Expert: James Michael Roan - 6/7/2005

Question
Hello there,Our son has recently been seen by an autism outreach panel.He was clearly autistic by mom and dad's interview,had some learning dissabilities as well as high anxiety.They were hesitant to put him on the spectrum due to anxiety and good eye contact and he smiled?They would like to medicate for anxiety then assess him again in 6months.My question,as I can have him privately assessed,I do not want to medicate,is 'Can he be so high functioning that he can mask himself for society and be'autistic' at home?He has a fairly good sense of humour and makes fairly food eye contact,but more so on his terms.We feel he holds it(aspergers) all in until he gets home from school...opens the door and let's it all go.

Answer
Hi Tanya;

You are most likely correct. In the past 2-3 years there has been both an increase of children on the autism spectrum as well as more diversity along that continuum. It is entirely possible that your son may be at the high end of the Asperger's Disorder scale. It certainly is not a discrete category. Children with Asperger's typically go relatively unnoticed at school by teachers until the age of 8 or 9, when these folks develop school phobias and begin requesting to stay inside with the teacher rather than struggle through the social jungle of the playground. Also, most learning tasks are until that age mostly concrete in nature. It's when learning tasks begin to require abstract thinking skills, that these folks begin to stand out to teachers; and, because of the recent changes in the profiles of children on the spectrum, some school professionals erroneously rule out autism because a child smiles or makes good eye contact.

If your son does, in fact, have Asperger's, then the high anxiety levels would certanly be the result of his social struggling.

I know and have known many children who are on the autism spectrum who smile and make limited-to-good eye contact and who have a limited sense of humor, however, their ability to understand humor initiated by others is limited to nonexistant.

I think you should have your son evaluated by someone expert in this field. It's essential that he get the services he needs if he has Asperger's. He will need to learn how to make "true" age-appropriate friends, to reduce anxiety and to prevent depression, which is common in these folks.

Let me know if I can help more. I am happy to do what I can.

Kind Regards,
James