Expert: James Michael Roan - 10/25/2007

Question
I have a seven year old son who I think is an angel. He always does everything he is suppose to do. He wakes at the same time everyday, gets dressed, brushes teeth, always wants the same thing for breakfast, lunch and dinner, with a few exceptions. Throughout the day we homeschool and have a pretty scheduled day. At night he takes a bath brushes teeth and gets into bed virtually on his own. He has always been this way. Very predictable and routined. He since birth hated the vacuum and cried every time I put him in a rear facing carseat. I split up with his father when he was 1 1/2 and he was just starting to speak so when his speech didn't develop normally I just assumed it was because of the split. He didn't start talking to anyone other than me until he was almost 3. Even then he was very shy so I assumed he was just scared. We did have him in public school and daycare but decided to stay home with him over the past 2 years because he hated going to school soooo much. I would fight with him every day to stay in the classroom. His teacher had to physically restrain him and a few times he did escape and ended running into the parking lot after me. Recently I had someone suggest to me that he may be autistic and I am just blown away by this. Could I have missed that? He has resolved so many issues but he is still different than most other kids. He doesn't flap his arms around or throw tantrums but he used to have pretty bad ones and still bites his hand if he is upset. He cries if you sing There was an old lady who swallowed a fly. He doesn't communicate well when he is anxious or upset but how do you know when this is normal or not? Who do you call? What do you say? His pedi Dr has seen him since he was a baby wouldn't he have noticed? What is the first step? Am I just overreacting?

Answer
Hi Holly;

You are NOT overreacting. Like all good mothers, you are hypervigilant. In terms of autism, I suggest you do a few online screenings for Asperger's Syndrome (AS). I don't have an opinion one way or the other yet until I get enough information to direct you. If you like, after taking the screening(s), you can scan and send me the answers for me to further review. If I suspect your son is at risk for AS, I will tell you so and what your next steps should be. I suggest you take all three screeners:

1. The Australian Scale for Asperger's Syndrome http://www.udel.edu/bkirby/asperger/aspergerscaleAttwood.html

2. The Childhood Asperger Syndrome Test (CAST) http://www.autismresearchcentre.com/tests/cast_test.asp

3. The online PDD-NOS at:
http://www.childbrain.com/pddassess.html
Note: If their is any risk indicated, then press "shift" and "Print Screen" on your key board then Paste into a word doc and email to me so I can look at the answers.

If your son did have AS, pediatricians and physicians would most certainly have missed it. Since he is not immersed in a class with his peers, his social difficulties would not have become apparent either.

Please note I do NOT diagnose over the internet, just assist in estimating risk for an autism spectrum disorder and help direct you to the right resources.

If you let me know that are willing to do this let me know in a private email and I will send you my email.

Kind regards,
James