Expert: James Michael Roan - 11/18/2008

Question
Hi.

First, thank you for this site. It really is helpful to have a variety of places to seek advice on this issue.

I'll try to keep this short, but there are a bunch of pieces to the puzzle. My 4-year-old son is very intelligent and sweet kid, but he is becoming increasingly defiant and aggressive, with major hitting issues. He has diagnosed language articulation problems, though his vocabulary is very good. He has been obsessed with fans and lights almost since birth (in fact, his very first word was "light"); so much so, that he gets very angry if he sees a "fanlight" (his word) that isn't working. He wants all fans and lights to be operational at all times. He is becoming increasingly anxious and frustrated, and his temper tantrums are increasing, rather than decreasing.

He's been this way for as long as I can remember.

For the first several months of his life (probably around 14 months or so) he screamed almost non-stop. Almost nothing except nursing comforted him (diagnosed and treated for severe reflux). He didn't smile a lot. He seemed fascinated by textures(like the nubby fabric of the easy chair), and although his motor skills were all on time or even early, his speech came more slowly.

At 18 months he was tested for hearing and speech and the IEP categorized him as having borderline delays, but he didn't qualify for services. Because I was concerned about sensory issues, they were willing to work with him for a few sessions, but they didn't suspect any additional issues at that time.

I brought him to a speech pathologist about a year and a half later, because of continuing articulation issues which were starting to frustrate him. She put him at a level of 2 years, 1 month (he was 3 years, 1 month).

At 3 1/2, the IEP folks said that he now qualified for speech therapy through the schools, and he began speech therapy.

When I went to pick him up from preschool today, the teacher told me that he is refusing to sit with the rest of the kids and is increasingly defiant there, as well. She thinks he should be observed by the IEP again.

I have ADHD, and for a while, I wondered if perhaps he did, too. But with the family history (my nephew is autistic), and my sister's input, I'm beginning to suspect Asperger's instead.

I know that autism is a spectrum, but one of the reasons I discounted autism earlier is because of his social skills. He loves people and seeks them out. He also seems fairly good at reading people's faces. He'll say, "Mommy, your eyes are sad. Are you sad?"

However, as he gets older, it becomes more apparent that he is good at socializing with older kids and adults, but not kids his own age. He does seem to have a good deal of empathy, but it could be that I have been working with him on noticing others' feelings from an extremely early age.

I know that a diagnosis can't be made through this forum, but is it possible for a child to have Asperger's, yet still have the ability to read people's reactions (at least sometimes) or am I just grasping at straws? I look forward to your answer.

Rachel

Answer
Hi Rachel;

Think of Asperger's syndrome (AS) on a spectrum as well. Really high functioning children with AS really only lack "social competence" around their peers. They may have the social skills but are not able to keep up in a group of peers, so they isolate themselves looking on wanting to join in but not able to for a variety of purposes. some of these skills can be taught. It's worth having him evaluated by someone expert in this area.

Kind regards,
James









James Roan Bio:

James Roan (roanpsych@gmail.com) has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disability and with enforcement of their rights. James Roan was the consulting psychologist responsible for many of the autism and ADHD screening tools and other content for www.accessspecialneeds.com. James Roan consulted with the graduate department of the Waterford Institute of Technology in the development of their graduate program for the certification of private autism tutors.