BellaOnline Forums Health and Fitness Autism Spectrum Disorders CONFUSED

Hi everyone,

I'm a lurker here, and have found some good advice from mothers like yourselves. But, I am just utterly confused. I have a two year old (July 4) who doctors/nurses/therapists themselves at times seems baffled as to what to dx him with. Maybe I'll just describe him and you mothers (who I deem for experts on these subjects) more than physicians at times, can tell me what you think if you get a chance.

- 2 year old with significant hearing loss, approx 9 mos lost, tubes put in May of this year - finally is babbling! only says uh-oh and go right now. says "dow" for down. when he wants something, he vocalizes, but it's not a word. he usually just grabs my hand, looks at me, and motions to go downstairs for instance.

- receiving speech therapy for about a month and soon will be receiving occupational therapy.

- is enrolled in the early intervention program in our state for under 3 yrs old. attends this two days a week for two hours where he receives additional st and ot as well.

- he didn't babble, point, do anything until his tubes were put in. now, he's following simple commands, like "go get your ball and bring it to me..." to "go throw this away..." or "go get your shoes..." and he's babbling and saying the words mentioned earlier.

- he's pointing to objects on flashcards and in books.. doesn't point out airplaines...just looks in the sky at them. likes going outside and swinging, catching baseballs that his brothers hits in the yard. but also just enjoys watching the tree branches sway in the wind. and if he finds a puddle, he's stomping in it!

eye contact is excellent. if you're not looking directly at him, he'll seek out your face and find you. very loving. of course, he's hitting right now too! sometimes he thinks it's a game, sometimes he's frustrated, i believe from lack of speech.

-plays with the family...like throwing the ball back and forth...not for long though. his attention spam is small. always bringing me something to look at...likes playhousedisney.com

-he visually stims. alot. after all of these assessments from nurses, doctors, teachers, ot and st...one thing rings true...he's a sensory seeker. no noise is too loud, and if there's no noise going on he'll probably make it. he follows patterns with his peripheral vision to make himself dizzy. he does this with lights, walls and ceilings. everyone once in a while, will twirl around in a cirle for a couple seconds. there's no classic signs such as hand flapping, rocking or sensitivity to noise. just a lot of visual stimming...he can be easily directed away from it. he has never thrown a temper tantrum because you took him away from it.

i'm looking forward to ot therapy, because the therapists feel it will unlock a part of his brain for whatever reason needs unlocked. they feel with ot therapy, the speech will soon come and the stimming will subside. he's just hyposensitive to alot. they have also mentioned dyspraxia and needing to help him with fine motor skills.

i get mixed answers...some docs feel he has autistic like tendencies, some say not autism...but spd, some say full blown moderate autism (that one blows my mind...) and some just say he has learning disabilities (possibly from the hearing loss) and he needs to play catch-up. what i'm asking for ... in your opinion as a mother, do you see some of my son's behavior as your child and what was your dx? i want to make sure i'm doing everything possible for a functional, successful child...

i appreciate any information and thank you...

hi hun
i am shell mum of 6 one with autism one with aspergers one with traits one with lbd
He will have speech problems because he has not been hearing well
also he will balance problems.
He does not sound like he has autism at all
the core diagnostic criteria for autism is the triad of imapirments
social interaction
social communication
imagination
this is the diagnostic criteria
if i can help some more please ask or visit my group link at the bottom

Autism
DSM-IV Diagnostic Criteria for Autistic Disorder*
A total of at least six items from (A), (B), and (C), with at least two from (A), and one each from (B) and (C):

qualitive impairment in social interaction, as manifested by at least two of the following:

marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures and gestures to regulate social interaction

failure to develop peer relationships appropriate to developmental level

a lack of spontaneous seeking to share enjoyment, interests or achievements with other people (e.g. by a lack of showing, bringing or pointing out objects of interest)

lack of social or emotional reciprocity

qualitive impairments in communication as manifested by at least one of the following:

delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)

in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

stereotyped and repetitive use of language or idiosyncratic language

lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:

encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

apparently inflexible adherence to specific, non-functional routines or rituals

stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole body movements)

persistent preoccupation with parts of objects

Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

The disturbance is not better accounted for by Rett�s Disorder or Childhood Disintegrative Disorder.

ICD-10 Classification for F84.0 Childhood Autism**
A pervasive developmental disorder defined by the presence of abnormal and/or impaired development that is manifest before the age of 3 years, and by the characteristic type of abnormal functioning in all three areas of social interaction, communication, and restricted, repetitive behaviour. The disorder occurs in boys three to four times more often than in girls.

Diagnostic Guidelines
Usually there is no prior period of unequivocally normal development but, if there is, abnormalities become apparent before the age of 3 years. There are always qualitative impairments in reciprocal social interaction. These take the form of an inadequate appreciation of socio-emotional cues, as shown by a lack of responses to other people's emotions and/or a lack of modulation of behaviour according to social context; poor use of social signals and a weak integration of social, emotional, and communicative behaviours; and, especially, a lack of socio-emotional reciprocity. Similarly, qualitative impairments in communications are universal. These take the form of a lack of social usage of whatever language skills are present; impairment in make-believe and social imitative play; poor synchrony and lack of reciprocity in conversational interchange; poor flexibility in language expression and a relative lack of creativity and fantasy in thought processes; lack of emotional response to other people's verbal and nonverbal overtures; impaired use of variations in cadence or emphasis to reflect communicative modulation; and a similar lack of accompanying gesture to provide emphasis or aid meaning in spoken communication.

The condition is also characterized by restricted, repetitive, and stereotyped patterns of behaviour, interests, and activities. These take the form of a tendency to impose rigidity and routine on a wide range of aspects of day-to day functioning; this usually applies to novel activities as well as to familiar habits and play patterns. In early childhood particularly, there may be specific attachment to unusual, typically non-soft objects. The children may insist on the performance of particular routines in rituals of a non-functional character; there may be stereotyped preoccupations with interests such as dates, routes or timetables; often there are motor stereotypes; a specific interest in non-functional elements of objects (such as their smell or feel) is common; and there may be a resistance to changes in routine or in details of the personal environment (such as the movement of ornaments or furniture in the family home).

In addition to these specific diagnostic features, it is frequent for children with autism to show a range of other non-specific problems such as fear/phobias, sleeping and eating disturbances, temper tantrums, and aggression. Self-injury (e.g. by wrist-biting) is fairly common, especially when there is associated severe mental retardation. Most individuals with autism lack spontaneity, initiative, and creativity in the organization of their leisure time and have difficulty applying conceptualizations in decision-making in work (even when the tasks themselves are well within their capacity). The specific manifestation of deficits characteristic of autism change as the children grow older, but the deficits continue into and through adult life with a broadly similar pattern of problems in socialization, communication, and interest patterns. Developmental abnormalities must have been present in the first 3 years for the diagnosis to be made, but the syndrome can be diagnosed in all age groups.

All levels of IQ can occur in association with autism, but there is significant mental retardation in some three-quarters of cases.

Includes:

infantile autism

infantile psychosis

Kanner's syndrome

Differential Diagnosis
Apart from the other varieties of pervasive developmental disorder it is important to consider: specific developmental disorder of receptive language with secondary socio-emotional problems; reactive attachment disorder or dis-inhibited attachment disorder; mental retardation with some associated emotional/behavioural disorder; schizophrenia of unusually early onset; and Rett's syndrome.

Excludes:

autistic psychopathy

Susan Mayes� Checklist For Autism In Young Children***
Problems With Social Interaction
Social isolation, withdrawal
Limited eye contact, reciprocal interaction, social smile, sharing, showing
Self-absorption, oblivious to others, in own world
Socially indiscriminate behaviour (e.g., going with strangers or invading personal space such as touching or climbing on people), lack of stranger and separation anxiety
Social skills deficit
Perseveration
Narrow or unusual range of interests and play behaviours, obsessive preoccupations (e.g., videos, toys with wheels such as trains, or symbols such as letters or shapes), attachment to and holding particular objects
Stereotyped and repetitive play (e.g., spinning, flicking, throwing, lining up, sorting, opening and closing)
Upset with change, difficulty with transitions, idiosyncratic or ritualized patterns or routines, desire to maintain sameness and order, things must be a certain way or done a particular way
Stereotypes (e.g., repetitive or self-stimulating movements or vocalizations such as rocking, head shaking, body tensing, toe walking, teeth grinding or clenching, hand or finger movements, facial grimacing, repetitive running, twirling, hand flapping or jumping when excited, pacing, playing with saliva, picking at skin, hyperventilating)
Somatosensory Disturbance
Love of movement, frolic play, tickling, climbing, rocking, and swinging
Unresponsive at times to verbal input (e.g., not reacting when name called, hearing may be questioned even though normal)
Hypersensitivity to some sounds (e.g., distress or covering ears in response to loud noise, sounds made by appliances or motors, or certain songs, commercials, or voices)
Distress with commotion, crowds
Fascination with specific visual stimuli such as spinning or rhythmic movements, details, fingers, lights, shiny surfaces, linear patterns (e.g., credits on TV, fans, Wheel of Fortune)
Abnormal sensory inspection (e.g., mouthing, smelling, scratching, rubbing, visually scrutinizing objects or fingers close to eyes, placing ears against things that vibrate or hum, pressing objects against face)
Tactile defensiveness (e.g., dislike being touched, touching certain things, wearing clothes, having face washed, teeth brushed, hair combed)
High tolerance for pain (e.g., not crying when hurt)
Sleep disturbance (e.g., difficulty falling asleep, awaking early or during the night)
Feeding disorder (e.g., limited food preferences, hypersensitivity to textures, retaining food in mouth, inconsistency in eating over time, pica)
Atypical Developmental Pattern
Possible developmental regression or slowing at approximately 1-2 years of age (e.g., loss of words)
Visual and motor skills higher than expressive and receptive language, especially for children with delayed development
Expressive language disorder: (1) no speech or absence of communicative speech with nonverbal communication at a higher level than verbal (e.g., pulling others by the hand and leading to what wants) or (2) limited reciprocal conversational speech (versus communication in stress- and need-related situations, self-directed verbalizations, or speaking on topics of interest to self)
Atypical vocalizations such as unusual voice quality or modulation, screeching, odd noises, repetitive vocalizations, echolalia, idiosyncratic jargon or speech, preservative speech, sporadic speech (e.g., uttering a word or phrase once and rarely or never saying it again), rote phrases out of context (from the past or videos), nonsensical speech, pronoun substitutions
Splinter skills: specific abilities significantly above the child's mental age that often involve (1) rote memory (e.g., identification of numbers, letters, shapes, logos, and colours; singing or humming tunes; memorizing car routes; counting; saying the alphabet; reading; spelling; reciting segments from videos or books), (2) visual, manipulative, or mechanical skills (e.g., completing puzzles, matching shapes, using a computer or VCR), or (3) gross motor skills
Mood Disturbance
Overactivity, irritability, agitation, tantrums, aggression, self-injurious behaviour (distressed by input or occurrences most children can tolerate such as intrusions, activity interruptions, proximity, confinement, performance demands)
Emotional lability with mood changes sometimes internally triggered (e.g., laughing or becoming upset for no apparent reason)
Flat affect, unresponsive in some situations
Unusual fears (e.g., elevators, steps, toilets)
Problems With Attention and Safety
Selective attention, situational over-activity (e.g., hyper-focused on activities, objects, or topics of interest to self and inattentive at other times)
Autism
Asperger Syndrome
Asperger syndrome
DSM-IV Diagnostic Criteria for 299.80 Asperger's Disorder*
Qualitative impairment in social interaction, as manifested by at least two of the following:
marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
failure to develop peer relationships appropriate to developmental level
a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
lack of social or emotional reciprocity
Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
apparently inflexible adherence to specific, non-functional routines or rituals
stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole body movements)
persistent preoccupation with parts of objects
The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning
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)
There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than social interaction), and curiosity about the environment in childhood
Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia
ICD-10 Classification for F84.5 Asperger�s Syndrome**
A disorder of uncertain nosological validity, characterized by the same kind of qualitative abnormalities of reciprocal social interaction that typify autism, together with a restricted, stereotyped, repetitive repertoire of interests and activities. The disorder differs from autism primarily in that there is no general delay or retardation in language or in cognitive development. Most individuals are of normal general intelligence but it is common for them to be markedly clumsy; the condition occurs predominately in boys (in a ratio of about eight boys to one girl). It seems highly likely that at least some cases represent mild varieties of autism, but it is uncertain whether or not that is so for all. There is a strong tendency for the abnormalities to persist into adolescence and adult life and it seems that they represent individual characteristics that are not greatly affected by environmental influences. Psychotic episodes occasionally occur in early adult life.

Diagnostic Guidelines
Diagnosis is based on the combination of a lack of any clinically significant general delay in language or cognitive development plus, as with autism, the presence of qualitative deficiencies in reciprocal social interaction and restricted, repetitive, stereotyped patterns of behaviour, interests, and activities. There may or may not be problems in communication similar to those associated with autism, but significant language retardation would rule out the diagnosis.

Includes:

autistic psychopathy

schizoid disorder of childhood

Excludes:

anaclastic personality disorder

attachment disorders of childhood

obsessive-compulsive disorder

schizo-typical disorder

simple schizophrenia

Christopher Gillberg�s Criteria For Asperger Syndrome****
Severe impairment in reciprocal social interaction (at least two of the following):

inability to interact with peers

lack of desire to interact with peers

lack of appreciation of social cues

socially and emotionally inappropriate behaviour

All-absorbing narrow interest (at least one of the following):

exclusion of other activities

repetitive adherence

more rote than meaning

Imposition of routines and interests (at least one of the following):

on self, in aspects of life

on others

Speech and language problems (at least three of the following):

delayed development

superficially perfect expressive language

formal, pedantic language

odd prosody, peculiar voice characteristics

impairment of comprehension including misinterpretations of literal/implied meanings

Non-verbal communication problems (at least one of the following):

limited use of gestures

clumsy/gauche body language

limited facial expression

inappropriate expression

peculiar, stiff gaze

Motor clumsiness: poor performance on neuro-developmental examination

All six criteria must be met for confirmation of diagnosis
Pervasive Developmental Disorder Not Otherwise Specified
DSM-IV Diagnostic Criteria for 299.80 Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism)*
This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behaviour, interests, and activities are present, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizo typal Personality Disorder, or Avoidant Personality Disorder. For example, this category includes atypical autism --- presentations that do not meet the criteria for Autistic Disorder because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these.

ICD-10 Classification for F84.1 Atypical Autism**
A pervasive developmental disorder that differs from autism in terms either of age of onset or of failure to fulfil all three sets of diagnostic criteria. Thus, abnormal and/or impaired development becomes manifest for the first time only after age 3 years; and/or there are insufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restrictive, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals whose very low level of functioning provides little scope for exhibition of the specific deviant behaviours required for the diagnosis of autism; it also occurs in individuals with a severe specific developmental disorder of receptive language. Atypical autism thus constitutes a meaningfully separate condition from autism.

THANK YOU so much for your response. I appreciate the time and effort with all the information. Sometimes I just want to give him a chance to play catch-up and hope everything will be OK. I want him to be functionable... I would also like to hear "Mama"...He just says, "Dada!" But, I'm going to print your info out and read more thoroughly. Again...thank you!

I agree that your son's problems seem way more connected to his hearing loss than any autistic disorder. He's just now starting to get a whole new world of sensory input that he was missing, of course he's going to be behind on speech.

From my own son's (aspergers) experience, he would totally ignore us - we even thought he had a hearing problem for a long time. But your son has just not had the chance to respond until recently.

And if it makes you feel better, most kids seem to say "da-da" more than "ma-ma" because we moms tend to talk about "daddy" way more than we talk about ourselves - so they hear that word more. (Unfair, isn't it?)

Thank you BellaHarmony for your response too. I never realized how important hearing is. It seems to affect everything from speech to understanding/comprehension. Maybe I'll start to use the word "Mama" more and see if that helps. I know I just need to be patient...a virtue I don't have!

Hi
I'm new and can use any help I have a 21 year old who is now out of school due to age and they are not helping me in any way to make that transition . He can't live on his own and he is high functioning . i'm stuck. I dont have a clue what to do he can't just sit in front of the tv for the rest of his life, i have a 6 year old and a 8 year old and they even ask what is Nick that is my son doing now he is not in school mommy. I did everything they told me he is in the sytem with DDD and DSHS but no one cares and is helping we are just one more in the system.Now what

Mine is 16, and I am starting to get worried about this very question. Given the events of the past couple of years, I am not sure he is going to be able to make it on his own. I don't know how he will hold down a job (other than helping catering with his grandmother).

We actually have an appointment with his psychiatrist at the end of the month to discuss some of these issues.

This website has some resources you might find helpful:
Autism Society of America

But I'll jot back in after we've had our one-on-one and let you know what advice we get.

What State are you in? Is there a local chapter of the ASA? What about ARC or Easter Seals? Did you visit any programs when he was still in school. I thought families and schools prepare for this starting at age 16 or 17. What was the transition planning about? Is he verbal? Are there any in home services? Did you stay in touch with the other students and their families from his class? I really think families need to start preparing at the age of 16 or 17 to visit organizations and find out what is in their community.

BellaOnline ALERT: Raw URLs are not allowed in these forums for security reasons. Please use UBB code. If you don't know how to do UBB code just post here for help - we will help out!