Expert: James Michael Roan - 11/4/2008

Question
QUESTION: My son is 3 and a half,up until today we though he had problems with his hearing though the doctor has confirmed his hearing is fine ,I spoke with her and she has referred him to be checked for autism so I would like to put the behaviour I see to you to see what your thoughts are .My son is very intelligent he can conversate with adults children and strangers with clear communication maintaining good eye contact.He plays better with older children and seems to get caught up in his own play when around his peers.He knew his colours and shapes 1-10 by age 2.His behaviour has become aggressive often hitting me when I'm telling him off,he doesn't like loud noises,he will hit himself when I tell him off,not much interest in toileting will only wee on potty.At the age of two he started lining up his cars and if you moved one and exchanged it for a different coloured one he would know from 30 cars,now he groups things together kept in containners and not played with if you try to play with them he gets very angry.I read him 3 books 'Hairy Maclary',and after a week I would start the sentence and he could finish it.He takes part in imaginary play,he doesn't like to try different food and if there is food someone else is eating that he doesn't like the look of he will throw up which is common to him as he suffers from reflux often vomitting when he is told off .Please let me know what you think as soon as you can ,from a worried mother.

ANSWER: Hi Gayeanna;

Based on my personal experience, your son does show many characteristics of high functioning autism/Asperger's syndrome. That should not be bad news though. These children have wonderful intellectual and personal gifts, but struggle most with friendship making and keeping skills, but otherwise have a pretty normal life.

I'm sure you have many more questions.

Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: Thankyou so much for your quick response I really appreciate it.I would like to ask you what the struggles would be in making friendships as I can clearly see now that he chooses who he wishes to be a friend and is more dominant than the other regarding the friendship,also what do you mean by keeping skills? I'm guessing things which are an issue to him and not really to other children his age so he doesn't like to clean his teeth,wash his hair and at times get dressed.I spoke to his pre-school teacher today who said that yes he did show some signs of stacking up toys and not wanting others to share but now he does share and she said he is so loving and polite to everyone ,so I wonder when do you draw the line between uncertainty ,behaviour summing up to autism.Sorry another thing what do you mean by personal gifts thanks once again I'am at a ground where I do not have much of an insight but the more I think back to certain behavior eg-smearing choc pudding all over the tv and floor the more links I make which is quite scary to go from a hearing problem to this is quite a leap thanks again Gaye

Answer
Hi Gaye;

Sorry for the delay, I'm very busy this week so I'm looking forward to this upcoming four day weekend. I'll have more than enough time to discuss this in depth with you then.

Let me try and briefly answer your questions here and now. "If" your son has Asperger's syndrome (AS), he will struggle with social reciprocity and turn taking because these skills require perspective taking, something not first nature in individuals with AS. They can be taught these skills, although they will almost never be fluid or natural with them. The teeth cleaning and hair cutting/combing are problematic because they are sensory related and unnecessary to someone who does not consider how others perceive them on a frequent basis. Friendships work fine when the other follows the agenda of the individual with AS, but quickly breakdown due to a lack of reciprocity.

Their gifts are many and difficult to list here, but here is what I have directly observed:

Giftedness in poetry, writing, music, science, and just about any profession EXCEPT politics. A genuine positive expression of all that is good about humanity. A strong desire to love and be loved, yet lacking the "know how" to make that work for them in a practical way. They also sense sometimes the deeper connections within and between people which, in a way, seems counter to their lack of practical social skills and social competence or social fluidity.

I've got to run to the office now. Talk to you later this weekend in depth, although you do not have to wait until then to ask more questions, just that I may be slow to answer. I am not insensitive to what probably seems devastating to you, but like I mentioned one parent in Dublin this summer, with AS and a well conducted and thorough assessment of the essential features associated with AS you literally have a road map of your child's life, something most every other parent does not have the benefit of. You know what to look out for and how to prepare for it.

Kind regards,
James