Expert: James Michael Roan - 2/27/2006

Question
My grandson has been diagnosed with Autism Spectrum/PDD.  My daughter, Jordan's Mom, a single Mom, and I are trying to find out all we can about this.  First, Jordan is 5 and he is in a special ed pre-K because he has been asked to leave every pre school and VPK in Florida since he was 3 yrs old.  He has no social skills and is very aggressive.  He is a one on one kid, hard to do in the school system, he doesn't do well in large groups, with loud noises, with smells or just sharing with other peers.  He has a wonderful vocabulary and everyone at first thinks, this a really advanced kid, however he really is not.  He only knows about cars, trucks, tires, batteries and how these things work.  He can't write his name, doesn't know his letters, or numbers, address, phone number any of the usually things kids learn and my daughter, who is a 1st grade teacher has tried since he was 2 to teach him things. Also he doesn't eat, this is a child that at 5 has never had a Happy Meal.  He has never eaten a hamburger, chicken nugget, grilled cheese sandwich etc. Oh he has in his life eaten a couple of hot dogs, peanut butter and jelly (if it is in seperate dishes, they can't mix and he has to have two spoons). He has survived on Pediasure, which my daughter refuses to give his, saying he has to learn to eat. He is very affected by the smell of food, gagging and he throws up easily if he is forced to try to eat something.  He has been to a phychiatrist, psychologist and his pediatrition, he "could" be, ADD, ADHD, ODD, OCD or just fine let him outgrow it.  HELP....  We are new in Highlans County now, Sebring, is there a place for us to take him here? a doctor? a program? can you give us any answers on any of his issues? Our family doesn't want him around because they are afraid for their kids, his cousins, it is very hard.  He is very aggressive then wants to play more.  I am sorry to go on and on, we need help.  Thank you for anything you can respond with.,  Carolyn Brown

Answer
Hi Carolyn;

It sounds like you and your family has had a rough go of it so I will get straight into it. Most autism spectrum disorder researchers consider PDD-NOS, high functioning autism (HFA), and Asperger's Syndrome (AS)as one in the same. The features you have provided me fit very well with Asperger's Syndrome, although please keep in mind I am NOT diagnosing here. Children on the autism spectrum are frequently misdiagnosed with ADD or ADHD which look remarkably like executive dysfunction but differ in terms of intervention techniques. Children with AS have a concrete thinking style and cannot tolerate someone breaking the "rules." They need and respond well to structure. Children with AS, because of their unique concrete thinking style, become aggressive when another child bumps into them in the line or at recess because they ascribe intentionality to a random or accidental incident. Social environments are extremely stressful for them and they frequently develop obsessive-compulsive behaviors in response to the daily anxiety they experience.

Difficulty with multiple food textures is a very common sensory problem associated with ASD. Children with Asperger's Syndrome respond very well to cognitive behavior therapy (CBT)for anxiety, depression, and behavior modification. There is hope and there is a light at the end of this tunnel.

I highly recommend you visit Dr. Tony Attwood's website. He has a great introductory DVD and DVDs outlining CBT for treating anxiety and anger.

The prevalence rate for AS is 1 in 250 boys. Where I live it is 1 in every 50 boys. There just isn't enough professionals knowledgeable about this issue.

Kind Regards,
James