Expert: Catherine Ridenour - 8/5/2005

Question
my son is 4. he has been going thru diagnostics since january. he has had a sleep study (found to have obstructed sleep apnea, therefore had tonsils and adenoids removed) normal hearing. i always expected severe adhd, which he is being treated for now, by neurologist and his pediatric specialist does the follow up. his ped. raised the suspision of hfa, and referred me to the local asa support chapter. unfortunately, with 5 kids, a faulty vehicle, and a traditional husband that does not help with the kids or house, i have yet to make it to a monthly meeting.
anyway, my concern is, the pediatrician wants her opinion of hfa upheld by the neurol. and i can't get in w/ him for another month. with my research on autism, i am completelty sure he is most definately hfa, but how do i know if he is really ahdh along with the autism, b/c so many of the symptoms are in the grey area of both diagnosis? his iep iq tests all came back in a 67ish bracket, which to my understanding TECHNICALLY classifies him as mentally retarded. BUT in none of his evaluations did they mention autism, just listed the sysmptoms that he exhibits, which are like the textbook lists on the autism classifications. why would the specialists that tdid the evaluations NOT suggest autism? it is almost conspiracy type beating around the bush...???!
i copied all of my sons evaluations, iep, a inventory list copied out of the back of one of the books on autism, and 4 pages of my own observations, supporting my suspicions of hfa and a cover letter asking the neurologist to review, asking him to try to see us sooner.  about 50 pages total.  
do you have any other suggestions?  i am concerned with continuing to give meds for adhd if they are not needed and something else can be less traumatic and more beneficial to my son for hfa treatment.


thanks,
kate


Answer
Hi Kate,

Wow, you are feeling overwhelmed, I'm sure.

First, ADHD and HFA can and do exist together.  IF the medication for ADD/ADHD is helping, then you can assume that he does have this problem along with the possible HFA.
You will not hurt him by medicating for the condition.

Now, getting a diagnosis for HFA is difficult for children who are not of school age.  This is sad, but true.  IQ tests can only accurately assess intelligence if the child is able to interact with the test giver and answer verbal questions.  Children with the difficulties of HFA don't always give accurate responses to the test.  If he is asked to stack 4 blocks but is obsessed with lining things up, he won't do as he is asked even though he fully understood the request.  Don't be too upset with the IEP people who gave the IQ test.  Most of them are trained in administering the test but not in evaluating the results.  Most of the scoring is done by a psychologist who did not even see the child.

Also, if they were not looking for autism, they may not have included any tests to tease that out of the symptoms.  Each child on the Autistic Spectrum can have a different mixture of symptoms with varying degrees of severity.

You have sent the neurologist an overwhelming amount of information.  Most doctors don't have time to wade through that much material.  However, waiting a month to get in is not a long time in the grand scheme of things.  Keep that appointment.

In the mean time, call the support group and tell them about your difficulty in attending meetings.  Perhaps a member would be able to come to you and give you some much needed parent to parent interaction.  Many groups will offer you a ride and may have babysitters at the meeting to help with the children.

Here are a couple of web sites to help you as you continue to educate yourself:

http://www.autismasperger.net/intro.htm
http://www.autism-society.org

Best wishes,
Catherine