Expert: Catherine Ridenour - 11/29/2010

Question
my 6 year old son was delayed in talking and walking and had a vocabulary of 10 words at age 3.  He is now in grade 1 can read at a grade 2 level, very smart with numbers and math. He has imaginative play prefers to be alone and has limited eye contact.  He was seen by a pschologist at age 3.5 and was labled as pdd-nos.  At age 5 there was a dramatic change.  His vocabulary is now at age level, he learned how spell his name in a few hours, he's been reading since kindergarten, he has some problems socializing.  He often has tantrums but still manages to get his work done.  He is very well behaved at home and loves to do homework.  He is a little behind in gross and fine motor skills, and prefers a quiet setting.  His assesment at 3.5 has since been ruled inconclusive because of his drastic improvement. He does have some traits of autism acording to a pschologist that seen him in 2010, however his paediatrician said he has mild adhd.  I don't know who is right on my sons diagnosis.  My son was also born 3 weeks early and i had a very difficult pregnancy, i had a few minor infections and placental colapse before I went into labor.  Could that be cause of developmental delay.  I just dont want my son to be pinned with a label if he is not autistic or adhd.  

Answer
Hi Cheryl,

I understand your desire for your son not to have a label that my hamper him in later life.

My philosophy is that if he needs a label to get needed care and services, it's worth having. Autism is such a common issue now, that it is going to become a "so, what's new?" thing in 20 years. It should not impede him in getting jobs. And, if he continues to blossom, no one will ever know because he does not have to tell them and it will not be obvious.

My guess on his diagnosis is that he may have Asperger's syndrome. It certainly explains his social issues and tantrums. AS kids have an emotional delay that can be 3-5 years behind physical age. They do grow emotionally and by mid-twenties, many are doing well, socially. But, it makes life difficult in school.

AS can also appear to be mild ADHD. Some direct teaching of social skills is always a good thing for these kids. He needs to build a repertoire of appropriate responses. He may not have the natural ability to read facial expressions and tone of voice.

Difficult birth and prematurity can create some developmental issues. It can also cause subtle brain damage that mimics autism.

It sounds like whatever has been done for his delays is working. If he is keeping up in school, even going beyond grade level, medication does not sound warranted.

Unless new problems arise, I would just keep to the path. Since the educational supports are virtually the same for PDD-NOS, mild autism and AS, nailing it down is really a moot point.

Best wishes,
Catherine