Expert: Catherine Ridenour - 11/12/2007

Question
Hello
I am writing about my 3 1/4 year old son who I am concerned may have ASD.
He has significant speech delays - waiting for a SLP assessment.  He likes being around other children, but more parallel play then interactive.  He is social with people he knows well (immediate family) but avoids eye contact with strangers.
He always had communication delays, for example, did not point until he was 2, never gestured, never really babbled.  Around 2 yrs, he started obsessively pointing and labelling certain objects, such as "Clocks" and "Fire Hydrants".  He was obsessed with fire hydrants for several months. He had about a 50 single word vocabulary at 2 years of age.  His language now is mostly 2 word phrases like "movie now" or "car ride now" and he uses alot of echolalia.  For example if asked if he would like milk or juice for lunch, he will repeat back "milk or juice". He can follow 2-3 step commands such as "Go downstairs and bring me your shoes". He has a large single-word vocababulary and a good rote memory.

With toys, he mainly plays with small cars and trains, lining them up. He does not engage in alot of imaginative play, however will occasionally do simple things such as offer his teddy bear a drink.

He is extremely upset by any change of routines, and will have screaming meltdowns for several minutes if we try to put on a different hat, or different pair of shoes than what he normally wears.  He had terrible temper tantrums and prolonged high-pitched screaming between the ages of 2 and 3 - these are starting to get better now.  He still gets frustrated very easily, for example will have a tantrum if his toy train comes off the track.
He seems very bright about certain things, for example knows all the letters of the alphabet, can count to 10, good with shapes and puzzles. He also likes books, especially books that classify objects, such as various types of cars.

Gross Motor skills are on par now, although he was a little late to walk and crawl.  Fine motor, he will hold a crayon and make stokes, but does not color or try to draw shapes.  He does not enjoy "crafts" as he gets upset when you try to help him - for example sticking objects on with glue, or cutting things out.  He has very specific ideas about everything, and if we don't know what he wants, he gets very frustrated and upset.

Would appreciate your input.
Katherine

Answer
Hi Katherine,

You are very wise to get an evaluation. Most of what you describe is typical "on spectrum" behavior.

The good news is you will be getting help early in the game. Much more is known about helping ASD kids develop useful speech and more normal social interaction.

Before you make decisions about the kind of therapy he will receive, research it thoroughly. Some Applied Behavior programs are so rigid it's hard to have any spontaneity at all.

One of the wonderful things about many ASD individuals is that they see the world in a very different way which can lead to some amazingly creative solutions or creations. Many are musicians and/or artists. Some become computer programmers.

Be warned that IQ testing for these kids can be inaccurate because they are unable to respond in the normal way to the questions. He may be far brighter than the test indicates. Usually, parents can tell because they see the child doing spontaneous intelligent things at home.

I am going to include some links for you to explore. A couple of them are web sites or discussion boards run by autistic individuals. They are good places to hear what adults who have ASDs think about the education system and how the "NT" (neurotypical) majority treats them. Don't be discouraged by what you read, these adults did not have the benefit of the knowledge now in use. But, do take heed of the stories some parents tell of the abuse of the system that their children experience. If your son tells you that someone at school was "mean", always check it out. ASD kids are usually brutally truthful.

In my opinion, the most important thing for you to do is prepare yourself to be his life-long advocate. You should be included in every IEP meeting regarding his education. Grow a thick skin and take him out into the world. If people are receptive, explain how the world overwhelms the senses of an autistic child. And if they are critical, you can either ignore them or have a "one size fits all" response you prepared in advance.

Rearing our daughter has been a challenge. But, she is a wonderfully creative and caring adult. She has her moments of overwhelmedness and still needs some advocacy, but she continues to progress. At 22, I'd say she functions as well as most 18 year olds. Keep believing in your son.

Here are those web links:

http://www.neurodiversity.com/main.html (many links to books, articles and resources)

http://www.patientcenters.com/autism/news/resources.html (books and resources)

http://www.ninds.nih.gov/disorders/asperger/asperger.htm (the definitions and
government links)

http://www.angelfire.com/pa5/as/asteachersites.html (teaching resources)

http://www.rettdevil.org (a discussion board for parents and persons with neurological and developmental disorders)

Best wishes,
Catherine