hyper at times but this appears to be fading with time. He also is a perfectionist and will cry if he does not win (much more so than other kids). His perfectionistic tendencies are our biggest problem right now. His fine and gross motor skills are average. He also has an interest in maps, but according to the psychologist, it's not pervasive.

Anyway, he seems to fit the criteria in some areas. Do I have him tested again or let this issue go?
He seems like he could be borderline. Any others out there faced with this situation?

Thank you.

Initially we experience similar responses from people... that our son was just unusually bright for his age. It didn't help that he is at his best in testing situations...one-to-one with an adult, in a quiet room (he LOVES doing tests, and he LOVES interacting with adults). We really didn't get anywhere until I started documenting the behaviours that were concerning us. Then, he was assessed by a PT, OT, SLP, which led to the developmental specialist and the ADOS. Each of the individual assessments before the ADOS showed mild delays...on their own they didn't look like much to be concerned about, but when combined they really started to show a pretty clear picture of Aspergers.

Trust your instinct. If you feel like there is a developmental concern, there probably is. You know your child best and spend the most amount of time with him. Document your concerns, read everything you can, and persist. An important question... "If it's not ASD, what is it?"

He sounds alot like me....

the social stuff maybe relative.... you may see that he has OK social skills, but in effect he is just really good at mimicking what the rest of the world does.

-Eye contact was one of those things, where I did it, but I didn't.... you'll find that he probably only uses eye contact when he realises that some-one is expecting it from him. To this day I only use eye contact when I know the other person is waiting for it, otherwise I avoid it like fire. - I find job interviews to be the most difficult (maily because it's a stranger which is also being authoritative).

Maps - yeah still love them. The family atlas was always in my room.

Lining toys up is a good thing! - can't stand kids with toys all over the place... put them away neatly, and group them according to use or function!

-there really isn't anything wrong with him -- he just hates and likes the world more than the average person.

-I still have to win... but I had a big lesson at about 7 when I made a bet with someone over a bar of chocolate that that Lamborghinis where made in Switzerland (I later found out that Lamborghini was the name of a guy that started a tractor company in Sweden -I think) when the other boy said they are italian. It just so happened that in the libraby was a book on exotic cars, there and behold it said italy. I cried, and the next day stole some cents from me parents to buy the specific chocolate bar.

can you afford to have him tested again ?...our son's first dx didn't really seem to fit. we had him tested again a year later, and were finally given the AS dx.

Thanks for the input. I could reasses in a about a year or so. It was costly for the neuropsych evaluation, but also I don't wan't to keep getting him analyzed for fear that he will think sonething's wrong with him.

Regarding the OT and PT, what do they look at? I'm not sure if he has any delays in these areas, but maybe I'm just not seeing it.

Also, I'm not sure what ADOS stands for?

My fear is that this will get more pronouned as time goes by.....

Thanks again the advice.

ADOS = Autism Diagnostic Observation Schedule
It is considered the "gold standard" for assessing and diagnosing autism and pervasive developmental disorders (PDD).

It is done as session of observed play that goes through different tasks that look at different parts of the DSM-IV and all for PDD and places the child in one of three categories: Not on the spectrum, PDD-NOS and Classical Autism. It is not a definitive evaluation though for Aspergers.

Could he have PDD-NOS.

Our OT was instrumental in recognizing signs of Sensory Integration Dysfunction (the book "The Out of Sync" child can be a very helpful resource for you to see if this is an issue for your child. The physical therapist picked up gross motor & fine motor issues, and also identified dyspraxia (a common trait of kids with Aspergers). The SLP's assessments found that his language skills are above age level, but his pragmatic language (e.g. conversation skills) are delayed. These combined traits all created a case for doing the ADOS, and an Asperger's assessment.

I have found that my son's differences have become more pronounced over time. As a younger toddler, many of his behaviours were more acceptable...although hindsight reveals that there were definitely signs at a very young age. As his peers age, though, many of his behaviours are becoming less socially acceptable, since they are "immature." In addition, as he ages and experiences more, some new problems arise. For example, being inflexible is pretty workable when your life consists mainly of hanging out at home with family...but when preschool started and we needed to get out of the house by 8:45 a.m., ds's inflexibility became very apparent. Social problems also became apparent when he needed to start spending his days with other children in his preschool...

Good luck!

Shauna

The diagnostic process for a very young child is long, frustrating, and exhausting for the Parent. We found that many competent professionals don't want to firm a diagnosis for younger children. Our son, now 10, has been seein psych pros since he was three, was dxd at five for ADHD, at eight for Aspergers and is still under observation for Tourette's . As has been said, you know your child best, don't be afraid to ask. Do not diagnose him to the doctor [that upsets their god-complex] but say "I wonder " " is this a possibility" "someone has said ____ what do you think?". Learn to work the system. Be prepared to do that at school too. You will have to fight for what is best for your child. Make yourself visible, annoying and determined. BITE DEEP AND HANG ON TIGHT!

Have fun, it is going to be a long roller-coaster ride!

Thanks everyone. I do notice differences, however, he is in Kindergarten now and the teacher is giving him high marks on socialization issues. (I also realize teachers aren't trained to look for Aspergers.)

The neuro psych evaluation basically said, yes, he is a quirky kid, but does not meet diagnostic criteria for anything. Is it possible that this could be true? I completely understand that as things such as socialization become more compex, he may run into trouble. I hope he can keep up, but am keeping an eye on all of this.

Also, regarding the PDD-NOS diagnosis, I think there must be some sort of speech delay. Maybe I'm wrong on that though.

I'm having a hard with this as all this is new, but part of me feels that if I see more specialsits one will eventually give him a diagnosis. Maybe it would be accurate, but how many people should I see before I give up?

I agree - trust your instincts. I learned the hard way. Had been taking my daugher to a psychologist for many years (she's a teen now) for social skills issues (not able to make friends) need for routine as well as some speech challenges, fine motor skill issues (got her some OT when she was younger) We saw him all those years when needed and then last fall we left him and found a LCSW who saw Aspergers in one visit. Then went to a psychiatrist for an official diagnosis..just a 2 hour appt. (1 for me, 1 for daughter then all 3) and MD saw AS too.

Got the DX, did 504 plan, found a psychologist who does social skills training and in 4 months, our entire life had turned around for the better.

I only wish I had done all this for my daugher years ago. I assumed the therapist we were seeing would have said something if there was any autistic spectrum signal but....taking day by day and thank goodness we know now.

Thanks Emma's Mom,

As my son was going through the neuropsych exam, I asked her to look specifically for Aspergers as that is what I thought he had (I researched obsessively on the Web trying to find out what is wrong before our appt.) She was familiar with it and had assessed other kids with AS. By the way, she does not do any treatment, she only does neuropsych evals for children. This should not be new to her. I would think the majority of kids she sees are on the ASD spectrum but I didn't specifically ask her this.

Anyway, I believe you are correct when you say "trust your instincts" and I may seek out an autism specialist.

thanks again to everyone....It's nice to be able to talk about this...

we also had the issue with several evaluators saying that our son was "an enigma"...and they couldn't quite figure out what he was.....although our daughter shows many signs of aspie-like behaviors, her evaluator siad that she has too much eye contact to be an aspie.
we pressed the issue with son to get an alternate dx, and he was finally given the dx of aspie. our daughter is only 8, and was recently dx-ed as ADHD...i don't believe it, but i don't want to press the issue right now for fear that she'll think there's something wrong with her. right now she thinks she's the best. and i'd like to keep it that way !
right now she's receiving services at school for the social issues.....if she continues to have problems, we'll look at having her reassessed in a couple of years.
i think the key to all of this for us has been to support our children in the ways they need to be supported regardless of what their dx is. ...i knew that what one evaluator dx-ed as ODD, was not ODD but merely an aspie getting anxious and irritated because he was doing what he thought was expected of him ( in other words, lack of communication on the evaluators part).