Expert: Paul Johnson - 4/8/2010

Question
My grandson is five years old. His speech is delayed. His processing is delayed. His fine moter is delayed. He loves people and is very social. He can play well with others. He has melt downs with changed of routine at daycare. At home he is dealing with everything very well. My question is, what is the average prognosis for a child on the autism spectrum? His issues don't seem as severe as many children I read about,yet he does has issues that make simple life situations difficult.Dental exams, hair cuts, and losing a special toy can upset him more than a typical child.Please let me know if you need more information. I am truly interested in finding out how these children have done as adults. Thank you so much. Jan Meyer

Answer
Hey Jan,


Thank you for your challenging and important question regarding your five year old grandson.

I believe for a diagnosis of full Autism one has to take into consideration speech and communication primarily. You mention that his speech was delayed for his developmental milestones thus it would lead towards an Autism Spectrum Disorder. Full speech would likely still not be evident for a five year old. There are some things that does not lend one towards a ASD diagnosis like his social abilities.

Overall I feel he has a mild case of Autism, some sort of High Functioning Autism of Pervasive Developmental Disorder. I do not usually say this but in the case of your grandson, I would recommend waiting a bit before pursuing a diagnosis of an ASD. I would consider him as being in the rule out category. Think of him as having it while helping him to cope with the difficulties.

I make this recommendation because most people who have an ASD do not know they have it. Thus they make natural adjustments as life's situations and challenges warrant. He would have to live this way anyway even if he knew he is on the spectrum. I was not diagnosed until the age of 46 and made natural adjustments to my deficits throughout my life as has many of my Aspie friends that were diagnosed as adults. Naturally we all have in common that we are high functioning.

Remember coping is the operative skill and learning to cope with life now will serve him well as he matures regardless of what a clinician diagnoses him as.