Expert: Paul Johnson - 4/22/2008

Question
I have been wondering lately if my 9 year old could have a form of autism.  She was a wonderful baby who hardly cried and was content most times.  About the age of 3, she started having tantrums.  I have an older daughter with ADHD whose symptoms also manifested about the age of 3.  I sort of assumed the same thing was happening with my younger daughter.  I delayed medicating her until the age of 6.  The medicines did help some, but my daughter continues to have behavioral problems and we have ended up switching medicines a couple of times.
There are a few reasons I am now wondering about autism.  She is a very smart girl, has a great imagination, and has a higher than average vocabulary.  She reads and comprehends above her grade level.  But her handwriting is very, very bad.  It does not come close to matching her reading level.  I think it may be due to some motor skill problems.  Another thing is her social skills.  On the surface, she seems ok.  She laughs and plays and is loving.  But she is almost too loving sometimes.  She constantly wants to hug, and can have difficulty calming herself without hugs.  And this is a fairly subjective thing, but it often seems like she's just 'not there'.  Many times it seems like she is acting out a script.  Her peer relations are pretty bad.  And it is difficult to have a conversation with her because she has a tendency to either run on, or else she has so many stops and starts that she loses her line of thinking.
In reading about autism/asperger's, I see my daughter displaying very few of the symptoms listed.  But some of them are spot on.  I live in an area with very few autism resources so I am thinking that if I did take her to a doctor here, they would run down the checklist and say, "Nope, she's fine."  Am I off base, or is it possible this could be a form of autism?  If so, how do I ensure I find a doctor who is knowledgeable in the different manifestations of autism and who can address my concerns?  Are there certain questions I should ask the doctor?

Answer
Hello Teresa,

Thank you for you question. It is an important one. I am sorry for the delay as I have been out of town a while.

Yes there are signs of Autism there and then there are some basic signs that are not simply endemic to Autism Spectrum Disorders.
Your daughter's signs are general enough that she most likely will be classified as having Pervasive Developmental Disoder.

I would like to know more about how repetitive is her behaviors and habits. I would like to know how much does she depend upon routine to organize her day. I know so many of us on the spectrum will regulate our days as we see fit because we do not understand how to organize our lives into what other's are expecting from us.

A complete and reasonable assessment for Autism is what is needed and can not be done realiably online. You should arm your self with knowledge about Aspergers/PDD/Autism and talk to the best pediatrician that has an open mind. This way you can feel your observations are understood and respected. There are many quality books and web sites; if you can not locate them let me know with a follow up question and I will do my best with furnishing them for you.

Good luck to you and your daughter.