AboutMichelle Fattig Expertise I can answer questions about educational testing, autism, Asperger's Syndrome, ADD/ADHD, Special Education, IEP, Learning Disabilities, Sensory Processing, Parent Advocacy, Response to Intervention, living and parenting with disabilities, parent rights in special education, school psychology, and more. I cannot provide a medical diagnosis.
Experience I am a school psychologist, medical technologist, author of the Annie Books series: Experience Aspeger's Syndrome and Attention Deficits Through the Eyes of a Child, RTI facilitator, ILCD facilitator, parent advocate, presenter, and researcher. My children and I have Asperger's, ADD/ADHD, and learning disabilities.
Organizations National Association of School Pyschologists, American Medical Technologists, Learning Disabilities Association of Nebraska
Education/Credentials Ed.S. in School Psychology, doctoral studies in SPED Law, SPED Systems Enhancement Leadership, and doctoral candidate Education Leadership. MT(AMT) and MLT(ASCP)
I have asked you questions in the past about my son and now that I am less focused on him I have some about my daughter.
She is 4 1/2 years old. She is very outgoing in general. She can go to a party and lead a bunch of kids she just met. However, when watching her interact on play dates I have noticed a few things. She has anxiety when trying to join in a pretend play game with dolls. She can play fine with me one on one. She has symbolic play and pretend play skills but almost freezes up in some situations. I asked her why she did not play and she said she thought it was because her friend did not want her to play when the other two were already playing, and that she gets a little shy. She also tries to control other games with ideas and rules. The other kids seem to do this to some degree too. They all seem to fight to be in control. My daughter is worse in the sense that when she is not in control she looses interest and some ability to play along. I am very concerned about this.
She never had alot of interest in toys as a baby or alot of elaborate pretend play like my son does. She loves to draw and can decorate a room better than a professional. She can converse with other kids and loves to tell jokes. She says she enjoys making people laugh. She's not too literal and can understand abstract language for her age. She can interact fine in a just hanging out situation. She seems to have overall low self esteem and is afraid of rejection. She is very into looking pretty, jewlery, and all things girly. She said it is because they have "who is the prettiest" competitions at school (remember she is only 4), and that person gets to be the "boss". I think her speech is fine. Same as the other kids. She used to be loud but has adjusted her volume. She has sensory issues to smell (gagging) and some loud noise. My son's OT said she would NEVER qualify for OT because her gross and fine motor skills are very good. She has a small problem with talking out of turn. This has improved with age. She was also very hyperactive as a baby but has mellowed out with that with age. She potty trained on time and is great with following directions etc. She can also answer questions well. She is loving, complimentary to people-complements details in a person's home, clothing etc, seems to know most social norms. The issue is really the impulsive out of turn talking to be in control type of behavior and difficulty with the pretend play with friends. Is this Aspergers?
Answer She has some peculiarities, but as long as she is happy and the characteristics are not interfering socially, emotionally, behaviorally, or academically, I would not be overly concerned at this time. Usually the "problems" do not manifest until school age, and are often misdiagnosed or dismissed as "a drama queen" or overly involved parent. Generally speaking, schools and medical professionals tend to prefer diagnosis of anxiety disorder or bi polar in females (don't ask me why!). I am attaching a bit of an article for you on females "misdiagnosed and misunderstood" which I will be presenting as a roundtable discussion at the Pacific Rim Conference in April:
The majority of all referrals for behavioral concerns and the diagnostic assessment of Asperger’s Syndrome are for boys (Attwood, 1999), and “because referral is such a strong predictor of special education eligibility,” (Hosp & Reschly, 2004), this disproportionate referral rate may explain why the epidemiological research for Spectrum Disorders indicates that the current ratio of male to female’s with a diagnosis of Asperger’s should be 4:1, while the actual rate is approximately 10:1 (Attwood, 1999).
Although many girls with Asperger’s Syndrome demonstrate similar characteristics as those of boys with Asperger’s Syndrome, their expressions of the characteristics may manifest in more subtle ways. Girls tend to develop camouflaging or masking abilities, and they appear to be “more motivated to learn and quicker to understand key concepts” and social skills (Attwood, 1999). However, making friends or social interaction can be “an exercise in frustration for (a girl) because no matter how hard she tries to fit in, she just doesn’t click with the other kids,” (Donvan, 2008). Girls typically evidence more social and conversational skills, and can sometimes go unnoticed if the testing for conversational skills is brief enough (Donvan, 2008, p. 2).
Our website www.anniebooks.com has a page about creative play in girls on the spectrum. Here is a questionnaire for you to copy/paste/print for your school's school psychologist, early referral team, or pediatrician:
EARLY CHILDHOOD/PRESCHOOL PARENT QUESTIONNAIRE
Name of Child: _____________________ Date of Birth: ________ Age: _______
Name of Referrer: __________________ Relationship to Child: ______________
Parent/Guardian: ______________________________________________________
Names Address Phone
Date of Referral: ____________
Referral Concern (Please list any concerns about child’s communication, behavior, or development): _____________________________________________________
______________________________________________________________________
Medical History:
Pregancy: _____________________________________________________________
Prenatal: ______________________________________________________________
Birth: _________________________________________________________________
History of Chronic Illness, Head Injury, Ear Infections, Hospitalization, or Accident: ______________________________________________________________
_______________________________________________________________________
Mother: ____________________________ Father: ____________________________
Siblings: _______________________________________________________________
Family History (Special Education, Developmental Delays, Learning Disabilities, Mental Health): _________________________________________________________
Who lives with the child: __________________________________________________
How does the child relate with:
Mother _________________ Father __________________ Siblings _______________
Family activities: ________________________________________________________
Does the child experience difficulty with peers, extended family, or social settings?
_______________________________________________________________________
As an infant, did the child experience difficulty with colic or soothing (stiffen or pull away when cuddled or stroked)? ___________________________________________
Communication:
1) Does he or she respond to his/her name: Never Sometimes Often Always
__________________________________________________________________
2) Does he/she express her needs or wants: Verbally Pointing Pulling Tantrums
___________________________________________________________________
3) Does he/she talk like children his/her age? ______________________________
___________________________________________________________________
4) Does he/she follow simple or complex directions? ________________________
____________________________________________________________________
5) Have you ever wondered if he/she is deaf? _______________________________
6) Does he/she seem to hear at times, but not at others? _______________________
7) Does he/she ever seem lost in own little world or stare off? _________________
_____________________________________________________________________
8) Does he/she mimic, copy, or like to immitate? ____________________________
_____________________________________________________________________
9) Does he/she seem to have lost words, or say fewer words than before? _________
_____________________________________________________________________
Social Concerns:
10) Does he/she smile at family members? __________________________________
11) Does he/she smile at strangers or become overly frightened by strangers? ______
____________________________________________________________________
12) Does he/she prefer to play alone or overly dependent on parent/caregiver for entertainment (you are his favorite/only toy)? ____________________________
____________________________________________________________________
13) Does he/she get things for self? _______________________________________
14) Is he/she very independent or overly attached (extreme separation anxiety)? ____
_____________________________________________________________________
15) Has he/she met milestones early or unevenly? ____________________________
_____________________________________________________________________
16) Does he/she seem to avoid eye contact or have too much eye contact (watching without mirroring or reacting like a little professor)? _______________________
_____________________________________________________________________
17) Does he/she often seem “lost in own little world”? ________________________
____________________________________________________________________
18) Does he/she seem tuned out or uninterested in other children? _______________
____________________________________________________________________
Behavioral Concerns:
19) Does he/she seem to have excessive tantrums or emotional outburst with little or
no provocation? ____________________________________________________
20) Does he/she express frustration or over react to small changes or routine? ______
_____________________________________________________________________
21) Does he/she demonstrate a lack of understanding in playing with toys (excessive mouthing, banging, lining up, sorting, focus on one part like spinning, or lack of interest)? __________________________________________________________
_____________________________________________________________________
22) Does he/she seem to get stuck on things regularly (wants to stick with one activity over any others, watch the same movie over and over, read the same book over and over, or other)? _________________________________________________
____________________________________________________________________
23) Does he/she have unual attachments to objects? ___________________________
_____________________________________________________________________
24) Does he/she toe walk or have unusual facial movements/grimacing? __________
_____________________________________________________________________
25) Does he/she make any unusual hand movements or spin for long periods of time?
_____________________________________________________________________
26) Does he/she seem overly sensitive to textures or sounds? ___________________
_____________________________________________________________________
If Age Appropriate:
27) Did he/she babble by 12 months? ______________________________________
28) Did he/she gesture (point, wave bye bye) by 12 months? ____________________
29) Did he/she use single words by 16 months? ______________________________
30) Does he/she seem to have an unusually advanced vocabulary? _______________
31) Does he/she seem to have an extremely good memory? ____________________
32) Does he/she demonstrate two-words spontaneously (not echo) phrases by 24 months? _________________________________________________________
33) Has he/she demonstrated any loss of language or social skills of any kind? _____
_____________________________________________________________________
(3-4 years of age)
Cognitive:
34) Show him/her a doll or stuffed toy, touch one to a box and have the other
pretend to look in the box. Ask him/her “Which one knows what’s in the box?”
Response: ____________________________________________________________
Michelle Fattig, Flower by the Water Publishing PO Box 579 Genoa, Nebraska 68640 www.anniebooks.com
Adapted Questionnaire: Recommendations National Autistic Society: What should health professionals look out for when parents express concerns? And ToM “Seeing leads to knowing.” (Baron-Cohen, 2000, p. 5)
I hope this is of help to you. Please let me know if I can provide any other information.
