Expert: James Michael Roan - 5/25/2005

Question
my son is gifted, adhd, mild ocd, and the school has diagnosed him with autism. i am having trouble with the autism diagnosis because from all the reading i have been able to do, it seems he is so high on the scale as to be what everyone else is trying to achieve. what is the benefit/liability of letting the school label him? he is a second grader, academically advanced. he has trouble with social cues, reciprical interactions (he has the intellectual understanding but does not apply the knowledge in real life), gets frustrated when people break the rules and responds inappropriately, poor conversational give and take.

when i look the big picture of what i have been able to read about autism, he seems borderline at best, though the school feels otherwise. he met all his speech and physical markers as he developed, he is athletically and musically inclined, no special food or clothing issues, he travels well to new places, talks to strangers if they have or are doing something interesting (such as a new neighbor walking a dog or a kid with a basketball, definitely the ice cream man). i just wish i could find more information to make me feel comfortable they have a correct diagnosis.

Answer
Hi Marci;

You have a very valid concern. With all due repsect to your school and special education team and realizing I have very limited direct knowledge about your son, here is what I have to say:

1. It is important to consider both your son's strengths and areas of challenge. It sounds like he has quite a few good things going for him. So when we are considering what is best for your son, we want to be sure he is equipped with ALL the skills necessary to be and feel successful, both academically and socially. It sounds like he is intellectually competent enough to meet the academic demands of school at this time. It seems to me then, that the first issue that needs to be addressed is poor social skills and poor social communicative ability as you have described it.

2. There are numerous causes of low social cognition (thinking) and communication. The most common is Asperger's Disorder, which is often considered to be synonomous with high functioning autism (HFA). It is characterized by a speaking vocabulary and quality that is much higher developed than the child's understanding of language. Pragmatic language is negatively affected, which refers, in a general sense, to the ability to use and respond to a variety of nonverbal communication skills such as body language, gestures, facial expresions, voice quality (prosody) etc. This delay makes friendship making and simple "chatting" with peers difficult at best. Another moniker is a concrete thinking style, i.e., the child always has to be right, first in line, etc.

3. Another common source of low social cognitive/communicative ability is what is known as a "nonverbal learning disability" characterised by a much lower developed fluid intelligence (nonverbal ability)than crystalized intelligence(verbal ability). This delay negatively impacts a child's ability to read social cues. These children appear teachers and other students to be impulsive and insensitive to others' feelings and social boundaries.

You can get more information on both conditions on the internet. Dr. Tony Attwood, in my opinion, is an excellent source of accurate information on Asperger's Disorder and HFA on the web.

Now finally, let's get back to your original question. Labels, when wrong, can deny your child of the necessary direct services he may need; when correct, a label gets everyone on on the same page and helps them to interpret your son's behavior within the proper context. It also directs needed services to where they need to be.

You are a brave parent with your son's best interests in mind; and with that having been said, it is my opinion that for your son to be academically, socially, and personally successful you should have him assessed by an independent team of skilled professionals experienced with Asperger's and autism outside of the school setting. Between what you glean from an independent evaluation and what research you do yourself, you will then be able to make an informed decision that you can live with and that will benefit your son a thousand fold. You will always have to fight for your son's rights at school, but it will be easier to do so with the correct information. Accurate data from a thorough assessment must drive the services in his IEP.

Please be comfortable with contacting me for clarification on anything I have said or with more questions.

Kind Regards,
James