Expert: James Michael Roan - 5/24/2005

Question
Hello,

My son is 5 y.o next month.  Since starting preschool this year the teacher has expressed some concern about his behavior.  I always though he was a little different, more intense, immature, etc...but couldn't put my finger on it.  Here are some of his concerning behaviors:  Uses voice too loud at school (sometimes singy), invades others personal space, trouble with transitions and finishing tasks (too interested in what everyone else is doing), tries to be the class clown but says irrelevant things that are odd, don't make sense, or aren't actual words and is not funny then says "get it, ha ha", throws self on floor and laughs at inappropriate times, talks to strangers about whatever is on his mind, has mini obsessions (interested in broken tree branches, bad things (violence), fishing (can fish all day without getting bored but cannot stick to most other activities for any length.  

He is very social and wants to play with friends but then offends them with his behavior.  He is very impulsive and physical (hits when he's mad)  

He is on track cognitively and very smart.  I've searched online and he doesn't seem to qualify for any catagory (aspergers, pdd-nos)  has some symtoms but not most.  Online test all say no PDD or AS.

My question is, what type of Dr (specialist) should I ask my doc to refer him too to rule these things out and figure him out?  Since he doen't fit into any catagory I fear I won't get any help with him.  Last time I ask my PCP she said she didn't care for the pediatric neurologist and gave me the name of a child psychologist.  I'm not asking for a diagnosis from you, but any insight you can give would I'm sure be extremely helpful.

Thank you,
Rachele

Answer
Hi Rachele;

Another cause of your son's social cognitive delay could be the result of what is known as a nonverbal learning disability. It is defined by the behaviors you have cited along with a significant relative delay in fluid intelligence (as measured by the Performance IQ on the WISC-III) compared to a much higher Verbal IQ , as also measured by the WISC-III. The WISC-III is a well-known IQ assessment tool. Most child psychologists who work with autism will also be able to administer the WISC-III or comparable IQ test. This should be part of a full evaluation for your son in any case.

Kind Regards,
James



Your son has what we refer to as a social cognitive or social thinking delay. The domain of autism spectrum disorders is growing all the time and there is a huge growth in prevalence and in the diversity of different populations such as autism and Asperger's Disorder.

I would look for a child psychologist who specializes in autism spectrum disorders, especially High Functioning Autism (HFA)and Asperger's Disorder.

I am happy to assist you further, as much as I am able.

Kind Regards,
James