Expert: Trey McGowan - 11/11/2009

Question
QUESTION: My husband was concerned with my sons development from very early on. I can recall him questioning his hearing and eye contact as early as 2 months old, by 6 months old there was a constant spinning of his wrists, and he never seemed to prefer faces, I don't remember it being hard to get him to look at me, but my husband always complained of this..

While other babies were mouthing objects he was busy figuring them out, he could do simple single piece puzzles and shape sorters by 10 months old. He crawled early but went straight to pulling up, was always very very cautious as though he had to have control of the situation. The biggest signs started around 10 months old with the stranger anxiety and he was always very clingy to me. (I asssumed it was because I was a Sahm and breastfeeding) the anxiety never went away though his first birthday was a disaster.. Just after his birthday his wrist roll turned into arm flapping when excited only he was excited by everything! He did babble early and by 14/15 months he knew 66 baby signs but he never pointed or asked for anything, he would sign pictures in books or after I told or asked him..

By 16 months we went in for his first autism evual, which he passed he had irregular eye contact but was enough, wasn't talking but they wernt concerned with that, he passed all tests above average, could draw a circle lines do many puzzles etc.. Had some pretend play. We started speech, he wasn't making much progress although his receptive knowledge was impressive, he learned to point but only to anwser questions never to share intrest. The speech therapist felt there was sensory issues so we started with an OT at 20 months and went back for a reevulation, at this time they diagnosed him with classic autism.

By this time he knew all his shapes, colors numbers up to 30, could arrange blcks to spell his name, or put the alphabet in order, he knew both upper and lower case numbers, his Stimson were still limited to flapping when excited.

They said since he had the speech delay ( had only 5 words and couldn't request by 20 months) it couldn't be aspergers)

But almost immediatly upon starting OT and a sensory diet he started picking up words by 22 months he had 50 by 24 he was pairig 2/3 words and now at close to 26 months he has well over 500 words. He can use full sentances. "I don't like little bike, I want big bike" or More commonly "I don't want to" or "I want the black and white swing please"

He can't or won't respond to any social greetings or questions, although if your playing with him hebcan tell you yes somethig is blue or no it's not purple... (or any other of these yes/no fact questions, but If you offer a banana he either reaches out or pushes it away and only after multiple prompts will he say no.. It's almost like the fact that the anwser is always differet confuses him..

He is still very smart can do 24 piece jigsaw puzzles without help, knows what everything is, he can spell roughly 90 words he learned on an iPod game, not only on the game but he can spell them outload..!


I'm curious since his speech was caught up by 24 months and now Is above average if it sounds more like aspergers? And how soon that can be diagnosed?



and soon after OT for sensory issues.

At 20 months we went

ANSWER: Hi there, Christina!

You're asking me 'Could this be Asperger's'. However, I have a feeling that the question you are hoping to have answered is '*Is* this Asperger's?'. Unfortunately, as I am not a doctor, I can't answer that. If you have concerns for your child's development, I suggest that you deal with an expert in the matter, rather than an AllExpert. ;)

However, if you genuinely *are* asking 'Could this be Asperger's?', my answer is 'yes'. The problem is, Asperger's is not such a simple diagnosis. Classic high-functioning autism and Asperger's are very similar, and in a lot of ways differ only by a few key symptoms. The primary one, as you have noted, is in language development. However, not all children diagnosed with Asperger's have a lack of language issue. Many of them will have some problems of varying degrees as well.

Age-wise, Asperger's can be diagnosed at just about any age that Autism can be diagnosed at. Generally, it tends to be diagnosed in a child old enough to be developing solid language, however, thanks to its primary difference of development.

The main thing here, however, is that just getting a 'different name' for the issue is not going to change what needs to be done. Your child, with Asperger's or high-functioning autism, will still likely need the same assistance, get the same treatments, and likely receive the same benefit from education as he is now. I'm not saying that the title isn't important to you, but at the same time, I would worry more about what is being done than what label is being applied.

Questions, comments, feedback, follow-ups, are welcome!

Trey

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

QUESTION: It was *could* I wasn't sure because of the documented speech delay, if he met the language criteria. The descrepencies among profissionals is confusing as well. From what I read, a "significant speech delay" is no words by 2, no phrases by 3.

Do you know of any written rule that this criteria must be met without speech intervention? Because I was told this by a family friend/ professional, I wasn't sure if this was an actual written rule for diagnosis or a personal opinion. There is simply no way to know if the speech would have developed without therapy or not, and his speech therapist has said the delay was due to oral motor problems, and all words came in after starting OT not speech...

At this point another screening wouldn't help my son since our regional center does not offer services to kids with a As diagnosis...

Answer
Hi again, Christina!

I am not aware of any written rule like this, no, but then again, I'm not an expert. I'm just a researcher and AllExpert. If you want to ask about the actual legal written rules, I suggest going to the professional who gave you the information and asking for it, rather than me. After all, they would certainly know better than I would, since they gave it to you in the first place!

Here's hoping for all the best of luck in your advances! As usual, questions, comments, feedback, follow-ups, are welcome!

Trey