Expert: James Michael Roan - 10/11/2009

Question
QUESTION: I am writing to you with regard to my son, who has just turned 5. He attends a school in Wales in the UK which as an autistic unit attached.  His x teacher, who is SENCO qualified, has suggested my son be tested for Aspergers.

She wrote to my Doctor with the following...
He has bad eye contact.
He fidgets and is constantly on the go.
He has disruptive behavior in large groups and pokes other children and makes loud shrieking noises, that he does not seem to help. (the noises seem to be her main concern).
He does not join in with the other children at play time and watches from the side.
When he does join him, he wrestles with the other children.
He's fine when he is stimulated.
Stares past the teachers in the morning when saying good morning.

I have always seen my son as different, but for his intellect.
He could wave goodbye at 6 months and shake his head to say know, which seemed a lot earlier then other children.
He could point at an early age at pictures, when I told him to point at certain things. He could also babble from an early age and was very alert.
He new his colours before he was two and his letters before 3.
He has the most amazing short terms and long terms memory.
He is extremely inquisitive and asks very intelligent questions.
He's curious.
Competitive.
Has the most amazing imagination.
Concerned about world issues.
Does not believe in Father Christmas anymore and knows the meat on his plate is dead animal.  He understands about death.
The other day he watched an advert on the tv about starving children and cried because he found it sad and he felt sorry for them.

In the holidays he lost his voice from the noises he had been making and we told him that this will happen if he continues with these loud noises, and so he has stopped.  This tells me that he can help making these noises.

Before he started school, I hardly had to tell my son off and I never had a "terrible twos with him". He was also very sociable.  I had no problems with his behavior until he started school and now he answers back and has an answer for everything.  I told his teacher that before he started school there was nothing wrong with his eye contact, and if he had asperger's, surely this would not have been the case, and she even said that when he joined his behavior was fine for the first three months.

I said to her that he is not fussy about anything and has no rituals that he performs on a regular basis. She said he his too young to have these, although my Doctor says otherwise.

He does not have a problem with any of his senses except he has sensitive hearing, and will occasionally put his hands over his ears in the supermarket etc and never use to like the hover. He did suffer with glue ear and hearing problems until he had grommetts put in on his 3rd birthday.

He has no problems with any food.

His conversational skills are far from one-sided and he does take an interest in what others have to say about things.

He notices when a routine has been changed, but does not get upset by it in the slightest.

I said to his teacher that I'm just not sure if he ticks enough boxes for aspergers.  She then went on to talk about tourettes.  I asked her to consider him JUST being gifted, but I think she has already put him in to a box for aspergers.


I have cried every day since January, partly because of the schools insensitive way they have handeled this situation and because of how much my son has changed since starting school.  I just want my little boy back.  

We are no further forward with finding why he is acting this way as the waiting lists are so long.  I have tried looking for a gifted/autistic expert in the UK, but don't really know where to look.  

My husband and I are constantly arguing other this and we have lost our way with regard to how to handle his behavior.  It's been difficult to know how to scold a child that never needed telling off until he started school.

Please could you express your opinion on the points I have made, being that you deal with asperger's children.

Someone suggested that he could have scensory processing disorder which could be the reason he behaves in this way. That he could have anxiety as he finds the all the noises in groups/playground too much.

I know you can not give me an answer as to why he is the way he is, but perhaps you could clarify some of the points.

Kind regards.

ANSWER: Hi Andrea;

"Please keep in mind that at no time am I diagnosing anything nor am I ruling out any potential condition, just providing guidance and direction."

This will take a bit more of a structured exploration before I make any suggestions regarding an assessment for Asperger's syndrome (AS). Please download the CAST at: http://www.autismresearchcentre.com/tests/cast_test.asp

Then, send my your answers so I can decide next steps. My guess is that he may be what we call "subclinical" AS. He certainly is gifted. I'll await your response.

Kind regards,
James


Disclaimer:

While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find our resources useful.


Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting assessment professional responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.






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

QUESTION: UNIVERSITY OF CAMBRIDGE

SOCIAL & COMMUNICATION DEVELOPMENT QUESTIONNAIRE - KEY
ASD relevant responses are underlined and score ‘1’. Maximum score possible is 31, cut-off currently is 15 for possible ASD or related social-communication difficulties.  Questions that are not underlined are controls

------------------------------------------------------------------------------------------------

Please read the following questions carefully, and circle the appropriate answer. All responses are confidential.


1. Does s/he join in playing games with other children easily?   No  Not in the playground at school but yes at home with one or a few friends

2. Does s/he come up to you spontaneously for a chat?      Yes      

3. Was s/he speaking by 2 years old?          Yes      

4. Does s/he enjoy sports?          Yes but likes to invent new games out of what he’s playing

5. Is it important to him/her to fit in with the peer group?      Yes      

6. Does s/he appear to notice unusual details that
  others miss?          Yes      

7. Does s/he tend to take things literally?          No

8. When s/he was 3 years old, did s/he spend a lot of time
   pretending (e.g., play-acting being a superhero, or
   holding teddy’s tea parties)?          Yes      

9. Does s/he like to do things over and over again,
  in the same way all the time?          No

10. Does s/he find it easy to interact with other
    children?          No but he does adults

11. Can s/he keep a two-way conversation going?      Yes      

12. Can s/he read appropriately for his/her age?         Yes      

13. Does s/he mostly have the same interests as
     his/her peers?          Yes and      No  he likes things other children do but also loves very grown up things

14. Does s/he have an interest which takes up so much
     time that s/he does little else?          No

15. Does s/he have friends, rather than just acquiantances?   Yes      


16. Does s/he often bring you things s/he is interested
    in to show you?          Yes      

17. Does s/he enjoy joking around?          Yes      

18. Does s/he have difficulty understanding the rules
     for polite behaviour?          No

19. Does s/he appear to have an unusual memory for
    details?          Yes      

20. Is his/her voice unusual (e.g., overly adult, flat, or
    very monotonous)?          No

21. Are people important to him/her?          Yes      

22. Can s/he dress him/herself?          Yes      

23. Is s/he good at turn-taking in conversation?         Yes      

24. Does s/he play imaginatively with other
    children, and engage in role-play?          Yes      

25. Does s/he often do or say things that are tactless
     or socially inappropriate?          Yes      

26. Can s/he count to 50 without leaving out any
    numbers?          No

27. Does s/he make normal eye-contact          No

28. Does s/he have any unusual and repetitive
    movements?          No

29. Is his/her social behaviour very one-sided and
    always on his/her own terms?          No

30. Does s/he sometimes say “you” or “s/he” when
    s/he means “I”?          No

31. Does s/he prefer imaginative activities such as
    play-acting or story-telling, rather than numbers
    or lists of facts?          Yes      

32. Does s/he sometimes lose the listener because of
    not explaining what s/he is talking about?          No

33. Can s/he ride a bicycle (even if with stabilisers)?      Yes      


34. Does s/he try to impose routines on him/herself,
    or on others, in such a way that it causes problems?          No



35. Does s/he care how s/he is perceived by the rest of
    the group?          Yes      


36. Does s/he often turn conversations to his/her
    favourite subject rather than following what the other
    person wants to talk about?          No


37. Does s/he have odd or unusual phrases?          No



SPECIAL NEEDS SECTION

38. Have teachers/health visitors ever expressed any
concerns about his/her  development?          No

If Yes, please specify...................................................................................................


39. Has s/he ever been diagnosed with any of the following?   

Language delay          No

Hyperactivity/Attention Deficit Disorder (ADD)          No

Hearing or Visual Difficulties          Yes      He had hearing probs due to glue ear

Autism Spectrum Condition, incl. Asperger’s Syndrome          No

A physical disability          No

Other (please specify)          No  

Answer
Hi Andrea;

Good news. Your son failed 4 items. A failure of 14 or more items warrant an Asperger's syndrome evaluation.

Kind regards,
James


  QUESTION: I am writing to you with regard to my son, who has just turned 5. He attends a school in Wales in the UK which as an autistic unit attached.  His x teacher, who is SENCO qualified, has suggested my son be tested for Aspergers.

She wrote to my Doctor with the following...
He has bad eye contact.
He fidgets and is constantly on the go.
He has disruptive behavior in large groups and pokes other children and makes loud shrieking noises, that he does not seem to help. (the noises seem to be her main concern).
He does not join in with the other children at play time and watches from the side.
When he does join him, he wrestles with the other children.
He's fine when he is stimulated.
Stares past the teachers in the morning when saying good morning.

I have always seen my son as different, but for his intellect.
He could wave goodbye at 6 months and shake his head to say know, which seemed a lot earlier then other children.
He could point at an early age at pictures, when I told him to point at certain things. He could also babble from an early age and was very alert.
He new his colours before he was two and his letters before 3.
He has the most amazing short terms and long terms memory.
He is extremely inquisitive and asks very intelligent questions.
He's curious.
Competitive.
Has the most amazing imagination.
Concerned about world issues.
Does not believe in Father Christmas anymore and knows the meat on his plate is dead animal.  He understands about death.
The other day he watched an advert on the tv about starving children and cried because he found it sad and he felt sorry for them.

In the holidays he lost his voice from the noises he had been making and we told him that this will happen if he continues with these loud noises, and so he has stopped.  This tells me that he can help making these noises.

Before he started school, I hardly had to tell my son off and I never had a "terrible twos with him". He was also very sociable.  I had no problems with his behavior until he started school and now he answers back and has an answer for everything.  I told his teacher that before he started school there was nothing wrong with his eye contact, and if he had asperger's, surely this would not have been the case, and she even said that when he joined his behavior was fine for the first three months.

I said to her that he is not fussy about anything and has no rituals that he performs on a regular basis. She said he his too young to have these, although my Doctor says otherwise.

He does not have a problem with any of his senses except he has sensitive hearing, and will occasionally put his hands over his ears in the supermarket etc and never use to like the hover. He did suffer with glue ear and hearing problems until he had grommetts put in on his 3rd birthday.

He has no problems with any food.

His conversational skills are far from one-sided and he does take an interest in what others have to say about things.

He notices when a routine has been changed, but does not get upset by it in the slightest.

I said to his teacher that I'm just not sure if he ticks enough boxes for aspergers.  She then went on to talk about tourettes.  I asked her to consider him JUST being gifted, but I think she has already put him in to a box for aspergers.


I have cried every day since January, partly because of the schools insensitive way they have handeled this situation and because of how much my son has changed since starting school.  I just want my little boy back.  

We are no further forward with finding why he is acting this way as the waiting lists are so long.  I have tried looking for a gifted/autistic expert in the UK, but don't really know where to look.  

My husband and I are constantly arguing other this and we have lost our way with regard to how to handle his behavior.  It's been difficult to know how to scold a child that never needed telling off until he started school.

Please could you express your opinion on the points I have made, being that you deal with asperger's children.

Someone suggested that he could have scensory processing disorder which could be the reason he behaves in this way. That he could have anxiety as he finds the all the noises in groups/playground too much.

I know you can not give me an answer as to why he is the way he is, but perhaps you could clarify some of the points.

Kind regards.

ANSWER: Hi Andrea;

"Please keep in mind that at no time am I diagnosing anything nor am I ruling out any potential condition, just providing guidance and direction."

This will take a bit more of a structured exploration before I make any suggestions regarding an assessment for Asperger's syndrome (AS). Please download the CAST at: http://www.autismresearchcentre.com/tests/cast_test.asp

Then, send my your answers so I can decide next steps. My guess is that he may be what we call "subclinical" AS. He certainly is gifted. I'll await your response.

Kind regards,
James


Disclaimer:

While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find our resources useful.


Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting assessment professional responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.