Expert: Valerie Herskowitz - 2/3/2009

Question
QUESTION: I have a child that has been in main stream education since preschool(age2.5) with special ed for 5 years in regular educatoin with consistent regression when tested against peers(up to 54%).  There is also a 2 standard deviation increase on timed tests when recalculated to eliminate time constraints and he is above average in intelligence.  On a WISC IV there were classic autism results and we were told that there was probably a brain injury-which there wasnt.  there is a 20+ point discrepancy between vmi and psi.  And a 2 standard deviation increase when compensated for by removing time constraints.  My question however is based on this.  When our child was young, we never evaluated for autism, and our child was never blatantly abnormal, or so we thought.  After having a recent neuropsych eval done we were given a dx of cognitive disorder nos. and learning disability nos with mention of decreasing neurological function.  after recieving this result i reviewed old home movies and asked friends and family about their memories of developmental delays.  based on this we now realize that there were delays in cognitive, motor, and social skills with a lack of understanding for jokes, a lot of literalism,an apparent loss of babbling at about 6 months, talking at about 2 years, and avoidance of social games like patty cake(crying and pulling away) and peek-a-boo games with pretend play beginning around age 7.  This information was brought to the attention of the neuropsych. and we were told that we should think about medication for ADD-IN, and told there definitely was a developmental problem which the neuropsych would not document.

We are concerned that our child is somewhere on the spectrum and is not recieving propper intervention.  who if anyone should we go to next?

thank you!



ANSWER: Some of the issues you bring up are consistent with ASD, so I would definitely look for someone in that area. What I would like to know is what issues that your child is presenting now. Then I can make a recommendation. Ask your neuropsych professional if he fits an Asperger's Syndrome diagnosis.

Valerie Herskowitz, MA CCC-SLP
valerieherskowitz.com

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

QUESTION: I did broach this with a neurposych however i was told that ASD symptoms are always so severe that they are completely debilitating socially, and cause a complete inability to attach, with headbanging or the like etc. and therefore this spectrum cannot be considered.  

Current issues are primarily learning based.  Poor reading, writing, written expression, word problems.  Also inabilities to understand and follow multi-step directions, very poor awareness of time, and inability to understand importance of issues that do not directly relate to his immediate interests, lack of understanding of jokes, sarcasm, and inferences, and lack of understanding rules, ie. a rule one day is still the same the next day.

Thank you again.

Answer
Where do you live? I am curious as the answer your neuropsych gave you is so wrong that it is actually scary. Though handbanging, inability to attach and debilitating social skills are a sign of a SEVERE ASD issue, ASD is on a spectrum from mild to severe and everything in between. The issues that you are describing that your son has are very consistent with ASD or actually, Asperger's Syndrome which is in the ASD spectrum at the higher end. Please let me know where you live.