Questions about AS - a bit lengthy
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| Fri, 05-11-2007 - 10:26am |
Hi everyone!
My ds Nick is 5 and was recently dx'd with ADHD with Social Anxiety disorder. I am concerned that there is more to it than just that though. We are going in next month to see the pdoc again and I have been doing a ton of research trying to muddle through everything so I can be prepared. DH showed me an article last night and asked me about AS and alot of it seems to fit Nick, but not everything. Can a child have a mild form of AS, fit most of the criteria, but not all? I know AS, ADHD and anxiety can all run together. The doc is confident we can rule out EOBP, but I wanted to ask about AS. Here is what we are dealing with:
1. Nick has no feeling for other's emotions, when I am upset, he gets mad. If someone is hurt, he walks away. If he physically hurts me, he just doesnt care.
2. He cant keep eye contact in conversations, if I need to tell him something important, I have to touch his cheek and tell him 2-3 times and make him repeat it back.
3. He is very dominating in conversation, he kind of takes over, doesnt wait his turn to talk.
4. Extremely controlling at play. Things have to be played his way.
5. He will not engage in team games, even in casual play. He doesnt like competition.
6. He doesnt even want to learn to ride a bike, rollerskate, he just wants to push his Little Tikes car around the sidewalk.
7. He can recite Monster Truck stats like Rainman (I mean that in the most loving way). He has been fixated on Monster Trucks for about 6 months and knows the trucks and drivers inside out. Before that, it was Thomas the Tank, he knew (still does) the inside out. He is also fascinated with real freight trains (Norfolk Southern, BNSF, etc.). He is now getting in to NASCAR and has committed it to memory at amazing speed.
8. He has a hard time with humor, he has a quirky sense of humor, but doesnt get simple humor, I have to explain jokes to him sometimes.
9. As mentioned before, he has social anxiety. Even at playdates with his friends, he is very anxious. He picks his lips and balks at new situations.
10. He has temper outbursts that go beyond the normal. He will explode into violent outbursts and "check out". He will throw whatever is in reach, he will kick, punch (usually at me), say nasty things, call names, storm around the house, break his toys, I usually have to restrain him until it passes or else I worry about him breaking something or hurting himself. Afterwards he is usually calm and apologetic.
11. He is very intelligent. When we had him evaluated the doc said he is in the 6-7 year old range and this was when he was 4 years 9 months. It is like talking to a little adult. He uses alot of words that a child wouldnt use and comprehends everything. He knows his letters, is already doing addition, subraction, spelling, and starting to read etc. DH and I spell alot of things out around him so that wont last.
I know some of these things are 5 year old behavior and some are the ADHD, but something just doesnt seem normal. He is going to start kindy in the fall, I can have him not start, he is so advanced. Not sure about family history of AS, my mom was adopted so not clear if history, on my side there is ADHD, LD's. I have anxiety issues as well.
I guess I am trying to find out if this is worth looking into. He doesnt have some of the other typical AS symptoms, but does he need to? He is my sunshine and I just want to get him the help he needs! Thanks so much in advance!
Christine


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If you look at the diagnostic criteria, you'll see that a person does not need to meet every criteria to be diagnosed. For example, within each category is a number of "required" items that have to be met...and the required number varies depending on the category. I know that sounds confusing, but more than a few ladies around here have a list of the criteria as presented in the DSM-IV. (Sorry, I lost my file with it in a crash a while back.) If you read that, what I'm saying should make more sense.
Come to think of it, I've never met an Aspie who literally meets every criteria provided in the DSM-IV.
I'm in no way an expert, but I have two spectrum kiddos and an Aspie husband...all of whom function on different levels of the spectrum. In my not-anywhere-close-to-expert opinion, from everything you've said, it sounds as if your son's behaviours certainly warrant further investigation.
Good Luck~
Amy
I agree that there are all levels of AS. And, unfortunately, because mild AS is less obvious to the casual observer, it's also often harder to diagnose without enough supporting documentation and without a good doc. What I have discovered was most helpful to our receiving a dx (diagnosis), as well as helpful to the docs providing a dx, was to do what you've just done: writing down numerous examples of the types of behaviors you see in your child.
A LOT, LOT, LOT of the diagnosis is based on what you tell the docs, in addition to what the docs test for and personally observe. Both our pediatrician and the neuropsychologist told me that my multi-page anecdotal list of my kids' behaviors was VERY helpful to them. The pediatrician had been dismissing a lot of my concerns over the years until she saw my comprehensive list of the kids' behaviors, and then she was better able to recognize a problem and refer us for testing.
The list of behaviors was also helpful for me because I'm so used to dealing with the kids' quirks that if someone asks me what their issues are, I go blank. I can't think of a single thing that's "wrong" with them. Even when I was in the interviews with the doctors, I had to keep referring to my written list to jog my memory of every-day type behaviors. After some of the appointments, one of the kids would do something on the way home that would make me think, "oh, I wish I'd thought to mention that behavior to the doctor!" You don't want to forget any details about your child's behavior that could be relevant to getting a correct dx, so just keep adding new details/quirks/issues to your list as you think of them before your appt.
Christine
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Christine
I would recommend pursuing a diagnosis before he starts school, because school administrations just do not understand autism spectrum.
The spectrum is like swiss cheese effect. There are unpredictable holes in development. What happens when they go to school is that the teachers will look at their "normal" abilities and expect them to perform at that level across the board. If your child can not keep his behavior in check during school hours, he will be disciplined like a neurotypical child.
I had this problem with my son and school. With a label in place, you can get easier access to autism services (which are expensive and public schools do not want to give them up easily) and people will understand why your kid does what he does. Even still, it's autism everyday and I think higher functioning kids have it rough since they are not blatantly disabled. I really want to scream whenever someone says to me, "He looks fine to me."
Christine
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Christine
Christine,
Welcome to the board.
Christine
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Christine
Thanks for the reply! I see the Asperger's in Nick too, but not until I started writing things down and things started clicking. We have been focusing on the ADHD and the anxiety for a while now and now that we have that definitely dx'd, he is classic textbook with that, I just know something else is "off" with him. If it is Aspergers, then so be it and we can get the help we need. I will let you know what happens!
Christine
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Christine
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