Expert: Catherine Ridenour - 4/19/2006

Question
my son is 10 and has been in special education since he was 3 because i noticed he had difficulty answering simple who,what,why,etc... questions.  he has never been formally diagnosed with anything other than speech/language impaired. recently the school did an evaluation of him in which they tested him for autism/aspergers using a questionaire we filled out at home. the results said he had less than 1% chance of having either.  they have however decided to change his school classification to autism based on a one time 30 minute visit to a psychologist three years ago who said he may have PDD.  we are very upset and confused by how a child is diagnosed with autism.  can it be done in one 30 min. session and what exactly is involved? we have been told by some psychologists i contacted that this diagnosis would take several visits over a period of a few months but the cost is too high for us to do on our own( a couple thousand dollars at least).  i really need to know what it takes to make a diagnosis like this.  the older my son gets the more worried i am that we are not doing all we can do for him. any help would be greatly appreciated.

Answer
Hi Maria,

Diagnosing autism is part science and part art.  Questionnaires are very useful in learning about behavior observed in the home and the classroom.  That data needs to be added to the direct observations of the doctor. After that, the experience of the physician is very important.

I have to tell you, having reared a child with a spectrum disorder, I can almost "smell" one.  I happen to work for a doctor and there are several patients who have come in who I know, in my bones, are affected.  One was already diagnosed, which I did not know.  Two are in the process of evaluation.

Since he has been in special education for so many years, some of his behavior is going to mimic the children he spends the most time with.  Social behaviors are impaired in Autistic Spectrum Disorders.  His social behavior is going to reflect, to some extent, the disordered social behavior of the special education classroom which usually contains children with multiple diagnoses.  This may cloud the issue somewhat.

It would probably be most helpful for you to read about the wide variety of symptoms involved in Spectrum Disorders.  They can be very mild and still have a profound effect.

Here are some web links to help you find resources for your research:

http://www.patientcenters.com/autism/news/resources.html

http://www.ninds.nih.gov/disorders/asperger/asperger.htm

http://www.autism.org/temple/meds.html

http://www.autism.org/

http://www.autismasperger.net/intro.htm

http://www.mentalhealth.com/

If you like, you can write back to me and tell me more about your son.  I really don't have enough information to form an opinion (only a guess on my part, I am not a doctor).

Tell me, does he seek you out to show you something interesting?  Can you get him to stop playing with his favorite toys or activities to pay attention to directions from you?  Does he form mutual friendships outside of school with the neighbor boys?  What happens if there is a sudden change in plans for something he really wants to do?

Best wishes,
Catherine