Expert: Valerie Herskowitz - 11/27/2010

Question
QUESTION: Hello. I am a Mom of 4. I'm pretty used to special needs with children. My oldest, my stepdaughter is 9 and is ADD and Bipolar. My oldes son is 7, and has been ADHD for as long as I can remember, but was just formally diagnosed. My younger daughter Jade is 5 and if quite fiesty. And my youngest son, Mikey, is 3. He is honestly the most well behaved child I have. He's very sensitive, loving, funny, and one of the greatest people I have ever known. He doesn't throw many fits, and thinks of other children first, for ex. When Grandma was helping him bag cookies for treats he started with his brother, then picked for his sisters and then himself last. He's usually pretty selfless in that way, in comparison to other kids. He's very smart. He knows his colors, numbers and shapes (he's not reading like the other little boy I read about, we're working on learning letters). He's done everything before the other kids,walking, etc. He's been speaking in sentences since about 15 months. He laughs alot and is a funny little guy! My sister has been watching my kids on Saturday (a special ed teacher), and 2 weeks ago began telling me what she was noticing with Mikey. She said when I'm there, he's a completely different child, he's happy and talking and smiling and very interactive. She said when I'm gone (7+ hours) he only said 8 things, he doesn't want to play with his siblings and cousins, he's unresponsive when she speaks to him and he just looks at her, and oftentimes with the other kids. She said he runs in circles and spins alot, and seems to do things repetatively (He likes to walk backwards is about all I seek, and he does like to spin). She said her father in law came over and was joking with the kids as they were eating pizza, and she said Mikey just stared at him without saying a word- he's been around him several times in the past. She says he plays with things that aren't meant for the purpose, ex. he slams the barn door on the FP barn over and over and over and the dollhouse doors, etc. which I've seen him do before to be honest, which reminds me of something from when he was an infant. I used to say he had an engineer's mind, because he would sit, for long periods of time, turning a toy over and over and examining it, trying to figure it out. This stuck out to me because the other 3 didn't do it, and I thought it was pretty cool. They would toss it to the side and move on to other things, but he rarely would. He is very articulate for his age. Also, he used to enjoy going to school lunches with the other kids at school and run around hugging other kids and being very social. The last couple of times he seems to frown and wants to sit in my lap and not look at/speak to the other kids, and he didn't use to do that. He is asthmatic and was born with deformational placiocephaly (sp?) where he had to wear a helmet for a year, because even at 3 weeks early, he was 8.4 pounds and his head was pressed into my ribs because he was running out of room. He's old enough for pre-school next year, so the socialization he receives is at church, the kids school, his siblings, cousins, etc., so I don't have any formal exp. with how he has handeled/processed this. He's in a phase where he doesn't want me to leave him. He always wants to help out, and he is my snugglebug. My sister mentioned to my Mom, and not me, that she thinks he is possibly autistic. She says he is completely different with me, and says she wishes she had a videocamera to show me how he acts when I'm gone. He's used to my sister, and Mom. My Mom used to watch him for my Mon. Wed. classes until my stepfather went ballistic about something stupid at Mikey, and Mikey hung his head looking at the floor. He pulled his chin up and yelled you look at me when I'm talking to you, and I took Mikey away and after I let him know how I felt about it, we haven't spoken since. My Mom says that was the first time that had ever happened, but I refuse to allow him to be around him. Just the way he reacted to that, as angry as that situation made me, reminded me that he, when he is upset, does not seem able to make eye contact and hides his face in my shouldar, or stares at the floor. I have a history of ADD without hyperactivity, and there is a history of depression in the family, and asthma between my husbands and my family. There is no family history of Autism ( I don't know if there is a genetic connection). I'm sorry this is so long, but I'm in tears as I say this, please understand, this little boy holds my heart, we are very close and I love my kids very much. He and I are very close, and he just amazes me everyday with how amazing and smart and funny he is, he really does blow me away, and just fills my heart with joy. It breaks my heart to think that on top of the asthma that there may be something else he's going to go through that will effect his life, or the thought that he is so different when I'm not around that everybody else may not see him the way I do and know just how amazing he is because he seems to shut down in a way that I have never seen/known. I keep thinking, maybe he's just shy? I just don't know. I picked you because I saw that you were a Mom, and that you have an autistic son, and just knew you would understand how I feel, and at some point have most likely been in my shoes. Can you please help me? Does it sound like he may be autistic? What are the signs? I've searched several websites, and can't really find a clear understanding. I know there is a wide spectrum, he doesn't rock or hit his head on the wall, he does like to run/spin in circles, but I just always thought that is typical of a 3 year old, isn't it? I've read alot on assbergers, and he has no problem understanding facial expressions, or how people feel. Please tell me if you think this is a possibility, what the signs are, and what I should do? Thank you SO much for any help!

ANSWER: Hi Julie

I know you are very worried. I read your letter a few times to be sure I got all the information straight. To be honest, there are a few concerns that I have. Basically, a person that is not the mom of a child makes a better informant as they are clearly more objective-which is totally natural. So the information that has been reported by your sister is probably the more accurate. Don't take this personally! I was in the field of autism for years and years and it was my mom that finally pointed out that she thought my son was autistic!

You have written several red flags:
1. the fact he is good with his numbers,shapes, and colors
2. the inappropriate social behaviors
3. the family history of ADD
4. eye contact issues
5. spinning

Understand that people with developmental issues are often quite smart and cute. But he is obviously struggling in certain situations. Rather than give it a label, I would seek out a professional who can help you such as a psychologist.

I am certainly not saying he has autism-it could be something else. But because he does have red flags, you need to take him to be tested.

Keep me in the loop and let me know what happens

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

QUESTION: Thank you for all of your help. I thought of one other question that I don't think I ever thought of until after reading your response. Is ADD indicative of autism? Do the two go hand in hand? Or is autism where there is a problem with the brain relays like ADD? Also, can a child who is autistic live a life where they can go to college, work, have a relationship (marriage), raise children, etc? I realize there is a broad spectrum, but does this keep a child from living their life the way they want to, does it inhibit the things they can do?

Answer
Question 1: Is ADD indicative of autism?
No, but there are many children with autism that also have ADD or ADHD. There is a relationship and there are overlap in terms of characteristics, but a person can be ADD and not autistic

Questions 2: Also, can a child who is autistic live a life where they can go to college, work, have a relationship (marriage), raise children, etc?
Some do, some don't, again because there is such a big range. It's also hard to say because most of the people in this world that have autism have not reached adulthood yet, so we don't really know what will happen. And there are various degrees of living life. Some will be able to live independently, but maybe still need some supports, whereas others may need lots of help. If a person ends up being mild Asperger's, then there is a greater chance that they will lead a pretty normal life vs a person that is diagnosed with autism.

Hope this helps