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Author Topic: Diagnosing S6 With ASD  (Read 484 times)
Turkish
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« on: July 15, 2016, 12:42:34 AM »

So we completed the second week of a 6 week series in a parenting class.  The children have their own space (ages 6-11). That was last night.  

About ten minutes before the class ended,  the T brought our son in.  He was jumping up and down needing to pee.  I took him.  When I returned,  my ex saying something wise,  and the T facilitator was nodding and smiling.  Earlier,  I resisted rolling my eyes several times when my ex was talking.  Some of what she says it's good,  but is also in the context of a high functioning
uBPD. I felt like saying, "you all don't get it! "

When they brought the kids in, our son ran past his mom and jumped into my arms, " Dadeee!" I don't encourage this,  but I don't reject it.  I know it bothers her. The other night,  :)4 got upset with me and said she didn't like me.  S6 said that he loved both mommy and daddy. I asked him why.  He gave two reasons for his mom (one of them being that she was pretty), and about 6 reasons why he loved me.  I'm not pretty.

When we got to the car (I met her and she drove), she commented that she thought that we were so much further ahead of the other parents in the class and asked me what i thought. I wasn't going to validate her narcissism,  so I ignored her and talked to our son.  

We had an appointment with the P today.  

Today the psychiatrist, who is a resident soon to be leaving next month,  talked about  ASD. Not to sound arrogant,  but in a previous session I had already commented that Asberger's was no longer a valid Dx under the DSM-V criteria,  that it was now Autism Spectrum Disorder.  She pulled out the DSM-5 summary.  

The kids' mom keeps focusing on his social skills,  that he is sometimes lost and doesn't make eye contact.  :)4 is very self assured, talks to everybody,  and you can't shut her up.  Our son just gets lost in his own thoughts sometimes.  The T commented that she thought he was brilliant (here I triggered since his mom is always calling him a genius).

The P then said she would make a referral to get him evaluated for ASD. Mom agreed.  I backed up and said,  why don't we go through the next 4 weeks of class and let the group therapist leaders write it up and make a suggestion.  This isn't a crisis,  right? Mom was ready to make the referral right there.  I stressed getting an objective opinion.  

Personally, I don't think there's anything majorly wrong with him.  His mom keeps fixating on his social skills.  She also works with teens and young adults,  some of whom have ASD  (by some of her stories about parents,  I wonder about the ASD diagnoses. ... I'm not commenting about the causes in general,  just about side effects of highly dysfunctional parents).

The P said that if he received a Dx, then it would open us up to more services: a T would come to our homes and observe things. Cue my black helicopter paranoia. 

After I started thinking about it,  however,  maybe that might not be such a bad idea.  Step-dad commented to me a few times how much much more calm the kids were when I brought them back as compared to his wife.  

And in other news,  my ex is filing a RO on step dad's brother. Last week when the kids were with me she called the cops on him.  H ended up being stupid , and he got cuffed,  put to the ground and "beat up" according to my ex.  He may have face a misdemeanor. Thus far she's compartmentalized this , and kept it from the kids.  If the therapists only knew... .
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« Reply #1 on: July 16, 2016, 08:58:04 PM »

Hi Turkish,

How are you doing after hearing this from a P?  Sometimes diagnoses or observations from a therapist can affect us, immediately and later.

The DSM-V did eliminate Asperger's but it's a little controversial.  Even if you S6 doesn't get diagnosed, if he has traits, it could be useful to apply strategies for kids with Aspergers.  Reading Tony Attwood. and Temple Grandin for strategies was helpful for me. 

I can understand why you are triggered in some aspects of this situation.  I don't know your child, but often boys are less developed socially than are girls.

I would suggest before or as part of a diagnosis you have your son's IQ evaluated.  It's very helpful to learn patterns of strengths and weaknesses.

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Turkish
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« Reply #2 on: July 17, 2016, 12:40:10 AM »

If anything,  mommy is Asbergeryish. But it'seems more the stunted empathy I think from BPD traits.

Yesterday evening I met her to pick up S6. I had spent the day with D4, but I have them this weekend. She was telling me that she had trouble with our son at the mall,  that he kept hanging on her arms.  When they ate,  he got mad at her because she wouldn't get him juice so he forbade her from sitting with him while they ate  (I'm thinking, "who's the parent here?".

When we were hanging out for a bit,  she was standing with her brother and sister talking.  He was trying to show her a DVD and tell her about it.  She was ignoring him.  Though she and her siblings were talking,  both of her siblings validated him briefly by each making a comment about the movie.  His mom didn't even make eye contact. It wasn't malicious or purposeful,  it's just the way she is.  

D4 wanted to be cuddled by her. She commented that she liked it because when she was younger,  :) didn't want to be cuddled.  I don't remember that at all in my interaction with our daughter.  What I remember (and documented by journal) is a mother who started checking out just before she turned 1, and started an affair/double life a couple of months later,  the kids often in crisis,  "where's Mommy?" S then 3 only verbalizing that of course.  

I took the kids to a community outreach today.  When we sat at a table, I did have to prompt my son to greet the ladies properly. I see that as a little shyness.  I had him talk to a few of the male volunteers,  watching him closely. He interacted with them fine,  and made eye contact... .they were paying attention to him.  I never have an eye contact issue with him either.  

What am I scared of? I think I said it in the first post.  I don't want him to be made out to be a martyr by proxy for his mother's anxiety.  I could see her running with a Dx, attaching to a community and making that a new validation crusade, and then putting things in his head that don't belong.  

Still,  from a logical standpoint,  there's nothing wrong with him being evaluated,  and asking for an intelligence screening is a great idea
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« Reply #3 on: July 17, 2016, 01:36:44 AM »

IQ evals are often skewed in kids with ASD and they will tell you that when they do them though it is standard practice to do an IQ test as part of the eval. Their intelligence is just *different* even when they are exceptionally gifted and it's not easily measured. My kid just flat out ignored the test questions and refused to try so he failed but is plenty smart in the things he gives a crap about.  Laugh out loud (click to insert in post)


If possible, I would consult with others who interact with your child. Teachers, daycare workers, camp counselors, whomever can offer you a balanced point of view. I realize that mom isn't the most objective pov in your scenario, but please don't dismiss these concerns based on that.

It took a long time after I was pretty sure s11 has ASD to get an eval and even longer to get a proper diagnosis as he continued to fall behind his peers with age. Because he's smart, highly verbal, makes eye contact and is "high functioning". An evaluation is never a bad idea and a dx is harder than you think to get. While services might be great or terribly unhelpful depending where you live, understanding ASD is light years easier and more predictable than understanding BPD and catching it sooner can help you know best how to set your child up for success.

Eye contact is one thing in a sea of things and S11 makes eye contact and always has, but any professional could tell you it isn't typical eye contact. What isn't clear at 6yo will become crystal clear in the coming years if it's true but getting input from a professional is always wise if a concern has been expressed.

I hope I haven't overstepped. I once laughed at the absurdity when his daycare provider suggested autism because I thought I knew what that was. And then cried. And then asked the pediatrician who also laughed but a few months later made the provisional diagnosis and referred us elsewhere. I hope you don't have to walk this road but if you do, there is much hope.
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Turkish
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« Reply #4 on: July 17, 2016, 01:56:24 AM »

Thanks motherhen, no. I welcome all feedback.  I almost feel desperate for it.  Even if I don't have a problem with him,  I am starting to realize that this is only our own orbit.  Earlier tonight,  I thought about scanning his final report card from kindergarten and sending it to the P. It's a good data point.

The funny (not funny) thing is that about a year ago,  I talked about our son maybe being something like ADD. His mom balked, almost paranoid that she didn't want him labeled.  Now it's me 
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« Reply #5 on: July 17, 2016, 02:55:55 PM »

It's actually really normal for one of both parents to have feelings like that about labels and potential diagnosis. And  denial that comes and goes even years after receiving a diagnosis.

Ages 5 and 6 are tricky to tell with boys, because there is still a wide range of "typical" behaviors but the gap gets much smaller in the coming years. Some of those kids just need lots of physical activity and time to adjust to the demands of school such as sitting still, not talking out of turn, the unwritten social rules etc.

When one parent is Aspergerey, the odds go up that at least one of the dc will fall somewhere on the spectrum. If you like I could ask you some questions that might cover some of the less obvious symptoms. Like, does he tend to take things literally and have a hard time understanding idioms and figures of speech? Does he have food or clothing aversions or limited foods he will eat? Do you find that you have to word things a certain way for him to understand? Does he perseverate or have intense focus on certain things?
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Turkish
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« Reply #6 on: July 18, 2016, 01:28:27 AM »

I'm (once again) arm chair diagnosing her as being Asbergery. It may just be her self absorbtion. Her mom used to chuckle when I'd ask her a question and she'd be absorbed in a soap opera.  Alone, it was often her fashion magazines.  Often frustrating for me,  yet I was the bad communicator.  On the phone,  and it's still like this,  the conversation would be over when she got what she needed,  "ok. Yeah, ok... ." a signal she was done.  Like the other day,  she only paid attention to our son,  negatively,  when he was acting out (he was spitting upon ants on the driveway,  but a few minutes later when he was telling her about the movie,  she was all but ignoring him. 

I haven't quizzed him on idioms specifically,  but he asks questions regarding stories regarding fiction vs non fiction and reality.  Can you give an example of idiomatic misinterpretation?

He does have physical OCD like tics. 

He used to organize toys and count much like autistic children, but that's lessened.  I remember a Facebook post by his mom's cousin about their diagnosed autistic son lining up toys,  and S6 used to do the same thing. 

Textures do trigger him with food,  yet we often eat Pho, and he has no problem with the cilantro in the soup.  Yet at home if I serve bbq chicken,  it had better not have a spec of something green, or he won't touch it. 

I don't have a problem communicating with him.  He does intensely focus on things,  like now his Legos.  He can spend over an hour with his Bionicle Legos,  happy.

He also can hyper focus on certain things,  the T noticed this.  He learned about a certain animal from an educational cartoon. One weekend,  I let him loose on YouTube with one video.  I let him spend too much time on there,  two hours  (I was busy around the house and with D4), but he kept clicking video after video,  and became an expert.  I had to log it out,  or he'd probably still be on there!
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« Reply #7 on: July 18, 2016, 02:07:46 AM »

There are some flags there that warrant looking into this further IMO.

For example on the idiom thing, if you said it's raining cats and dogs my literal thinking kid would not deduct that  this means raining hard and would be all excited to see dogs and cats falling from the sky. Cause we need ALL the pets LOL. Similar with puns or jokes that involve play on words.

Most people hyperfocus on things, that is how we learn and master concepts. So while that isn't a concern in and of itself with ASD it tends to become an obsession and they will continue to go on and on about it unconcerned that it's not something others want to hear about endlessly. My son also has OCD so it's hard to sort out which is which there.

www.childbrain.com/pddassess.html is not considered a diagnostic tool but might be helpful.
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Turkish
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« Reply #8 on: July 18, 2016, 11:11:25 PM »

I took that test and it said that he wasn't ASD. Maybe I should take it trying to think like my Ex *eyeroll*

I sent the P a message asking for the referral.  I also attached our son's kindergarten report card which summarized all three trimesters as another data point.

I didn't alert their mom.  She finally reset her password to access the HMO site after me handling all medical emails for over a year.  I'll tell her when I see her the day after after tomorrow. I also stated that I didn't observe him to have issues in social interactions. Your point about the eye contact is taken though,  so thanks.
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Turkish
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Dad to my wolf pack


« Reply #9 on: July 20, 2016, 11:37:10 AM »

Email back from the doctor after she talked to the kids' group coordinator. S6 has been to two classes. The third is tonight.

The coordinator told the P that while S6 does well listening and following instructions and rules, S6 has some difficulties in dialoguing with others and transitioning activities. The coordinator and the P both agree that those symptoms and others reported by my Ex (hand flapping, difficulty making eye contact) indicate a possible Dx of ASD and that an evaluation would be helpful for a diagnostic clarification. They just want a better understanding of how to best support him.

I still think that while he does have a few quirks that are ASD-ish, a lot of his anxiety stems from both the stress and confusion over the past year and also the way in which his mother interacts with him. Though he loves her, he's shown a lot of anger towards his mom, the most starting within a couple of months after she moved out because she had replaced me in our son's eyes with a new "dad" right away.

The story of him refusing to sit with her to eat in the mall last week is reminiscent of how he acted towards her back then, defiant and even kicking and hitting her. He seems far more comfortable with me, and if even her H has commented on it, then it's probably true.
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« Reply #10 on: July 21, 2016, 01:03:22 AM »

Hi Turkish, I think you really hit on something when you say it's hard to tell if your S6 symptoms are due to the stress and many changes he's experiencing, or if he indeed falls somewhere on the spectrum.  I wonder if you can convey your thoughts about this to any P who might diagnose your S.  If your exW has been diagnosed with BPD that, I think, would be something to mention to the P.  I wonder if a T would wait to or hesitate to diagnose because of the recent family changes?

I wonder if it would help you to have the P do an anxiety evaluation on your S?  I did that with mine when he was 5 and it indicated he had a lot of anxiety.  The T coached me on strategies.

Do you have a poster in your home with different faces indicating different feelings?  That can be helpful for any kid, and especially those on the spectrum. 

I forgot about the obsessing/perseverating that motherhen mentioned.  When my S was younger I  knew more than I ever thought I could about dinosaurs.

I'm sending my support to you.  It's not easy getting diagnoses about our children, and we can have varied reactions.  The books by Tony Attwood really helped me see the positives in the child with Aspergers, as well as concrete advice.   

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