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 am writing about my son who is 40 months old. He has been having good motor skills and upto 30 month his communication was quite ok (able to identify 20-30 objects, 3 nursery rhymes, asking for things, reading book etc.). Suddenly he stopped taking interest in learning and was always itching to go out after his sibling was born. We put him in a play school where he was crying a lot and they told us that he was aloof & not interacting much (which was a surprise as earlier he was very fond of childrens and always playing with older children if he found a companion).After suspicions of autism, we saw an ENT specialist who prescribed medicine for wax removal from his ear. Suddenly his behavior changed he again started taking inteeests in books and at play school playing with the kids, the caretaker took back his words about autism. Then again after a month his crying started & he use to sleep v infrequently, eat very less and would calm down if we took him in a car. We went back to India where he had all sorts of test (MRI, EEG, ENT..) which came out ok. Afterward he was diagnosed as having liquid behind eardrums & enlarged adenoid for which he was operated. His crying stopped he is reading books again but not speaking much only repeating most of the times (also speaking a whispering tone which we can't follow as if to calm himself). Also he is hyeractive doing something or other. He is affectionate with his brother, plays properly with toys, shows proper expressions, chooses the right key to open the door, has good eye contact, responds to his name, follows simple instructions. But in the M-Chat test I could see him failing in item in pointing to parent object of intest or failing to look at something if pointed. Is it symptotic of severe autism because Aspergers are highly vocal.What you suggest to look out as we don't have good diagnostic facilities in India and he will be coming back to Europe next month.
Answer Sounds like a very interesting little boy. The following is a good checklist for children with High Functioning Autism:
Child’s Name_______________________________
Checklist for Autism Spectrum Disorder (Susan Mayes, PhD, Penn State College of Medicine)
Check each item that applies to your child now or in the past
PROBLEMS WITH SOCIAL INTERACTION
__(1) Social isolation
withdrawn, aloof, avoids contact with others, or prefers to play alone rather than with peers
parallel play along side but not with peers
difficulty establishing friendships
__(2) Limited reciprocal interaction
limited social smile or eye contact (looks away, looks through people, looks at speaker’s mouth, needs to
be prompted to make eye contact, or does not make eye contact when communicating)
limited sharing and showing (e.g., does not show a toy to an adult, seek recognition, or share an
experience or accomplishment with others)
excessively rigid play with peers (dictates play according to his/her peculiar and repetitive interests and rules)
enjoys physical or sensory play with others (e.g., tickling, chasing) but has limited reciprocal social
interaction (e.g., does not play social games or games involving turn taking)
__(3) Self-absorbed
self-absorbed or in own world (e.g., engages in self-stimulating behaviors, talks to self, or fantasizes
excessively about things such as movies or cartoons)
oblivious to the presence of others or unresponsive to the social overtures of others
__(4) Socially indiscriminate behavior
inappropriately talks to or hugs strangers
invades personal space (gets too close to or touches others)
no stranger/separation anxiety when young (not wary of strangers or upset if separated from parents)
socially inappropriate, insensitive comments or behaviors (picks nose in public, asks personal questions)
__(5) Problems with social skills
does not appropriately initiate or sustain peer interaction though may interact well with adults
poor social reasoning (difficulty understanding social cues/comments, facial expressions, body language)
wants to have friends but does not know how to make friends
PERSEVERATION
__(6) Narrow or unusual range of interests and play behaviors
obsessive preoccupations or extreme fixation on things such as certain movies or TV shows (reenacts or
watches the same movies over and over), computer games, letters, shapes, numbers, counting, objects
or topics (e.g., trains, dinosaurs, NASCAR, maps, planes, electricity, Yu-Gi-Oh, cartoon characters, etc.)
unusual attachment to and holding or hoarding objects (e.g., small figures, string, other______)
__(7) Stereotyped and repetitive play
repetitive play (e.g., excessively lines up, sorts, spins, or throws objects; opens and closes things
repeatedly; plays with the same toys without variation; draws the same pictures repeatedly; other_____)
disinterest in toys or lack of normal and varied imaginative play
unusual preoccupation with parts of objects (e.g., repetitively spins wheels on a toy)
__(8) Upset with change
distressed by change (e.g., change in routine or schedule, parent takes a different car route home from
school, furniture or child’s toys are moved, seasonal change in clothing, other______)
difficulty with transitions (e.g., from one activity to another)
extreme need to finish what he/she starts
idiosyncratic or ritualized patterns (e.g., drinks only from a certain cup, wears only certain clothes, insists
that food be arranged a certain way on a plate, other_____)
insists that things be in a certain location or a certain way (e.g., doors must be closed, coats zipped, etc.)
insists on doing things the same way every time
overly precise and inflexible, upset if someone breaks a “rule,” rigid and literal thinking
__(9) Stereotypies (unusual repetitive movements such as hand flapping when excited, toe walking, body
rocking, head shaking, body tensing, teeth clenching, teeth grinding while awake, finger movements, facial
grimacing, repeatedly running back and forth, twirling or spinning, pacing, playing with saliva, skin picking)
SOMATOSENSORY DISTURBANCE
__(10) Excessive atypical craving and love of spinning, tickling, climbing, rocking, swinging, bouncing, jumping
__(11) Unresponsive at times to verbal input (not react when name called or spoken to, hearing questioned)
__(12) Hypersensitivity
unusual hypersensitivity to some sounds (e.g., distress or covering ears in response to loud noise,
motors, vacuum cleaner, hair dryer, baby crying, sirens, clapping, alarms, toilet flushing, people singing)
unusual hypersensitivity to smell, light, or temperature
__(13) Distress with commotion or crowds (uncomfortable/anxious in large groups, theatres, cafeterias, parties)
__(14) Extreme fascination with spinning or repetitive movements (e.g., revolving fans, Wheel of Fortune,
running water), linear patterns (e.g., credits on TV, window blinds), minute details, lights, shiny surfaces
__(15) Abnormal sensory inspection
excessively smells, mouths, chews, licks, or rubs inanimate objects or surfaces
repetitively visually scrutinizes objects or finger movements close to eyes
places ears against things that vibrate or hum or presses objects against face to an unusual degree
Also, a big part of Autism Spectrum Disorders is Sensory Dysfunction or Sensory Integration Issues. The following is a wonderful website and checklist:
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:
Pregnancy: _____________________________________________________________
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? _____
_____________________________________________________________________
People mistakenly believe that there is only severe autism and Asperger's Syndrome. Severe autism is actually Kanner's Syndrome and there is a spectrum of autism, which also includes High Functioning Autism as well as Asperger's Syndrome. Your son may be somewhere in the mix. There are many, many highly successful and fully functional individuals with Autism Spectrum Disorders. Because it is a hereditary difference (not necessarily disorder) you may want to check out the website:
After you have printed out an completed the questionnaires, you may have a better sense of if he is somewhere in the spectrum. You can provide this information to his physician, psychiatrist, neurologist, school psychologist, speech pathologist or a clinical psychologist for recommendations or diagnosis. I hope this is helpful!
