Expert: James Michael Roan - 8/25/2006

Question
I have a four year old daughter.  For the last year we have been going back and fourth with autism.

In the beginning of this year we took her for an evaluation at a local childrens hospital.  Autism was not dignosed.  During the evaluation my daughter did not show any social deficits.  She has never had a problem with eye contact and she is a social person.  She does not have a problem interacting with other kids or adults. I also do not see other autistic traits such as a need for routine or samness.  

On the other hand she does have language and sensory issues.  I thought she was speech delayed but after an evaluation with a speech therapist I found out she is not.  She has problems with social pragmatics. She scored above age level (almost for a 5 yr old) on the receptive language and at age appropriate for expressive language.  The ST described my daughter as having the "tools" for language but she lacks the "know how."

The sensory issues are purely seeking.  You would almost think ADHD.  She is very active, she has problems with attention and she has many seeking activities like running, jumping and crashing on furniture.  She also makes a repetitive movement when she gets over excited.  She will hold her arms down tight and wiggle her fingers.  She also makes a facial grimace.  The whole thing lasts just seconds.  It looks like a burst of energy.  Ocupational therapy will begin for her next month.

So, with the language issues and sensory issues, is it safe to say she is on the spectrum anywhere?  Is it possible to have these problems and not have asd?  I am so confused?  Her dad, he is not around, had ADHD, can this be playing a part?

Thank you so much.

Answer
Hi Kris:

Have you considered Asperger's Syndrome? It is on the high functioning end of the autism spectrum. Since girls are naturally more social than boys, it is overlooked and usually not diagnosed under most circumstances. Consider looking at Tony Attwood's website and then go here and print and share the results with me if you like: http://www.udel.edu/bkirby/asperger/aspergerscaleAttwood.html

ADHD is usually the first diagnosis given to a child with Asperger's, when in fact, it is an executive dysfunction.Facial tics are present in about 40 percent of the Asperger's population along with low social competence and low social thinking. Children with Asperger's desire to be social but don't get the sublties, which we can discuss further if you like.

Let me know how your daughter scores out.

Kind Regards,
James