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Does My Child Really Have ASD - or Is It Something Else?

Question

We have a diagnosis of ASD from our pediatrician, but our counselor is telling me that she does not agree with the diagnosis because my son is very social with her and he always makes eye contact. He has ASD traits, and then some that are not:
  • He has problems keeping friends. No boys, just has friends that are girls.
  • Everything is black or white, there is no in between.
  • Everything is taken in the literal sense.
  • He does not understand that benefit him.
  • Refuses to do school/homework statements like "I shouldnt have to make up that school work, it wasnt my fault that I broke my shoulder at school!"
  • Dominates all conversations
  • Targets music (very talented) and will hound relentlessly for you to hear him play at inappropriate times (mom on a business call)
  • Doesnt understand jokes - gets offended because he thinks that they are directed at him in a negative way
  • Does not try to fit in with others (has his own style - not intentially, but because he has no interest in social norms)
  • Always raises his hand in class to answer EVERY question, to the point where the teacher has to ignore him and he does not catch on that he has has his turn.
  • Interrupts all conversations.
  • Was an "outstanding" citizen at school and wanted to always do the right thing, but has recently become a rule breaker, lying and stealing (only stealing things that he wants and says he took it because he wanted it and doesnt show remorse).

I know that you cannot diagnose through an email, but these are things that we have noticed and that he is much different from other kids. We are trying to get counseling and help dealing with his behaviors (everyday is a blow up over nothing) but the counselor thinks he does not have ASD because he makes eye contact. He also has Tourette's, but he does not suffer from coprolalia, just vocal and motor tics. I have seen other autistic kids who make eye contact and can be social, but dont key into social cues, understand body language, etc. How do I approach this with our counselor?

Thank you,

D.


Answer

Kids with ASD level 1 (high-functioning autism) experience many difficulties, and to complicate the situation, many of these difficulties are associated with other disabilities. Ultimately, ASD is hard to diagnose and is frequently misdiagnosed. Also, kids on the spectrum frequently have other disabilities as well. 
 

Following are some traits to help clarify what ASD is and how you can recognize it in your son:

1. Cognitive Difficulties: Frequently the ASD youngster experiences difficulty with empathizing with others and says inappropriate things because he fails to consider others' feelings. A significant problem for the ASD youngster, mindblindness occurs when he is unable to make inferences about what others are thinking. Mindblindness hinders communication with others.

2. Delayed or Impaired Language Skills: If your child starts talking late and exhibits lagging language skills, this may be a sign of ASD. My autistic grandson son talked late, but when he did, he began with full phrases and sentences. He also mixed up pronouns. The autistic youngster also fails to understand the "give and take" of communication; in other words, he may want to monopolize a conversation and fail to acknowledge the comments of others. The youngster with ASD understands communication as a way to share information but fails to recognize communication as a way to share thoughts, feelings and emotions.

3. Development of a Narrow Range of Interests: If a child seems stuck on a certain topic and seems a bit obsessed about always talking about that topic, s/he demonstrates narrow interests -- this a characteristic of ASD. Often the youngster learns everything s/he can about this special interest and then feels compelled to share information about the topic with everybody around them. Usually focusing on narrow interests affects social interactions negatively.

4. Difficulty with Social Interaction: Although the autistic youngster may want to interact with others, s/he lacks the skills. The child fails to understand both verbal and nonverbal cues, and communication with others breaks down. The child may lecture others, fail to ask questions to continue a discussion, or simply not even acknowledge the other person by looking at them. The desire to communicate may be there, but the language abilities others seem to develop naturally just don't develop easily for the youngster. But, ASD kids develop these skills with early interventions and teaching.

5. Motor Clumsiness: Sometimes, but not always, kids on the spectrum display poor coordination because they experience difficulties with either or both fine and gross motor skills. This problem is due to difficulties with motor planning in completing the task. For example, the youngster may experience difficulty in riding a bike because of planning the different steps to successfully complete the task.
 

6. Sensory Sensitivity: The youngster with ASD may be underactive to a sensation, or s/he may be intensely reactive to a sensation. The sensitivity could involve one or involve many of the senses. For example, before my grandson was diagnosed, I was appalled when he wanted to run outside in the middle of winter with no shoes or boots. I was so afraid he would sneak out of the house and get severe frostbite. I also remember he was fascinated by lights. Some moms and dads detail how their youngster may scream when the vacuum is turned on or how he refuses to brush his teeth due to the sensation caused by the tooth brush.

7. The Need for Routine: Perservation is a common characteristic of the youngster with ASD. Perservation involves repetition in language and/or behavior. For example, with language a perservative tendency is to repeat certain phrases over and over. In terms of action or behavior, the youngster may line objects up and insist the objects not be disturbed. Completing a certain set of rituals in a specific order also demonstrates perservation.

Although some of these traits are common to other disabilities, the whole bunch together certainly suggests further investigation into an ASD diagnosis. A professional, like a psychologist or a psychiatrist, should be consulted because early intervention is very important.

What ASD Is - and What It Is Not

Young people with ASD  have difficulty communicating or interacting in social settings, expressing emotions or empathy toward others, and may have eccentric language and behavior patterns. ASD is a developmental disorder. This means the brain of someone with the disorder processes information differently than most people.

What ASD is not is an illness per se. It is a neurological problem within the brain, causing impairment in language, communication skills, and repetitive thoughts and behaviors. Often, those with the disorder are thought to be eccentric and unique.

Although children on the spectrum retain their early language skills, some other things to look for include:
  • An obsessive preoccupation with a particular subject or object to the exclusion of any others
  • Clumsy and uncoordinated motor movements
  • Crawling or walking late, and later clumsiness
  • Difficulties with non-verbal communication, including no use of gestures, flat facial expressions, or a stiff gaze
  • High level of vocabulary and formal speech patterns
  • Peculiarities in speech and language, such as lack of rhythm, odd inflections, or in monotone
  • Socially and emotionally inappropriate behavior and the inability to interact successfully with others
  • Taking figures of speech literally
  • Talking incessantly about one particular topic, but in a random stream of facts and statistics with no point or conclusion

 
Causes Too Early to Know

The exact cause of ASD is still unknown. But there is strong research evidence to suggest a genetic connection. In fact, the brother or sister of someone with ASD is 50 times more likely to also have the disorder. The particular gene or group of genes has not been isolated yet. Research is ongoing and promising in this direction.

Your Autistic Child Can Have a Normal and Productive Life

Although there is no known cure for ASD, there are many ways your youngster can learn to cope with his or her condition. Your child's treatment plan must address three areas of their disorder:

1. Obsessive or repetitive routines
2. Poor communication skills, particularly in social situations
3. Poor motor coordination

Treatment includes social skills training, cognitive behavioral therapy, occupational or physical therapy, and speech and language therapy.

Many kids with the disorder grow up having learned how to cope with and manage their disability. They often lead lives holding mainstream jobs, maintaining intimate relationships, raising kids, and being socially active.

The best means of handling your youngster’s diagnosis is to educate yourself. Find out everything you can about ASD by reading, asking questions of medical and psychological professionals, going online to find support groups in your area and all other resources.

The important thing to remember is that your child is unique and precious just like any other youngster. The greatest gift you can give him/her is a strong sense of self-esteem, encouragement, and love.

 
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