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Speech and Language Disorder + SPD = ASD?(8 Posts)
I was wondering whether anyone had similar expreience and can help with advice. I am driving myself crazy with these thoughts. Our little one has been undergoing ASD assessment and as a result he was dignosed with SLD and SPD. Through his assessment it was never a clear cut whether he is or not on a spectrum, but as they were not sure and he is quite socially motivated, they have decided against ASD. But obviously crazy mommy brain does not stop, I feel there are a lot of red flags. So I was wondering whether there is any information/book/experience someone can share to help me to understand this. Thank you!!!
AAmommy are you in the UK or US?
I don't have similar experience. But, as you may well have read, there has been long-running debate about whether SPD is actually part of the autistic spectrum. See the refs at the bottom of this http://www.mugsy.org/spd5.htm
How old is your DS? Does he use his language in restrictive, repetitive ways? This itself may qualify him for a diagnosis of ASD. ASD is not so much about whether the child is socially motivated (I have a dd being assessed for ASD this year. She is extremely socially motivated). It is more about the quality of the social interaction. It may be that another practitioner would diagnose him with ASD.
Are you going back for a review? Sounds like you have some lingering doubts about this diagnosis which is completely understandable given the diagnosis, because SLD and SPD pretty much makes up a diagnosis of ASD (in my very unqualified opinion!). It just lacks the nonverbal element, really. And I think part of the new DSM-5 criteria is about doing away with multiple diagnoses which are rather clumsy.
Are you keeping a diary of the red flags and how they manifest themselves?
Yes I have experience! Ds is 7 and still no dx. Upshot is use the intervention that fits the issue.
Ultimately a child who;
finds social interaction difficult and unpredictable because they are guessing huge percentages of what is said,
needs routines because they don't have the facility to understand the language around changes in plan,
and has become immune to social pressure because they are so often wrong,
may have these problems purely because they have a language disorder or may have ASD.
There is a huge assumption that "a language disorder" is somehow less serious than a dx of ASD. So people will often assume you are "in denial" about the child's issues. There are also far less children with language disorders out with ASD (weather this is the real situation or the result of sloppy diagnosis is hard to tell). It should be noted that my reading suggests that outcomes for ASD seem to be rather more positive.
Going purely from observing my own child, I suspect that a bright language disordered child, even given huge and comprehensive support is likely to feel very similar stress (isolation, confusion, unpredictability) to a child coping with ASD.
The techniques used to alleviate this stress are the same.
Routine to hang your day on.
Augmented communication (pecs, music, sign).
Books, "send in the idiots", "emergence", "language for Thinking", "Einstein Syndrome"
Expect progress to be made. I wish I had understood that he would grow up and improve, sometimes achingly slowly, but progress is made. We are happy and have happy times in a perfectly normal family way, not in a "aren't they wonderful how they've managed to focus on th good blah blah blah way"
Thank you so much for your replies! I do feel very lost within this diagnosis nightmare and I think I was in a bit of denial too. I keep thinking that I didn't push enough for proper diagnosis, because at that point I didn't think I was able to cope with it. Everyone kept talking about "labelling" the child, where even if he is on the spectrum, it is not so clear. I think all of us heard this popular myth.
I am in UK, my LO is 3 and I have started an ABA program for him. My red flags are very RED:
- He does not know how to approach children and though he might want to join, he does not know how (yes, I was told that it can be from the lack of speech, but I saw other children who did not have any language but chase each other or follow some natural cues). He used to come quite close to kids or touch their faces.
- Yes, routine and control is what he is. Control is the most important part of our struggles. Building routines, he just needs to be left for couple minutes with activity for him to start building his routines around it
- Obviously speech and language is the main issue, he has just started vocalising, lots of repetitive words, but it is very early days to see whether he is using speech appropriately
- very anxious and sensitive
- and of course, sensory issues - both auditory, textures, vestibular, etc
- lots of food intolerances
Just by writing it all down now, I think I can pretty clearly diagnose him myself
PS I also did private assessment, but they felt he does not present "enough" to be diagnosed. I keep asking myself how much is "enough"?????
My DS got a private diagnosis of ASD following reports from other professionals diagnosing a language disorder and SPD. She felt that the combination of the two was consistent with ASD. My DS was nearly 5 though when he was assessed. If your DS has just turned 3 there may be some reluctance to diagnose him at this stage. I should say that at 3 my DS was seen by a paediatrician (NHS admittedly) and we were told that he didn't meet any of the criteria and we really shouldn't worry at all as in 6 months' time he'd have probably caught up. Of course 6 months later things were much the same...
Your posts are really making me believe that my feelings are right. But I feel it is so unfair that the diagnosis is dependant on judgement of certain professional. The educational psychologist was very unsure about our DS but when she saw him the second time, he was just the best behaved child ever. But it was just one of those good days. But you have to see him on a regular day (not even the bad one) to see the picture. Another concern for me is that if he is not diagnosed with ASD, he is not going to get appropriate support.
Support is not based on diagnosis. In fact a dx of ASD can limit support in some areas . There are several mums who have posted that they were discharged on dx. Certainly in m area there SALT was not offered to children with ASD.
It all definitely depends on where you are. Where I am currently, I was offered Salt only. I was told that it does not matter that he has significant sensory issues, problems with balance, clumsiness etc. they do not have any OT service to help with this. Conversation over. Loved the attitude as well. We are currently moving to another area, and I heard the support there can be diagnosis dependent. Will find out soon....
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