Expert: James Michael Roan - 10/24/2006

Question
Mr. Roan,

Hello.  I would appreciate any advice you have about what might be going on with my son and how to best help him.

He turned six and began kindergarten two months ago.

--He was a very easy baby and toddler (sleeping through the night, toilet-training, etc.)
--He started speaking slightly later than his peers but within the range of normal I believe.
--He is an only child, and we have moved twice in the last two years.
--He is a pretty happy guy at home (most of the time) and is affectionate with me and my husband.

These are the concerns:
--He seems very behind in social development.  I noticed even when he was a toddler that he would play by himself while the other kids interacted.  I attributed it to shyness and thought things would improve.  He makes poor eye-contact and I have always had to prompt him to answer when people talk to him (even my husband often).  I have noticed other kids try to initiate interaction, but he sometimes doesn't even seem to notice or just doesn't respond.  He doesn't seem to understand social cues.  Kids are starting to look at him as 'different,' and I think adults who see him think he is not very bright.
--He is bright, though.  He began reading at three and reads well.  He loves math and can add two-digit numbers, do multiplication, etc. mentally.  He does seem to have some logical reasoning skills with math as well (as opposed to rote memorization only.)
--He plays with toys pretty normally I guess, but he has a weird thing where he focuses a lot on his classmates' names.  He has all their first and last names memorized, and he will write them on lists, alphabetize them, etc. He seems to really enjoy this.  He did this with his T-K class last year as well.  
--He has had behavior problems at school.  He has had some meltdowns there and also hit his teacher once.  (This surprised us.)  He also seems to have a very hard time getting the routines down and needs constant reminders.
--He is very sensitive and a perfectionist.
--He has some sensory issues with loud or sudden noises.
--He is starting to show increased anxiety since starting school.
--I have noticed that people stare at us sometimes when he is talking.

Anyway, the school is planning to do an evaluation but they probably won't begin until December.  We live in NC, and there is a TEACCH center fairly close.  Their waiting time is approximately 18 months however.

Thanks for any advice you can offer.

Sincerely,

Shannon

Answer
Hi Shannon;

Don't be too alarmed. He certainly doesn't need TEACCH, although it is  a great program. I do not diagnose via the Internet, however from the behaviors you listed, it sounds like a classic example of Asperger's Syndrome (AS), which is synonymous with high functioning autism.

The behaviors you listed fulfill the definition for AS:

1. Late in speaking a bit.

2. Happy with adults, less so with peers due to low social competence (not desire).

3. Low verbal but high visual-spatial and quantitative reasoning skills. Most folks with AS become some sort of engineer. Other popular careers are university professor, archaeologist, librarian, scientist, etc. Jobs that require solid concrete thinking skills. The same thinking that causes his melt downs at school and contributes to his perfectionism.

4. His reading skills are advanced to the degree to be considered hyperlexic. Although I'm sure is reading comprehension skills are much less developed.

5. He makes lists, which in the literature refers to "systemitizing (see Simon Baron-Cohen).

Shannon, I'll get down to the essence here. Your son's biggest difficulties will stem from his low social competence and low social thinking (see Michelle Garcia-Winner). He wants friends and wants to join in but probably doesn't have the skills yet and will often get mislabled as "immature." This low social competence will cause him to be bullied and put him at significant risk for anxiety and clinical depression, which you must be on the close watch for these next several years.

When he is evaluated, make sure they use an AS-specific standardized assessment, do a pragmatic language assessment while he is interacting with his peers in the "field," a social competence assessment, a social sequencing assessment, and a social-emotional assessment.

I suggest you purchase one of two or both books by Prof. Michael Fitzgerald of Trinity College, Dublin Ireland. He has made a study of historical figures who he makes a case for as having AS. I think it will shock and surprise you.

Let me know if you have any more questions.

Kind Regards,
James