About Michelle 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)
Question Hi Michelle,
We have two 22 months old daughters (fraternal twins) who don't speak in two word sentences at all. They have started to “talk” when they were around 16-17 months old, and by talking I mean labeling things (daddy, mommy, cat, dog, etc). We are a bilingual family and I know that children start talking later (our 7 years old son started to talk later than he was supposed to according to the extensive literature available due to that fact.) Another thing they do is a lot of babbling. They talk to us for minutes at a time like they are explaining things in a different language.
They just recently have started to interact between each other sometimes. Before, they completely ignored each other. They smile a lot and look us for to show us her animal toys (which they love) and start saying the names of the animals for us to do the noise or vice versa. They know all the letters and numbers 0 to 9 if we show them and they only mix them up between languages. The problem is that none of them answer consistently to her names. We haven’t done a hearing test yet, but I am almost sure they don’t have any sort of hearing problem. Sometimes, when bare feet, they walk on their toes. They don’t flap arms or hit themselves, but the inability to communicate is starting to frustrate them and they are started to show some tantrums.
We had them evaluated by an Early Intervention psychologist, but the thing is that they have taken a lot of time with our case and only recently, after us threatening with leaving and filing a complaint, they have come forward and we are to receive services next week. They were diagnosed with a 33% delay in speech. This evaluation is from last October and the girls have improved a lot since. However, we are not in denial and we know something is not right since some of the characteristics I explained above are autistic features (I just did the M-Chat, and they failed it). Our question, is that if they are any other developmental (or any kind) disorder that share these characteristics other than autism? In case it is autism (which we suspect), the fact they are fraternal twins make them share the same "level" of autism or they can manifest the disorder diferently?
Thank You for your time and help
Ruben
Answer Many "experts" do not understand (or even acknowledge sometimes) high functioning autism or Asperger's Syndrome. These are the diagnostic criteria:
DIAGNOSTIC FEATURES
The essential features of Asperger's Disorder are:
Criterion A. Severe and sustained impairment in social interaction
Criterion B. The development of restricted, repetitive patterns of
behaviour, interests, and activities
Criterion C. The disturbance must cause clinically significant impairment
in social, occupational, or other important areas of
functioning.
Criterion D. In contrast to Autistic Disorder, there are no clinically
significant delays in language (eg: single words are used
by age 2 years, communicative phrases are used by age 3
years).
Criterion E. There are no clinically significant delays in cognitive
development or in the development of age-appropriate
self-help skills, adaptive behaviour (other than in social
interaction), and curiosity about the environment in
childhood.
Criterion F. The diagnosis is not given if the criteria are met
for any other specific Pervasive Developmental Disorder or
for Schizophrenia.
Since sensory integration or dysfunction is a part of autism, this information will help to understand their needs a little better. Also, this is a questionnaire that you can fill out on each:
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)
You can request a free multidisciplinary evaluation through your local school district, and the above information will be helpful in determining appropriate services and supports. They most certainly can have differing forms or levels of severity regarding "autistic characteristics." Many, many high functioning autistic or Asperger's people go on to live happy productive lives, but Kindergarten through 12th grade can be very difficult socially, emotionally, and behaviorally. Arming yourself with information is the best way to help them.
