AS or just Speech and language problems?

[catuxa]

Hi everyone
My DS is 5.9 and has speech and languages problems. He didn't start talking until very late (3y.o.) and has been having speech therapy for the last 2.5 years and he's been progressing. We took him for the ICAN assessment last December and although they didn't come up with a dx they said he clearly has SN and needs support from school, local authority etc. What they did say is that he's extremely clever but his poor language skills make him score really badly on any test where language is involved. School seemed to downplay it all and they put him on an IEP but by the end of last school year we (school, us and SALT) were all worried about his lack of academic progress and social interaction. His SALT is being very supportive and referred him to community pediatrician. We've just been back from the appointment and she's been talking about AS and/or dyspraxia as possible dxs. I can see the dyspraxia but I have always ruled AS out as his language skills are poor and he has no obsessive interests (apart from always wanting to watch TV or play computer/ps3/iPad). He's socially awkward and has a tendency of behaving like a baby (baby noises, shouting and screeching, licking and sucking things) and other AS criteria but not the obsessive interests. I do have a long list of odd things he does but could it be all caused by his SL delay/disorder? Unfortunately we have a history of AS, SEN and mental health history in the family. Any thoughts will be greatly appreciated.

[Gorta]

Hi,

Has anyone mentioned specific languge impairment to you? My ds has been diagnosed with this. He is attending a language unit. He scored very poorly in the O.T. Assessment the movement ABC. My son scored high average in his non verbal IQ. I would see a lot of autistic traits in my child but I think as he grows older he will grow into them. Other children with SLI go on to be diagnosed with autism but not all. I have a dd with semantic pragmatic language impairment and dyspraxia who I think will be diagnosed with autism as the years go on. She was recently assessed by a combined clinic and educational psychologist she didn't feel she had autism but social anxiety. I feel the professionals don't always agree with each other when the child is in a grey area. Girls are so subtle and copy each other social skills. The few friends she has are very kind and almost like to mind her. Typing on an iPad! Hop this helps

[catuxa]

Gorta thank you for your post. To be truthful SLI was the dx we were hoping for when we had him assessed at the ICAN Meade school ( Bill Harrison Independent Multi-disciplinary assessment) but they didn't actually put a label to it, they just said he had significant difficulties. His language is getting better but his behaviour and social skill are getting progressively worse. Do you mind me asking which professional has your ds diagnosed and which route did you have to take to get there?

[Handywoman]

I think that aside from the difficulties of reaching these overlapping diagnoses, the disorders themselves can be very poorly defined. For example it is difficult to distinguish language 'delay' from 'disorder' at a young age (and the treatment is very much the same). Ditto for semantic pragmatic disorder and ASD. Deficits in social communication can emerge as time goes by (by becoming more obvious as social demands of life increase, e.g. at school) and restrictive interests might be more subtle than things like being upset by changes in routine, etc. Ultimately a skilled clinician needs to look carefully at the full picture and interpret...... This is what I have to tell myself as I sit out the long (1yr) wait to have an assessment done on my dd who, like your DS,does not show obvious repetetive and restrictive interests but had 'severe language difficulties' aged 3-5yo and who has an awkward social style and severe difficulties with non-literal language. My advice (if any) would be to document all the 'odd things that he does' and take examples along for the community paed to 'make sense of'. Until then, if you are anything like me, nothing will stop you from mulling this over (aka driving yourself mad!) and you will not settle until the assessment is done! It is great that your ds has been referred and that you have a brilliant SALT (they are worth their weight in gold). Meantimes stick around on here for continued advice and support...
Handywoman x

[catuxa]

handywoman thanks for the tip. I actually wrote a long list of his peculiarities and took it with me to the appointment to be able to remember them all when talking to paediatrician. She said it was very useful and kept the list with her own notes.
I think ds is becoming aware of his own limitations and becomes more frustrated by the day. He's got a few friends at school but I have already seen other kids being mean to him for being 'weird'.

[used2bthin]

Hi, my dd has SLI, we went to ican when she was four and they said similar to what you were told, ie dd has significant difficulties and at the time her expressive language was around the 20 month mark, it was all quite devastating at the time but she is progressing, just still on the 1st centile for her age.

As her language improves I have also found her behaviour has got much worse but she is able to tell me more-for example she said school is "too noisy" and she also has been able to put her foot down a bit more (understatement of the year) about things and so I am seeing autistic traits more. I am not sure if they were always there and I know more about them or if they are more apparent-she has always had phobias and a few obsessions though. Also we saw an OT about her very active over the top jumping about etc and the OT said she has sensory processing "difficulties!"

[used2bthin]

Meant to say, I was so sure she was completely different to a child with ASD but now I see overlaps, or she has autism I am not sure which but have got to a stage where I just want to know and would not be shocked either way iyswim. Someone once said to me that her obsessions are her clinging on to the familiar as she finds life confusing which made sense to me and again could be because she has autism or because she has SLI, hard to pick it all apart sometimes.

[fedupwithmorningbattles]

Funnily enough I was told recently by a peadiatrician who observed my Dd (Ds currently awaiting assessments with camhs so SALT suggested refering Dd just to be sure all was well) after various tasks she flagged an isolated speech problem which can cause autistic traits. There are some behaviours that I see in my Dd which I see in my Ds but I wouldn't say I was concerned (about either child) until Ds's were pointed out to me.

Ds currently attends scouts and after he expressed an interest in an activity weekend we felt the need to mention to the leader that he can become anxious in some situations (namely school), after the weekend was over the leader (30 yrs experience) spoke to us and said he was the best behaved child there, no signs of anxiety so pretty much the same as he is at home during weekends and holidays (minus school-where he kicks,punches,shouts out,throws things,is very rude to staff,refuses to do his work) and the other leaders actually thought she had lost her marbles when she informed them about the anxiety...so I can safely say my head is now well and truley up my backside and I too am now eagerly awaiting the assessment to tell me what is going on x

[Handywoman]

We are the same UTBT. I was clear a long long while ago that my dd's issues were due to confusion and that she had SLI (aged 4 her understanding was at the level of a nearly two yr old) but now aged 7 with normal language (apart from conversational and non literal) our next step is formal assessment for ASD. I agree it is a matter of unpicking everything.... Unsurprisingly it takes years.
HW x

[Gorta]

Hi,
I'm in Ireland and I find from reading posts here the uk is so further ahead than our system. My ds started slt at 18 months old then started early intervention services at 2.5 where he was diagnosed with severe sensory processing disorder. I was getting 6 sessions of slt per year a disaster! I asked for him to be assessed by the slt therapist and he scored on the 1st percentile with receptive language. He was then cognitively assessed by a clinical psychologist to diagnose a specific language impairment and his non verbal iq had to be above 90 o be allowed to apply for a place in a language class. We were very lucky to get a place -24 applications for 9 places. I think we are lucky to have caught our children so early. I think it will make such a difference to have our understanding and for us to meet their needs.

[catuxa]

Thanks for all your messages, It's my first time in the SN forum and I find all your input extremely useful and I really appreciate having people to talk to that understands what we are going through. It really irritates me when people (mostly extended family) say things like 'all children do things like that' ( no, they don't); 'at least he's happy' (no, he isn't).
So thanks again.

[sazale]

My DS 5 has a phonological speech disorder and has social anxiety which is displaying as selective mutism. He's due to be assessed this month to see if the soial anxiety is caused by ASD (I have a dd 13 with ASD and many comorbids). I'm not sure it is ASD but likewise I'm not sure it isn't.

[Handywoman]

To the OP, go to You Tube and search the RALLI campaign (raising awareness of language learning impairments) for a video about the difference between SLI and ASD. Also has references for further reading.
Xxx

[used2bthin]

Handywoma I remember reading on here how long it all took and it never occured to me I would still not know about dd1 this far on. Her emotional development is at the two to three year old level I have heard today. Which could be because its so impossible to assess her due to the language issues. We are part of the ddd study so you never know there may be answers one day.

[catuxa]

handywoman and zzzzz, thank you very much for the links. I didn't actually know anything about Dr.Bishop or the RALLI campaign but I thought their videos were very informative.
Since talking to paed and writing in this forum I've been reading about Aspergers and now I realise how ignorant I was about the subject. I had the misconception of ASD individuals to be all very much the same, I didn't appreciate that they are as individual as NT people. Everytime I've tried to ruled out ASD as a dx for Ds because 'ds does this and ASD don't do that sort of thing' I was shocked to see that that isn't necessarily the case. And I thought I knew a bit about the subject as I've got ASD friends and family. In fact quite a few people have suggested I might be ASD but that's another story.
We'll have just to wait and see what the dx is. In the meantime, we'll try to gather as much information as we can about both ASD and Dispraxya. We'll hope to stay positive, whatever the outcome. Wish me luck.