Rad v AS

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What is the difference in criteria RAD v AS, also I have a problem with spelling I keep having to make sure I spell things right, even if I have, why do I have check my spelling? Thank God for the internet, otherwise I have to look the spelling up dictionary,see I had to google that to spell it!

I had to google RAD, as I was unfamiliar with the acronym. Apparently, I am also unfamiliar with the disorder, but here is the criteria from the dsm-iv:

DSM-IV 313.89: Reactive Attachment Disorder of Infancy or Early Childhood

Beginning before age 5 and occurring in most situations, the patient’s social relatedness is markedly disturbed and developmentally inappropriate. This is shown by either of:
Inhibitions. In most social situations, the child doesn’t interact in a socially appropriate way. This is shown by responses that are excessively inhibited, hypervigilant or ambivalent and contradictory. For example, the child responds to caregivers with frozen watchfulness or mixed approach-avoidance and resistance to comforting.
Disinhibitions. The child’s attachments are diffuse, as shown by indiscriminate sociability with inability to form appropriate selective attachments. For example, the child is overly familiar with strangers or lacks selectivity in choosing attachment figures.
This behavior is not explained solely by a developmental delay (such as Mental Retardation) and it does not fulfill criteria for Pervasive Developmental Disorder.
Evidence of persistent pathogenic care is shown by one or more of:
The caregiver neglects the child’s basic emotional needs for affection, comfort and stimulation.
The caregiver neglects the child’s basic physical needs.
Stable attachments cannot form because of repeated changes of caregiver (such as frequent changes of foster care).
It appears that the pathogenic care just described has caused the disturbed behavior (for example, the behavior began after the pathogenic behavior).

IMO, this is very different from AS. For one, AS is a pervasive developmental disorder, which means it covers many elements of development. RAD seems to just be covering attachment, neither of which would explain someone (or at least most people) with an ASD. People with ASDs do not usually create unusual attachments to strangers. Also, I wouldn't say most people approach their parents with "frozen watchfulness". Whether or not some people on the spectrum fit loosely into either of these categories, I really do not know, but as you can see, a person with RAD cannot have a PDD (which AS is). Neither of these are mentioned as such in the diagnosis for ASD. Also, one thing is for certain: autism is not caused by neglect.

This is the first of many diagnosis I got for my children, thank you for explaining, I really know my son is AS! I will just add my children, first a girl, second a boy we bonded The experts say it was RAD whatever is my reply, I know my kids AS

A good psychologist would tell you why he does not agree with you. Did he tell you why he does not think the diagnosis is AS? If his reasons are not valid, then maybe seek a second opinion and see if you get a similar diagnosis or one of AS.

I have taken my children to a private specialist which has confirmed AS for my son, I strongly suspect my daughter a lot of traits, but also different to her brother.

I am happly married for 18yrs two beautiful children who are loved and wanted, never neglected, abused or anything. My children are very dependent on me find it extremely difficult in social settings. I really cant work out how they came to that conculsion as you can imagine its very upsetting.

I was in a similar situation. They thought my son had RAD up until the point where he had a full autistic breakdown.

You would have thought the sensory issues would have given it away...

It's legit to search for another diagnostician, if the one before didn't know AS.

If you find one who knows ASDs, you should demand they check the previous diagnosis of RAD during the testing to remove it from the medical record if it is wrong.

RAD and autism-spectrum conditions can be confused if the RAD was caused by institutionalization (eg orphanage kids) because severe sensory and emotional deprivation triggers autistic-like behavior in NTs. The difference though is that the postinstitutional autistic-like behavior tends to disappear completely within the first six months of being in a healthy environment. Also, there's some evidence that sensory deprivation in infancy can cause sensory processing issues, because the child's brain isn't trained to handle certain things (just like a blind kid who regains sight after infancy has visual processing issues).

After the first six months, or in a RAD kid who was not institutionalized (it can also be caused by abuse or too many foster homes), RAD and AS can be fairly readily distinguished. Both tend to have social difficulties, but in AS those are due to not understanding social rules and not recognizing facial expressions, while in RAD it's due to issues about trust - being too trusting or else not enough. Both have meltdowns, but AS it's generally caused by sensory overload or interfering with an obsession, while in RAD it's caused by emotional triggers that set off their fears, such as fear of abandonment, fear of getting too close to someone (if you don't form a connection you won't miss them when they're gone), fears related to bad things that happened to them (such as a physically abused kid fearing sudden movements), etc. I heard from some parents of RAD kids that these kids often smell strange when they're about to have a meltdown, which is basically the smell of fear.

RAD also typically have a lot of disruptive and 'troubled' behavior. In psychological terms, they'd be said to have high internalizing and externalizing behavior. Internalizing behavior is depression, anxiety, somatic issues (psychologically caused physical illness), basically stuff that involves turning your feelings 'inward'. Externalizing behavior is hyperactivity, aggression, conduct disorder (delinquency), abusive behavior, basically 'acting out'. Some of these issues can be seen in AS (especially if poorly managed) but are generally less severe.

Of course, a kid can have both. An AS kid who experiences a RAD-causing environment is just as likely to develop RAD as an NT kid.

An Autism Spectrum diagnoses generally precludes a diagnosis of RAD. It seems like it would be possible for a child to have both, but technically they are exclusive to one another.

318.89
B. The disturbance in Criterion A is not accounted for solely by developmental
delay (as in Mental Retardation) and does not meet criteria for Pervasive
Development Disorder.

I wonder if they are going to change that. I worked with a child like that who sure had a long list of diagnoses, come to think of it.

RAD, FAS, ADHD, AS/PDD-NOS - because the severity or the absence of symptoms just would not fit in with each other or fit with the parental history. On the bright side, that mazy combination of genetic predisposition, neurological damage and personal history was likely the reason he had quite a few amazing strengths.