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Advice on ASD and Dyspraxia.

(18 Posts)
JustPondering Mon 05-Nov-12 10:28:11

My son finallyhas his peadiatrician appt today. He has been seen on and off over the years due to a language disorder and autistic traits, never been assesesd though due to his good imagination and seemingly OK social skills.

However he has been going to a social skills group through speech tehrapy and the report shows that his social skills are actually impaired, he talks over people, cant share, cant take turns and other things too.

I accept that his imagination is good so he maybe doesn't fit ASD criteria, but he just has so many sighns, like toe walking in front of the TV, spinning and NEVER getting dizzy, watching TV upside down, over emotional and of course his language problems. He is 6.

Could it be dyspraxia? He has no problems with handwriting but cant do buttons, is a messy eater, cant pedal a bike or trike, cant play row row row your boat as his arms just give way, he W sits, cant open heavy doors, can't seem to sit still unless in front of a screen. Could he have dyspraxia and have Ok handwriting?

The language disorder he has is phonological disorder which I have seen is sometimes called verbal dyspraxia if it is known to be neurological, he also has expressive and receptive delays. He also can't read yet, not even the cat sat on a mat type books, he cant seem to sound out words phonetically and reads them backwards instead. He is good with maths though. My 18 month old is waiting for ASD assesment as his peadiatricain thinks he is probably autistic.

porridgelover Mon 05-Nov-12 11:01:05

To me, a lot of hints in your post indicate enough to go for a thorough assessment of ASD.
Language issues with impairment of social skills.
Imagination...I would have thought my Ds had a good imagination until I really looked at it and realised it's a lot of repetition of what happens in his favourite programmes.
Difficulties with relationships.

Then you have the motor and sensory components
Vestibular issues (doesnt get dizzy, hangs upside down) proprioceptive issues (toe walking, buttons)
Muscle tone (w sitting, heavy doors, row-your-boat).
Emotions not on an even keel.

If you look at this it will help to see the variety of issues that affect children on the spectrum.

The SaLT that I attended banged on about Theory of Mind. She felt that this is not fully mature in NT children until about 6 years. Which is why, she felt, so many HFA children remain undiagnosed until after that age.

Lots of conditions co-exist or are also symptoms of ASD e.g. dyslexia and dyspraxia. I feel that, while these are useful labels to explain to school why my DS has these difficulties, it's all part of the ASD package.

DrWhoNeverTires Mon 05-Nov-12 11:14:30

you could of just described ds1. he does all the above except w sit, he sits on his knees mostly. He seems to be a boggling mix of adhd, asd, dyspraxia etc but not quite fit any box. Socially hes not shy at all with talk to anyone and every, copy everyone and play with anyone but he seems to me to play alongside them while they get on with someting else yet ds is oblivious, dosnt really notice when other people are not intrested gets in your face, never tires, wants his own way etc. and he had obsessions i.e dr who but retains no imformation about them strangely. I know in my heart there is something not NT about him but dont know what, its difficult.

JustPondering Mon 05-Nov-12 11:14:40

Right I am going to insistent at his appt then and insist he is assessed smile Wish me luck.

It may be helpful that my younger DS is thought to be autistic, middle DS may just not be presenting typically. It would be helpful if I had his results back from speech therapy as he had some assessments done on his language skills and he didn't seem to do so well, its been 3 weeks and no results posted as yet, I am waiting for someone to ring me back after looking in his notes to see if the results are there so fingers crossed.

JustPondering Mon 05-Nov-12 11:21:03

DrWhoNeverTires It's so frustrating isn't it! I just know that he isn't quite typical but yes he doesn't quite tick enough boxes for anything. My DS is very very friendly and chattty but doesn't know when to stop talking or when people are not his friend. Speech therapist at social skills group noted that although he initiates conversation he is very domineering and doesn't recognise when he should stop talking. Yes I feel DS is a mix of ASD, dyspraxia, ADHD and dyslexia but not every symptom of any disorder, there's something that doesnt fit with all of them.

SallyBear Mon 05-Nov-12 11:21:44

Good luck indeed. I agree, I would definitely say that he does display (ime with two DS on the spectrum), ASD symptoms. Also look into the dyslexia too. It would appear that maybe he has the hallmarks of that too. Hope it goes well. Be assertive and spell it out to the paed. smile

ProcrastinatingPanda Mon 05-Nov-12 11:23:31

My son has a great imagination but has an ASD dx. You should still push for it and outline all your other concerns.

ProcrastinatingPanda Mon 05-Nov-12 11:24:44

And for what it's worth, you've just described my DS perfectly!

JustPondering Mon 05-Nov-12 11:49:08

I think he would pass an ADOS test though, is that the only way they can diagnose? My friends little girl passed the ADOS test with flying colours, so her mum took her to CAMHS instead where she was diagnosed as having moderate autism at the age of 8, not a clue how she was diagnosed though, although there must be other forms of testing.

SallyBear Mon 05-Nov-12 12:30:21

I don't think we ever did an ADOS for either DS1's Aspie dx or DS4 ASD. I think in truth it was down to me describing them, the SENCO report for DS1, the SALT and the EP for DS4 that the paed used for a dx.

porridgelover Mon 05-Nov-12 12:31:12

There's a good discussion on this thread re the Triad of Impairments.

DD1 has been assessed on the ADOS and passed. Psychologist has seen her once and felt there were no issues. I, however, am convinced that actually she is also HFA. She has the lack of social imagination, rigidity of behaviour, anxiety, sensory issues and the most awful tantrums when she is finding things too much.
Sorry, that was a sidetrack.

My DS was diagnosed when I took him to a private Psychology assessment. School had failed to see any issues (hmm angry). Psychologist did full WISC, language assessment, listened to my Sensory Profile, his difficulties with fine and gross motor skills, clinical obs of social interaction. She immediately came back with dx of HFA/Asperger's. (whereupon school nodded sagely and said yes, they had noticed some social difficulties grrrrrrrrrrr.) She didnt do the ADOS as I remember but I can look up the report if it helps?

DrWhoNeverTires Mon 05-Nov-12 12:36:04

justpondering yes its very frustrating, thats sounds just like ds1 he talks constantly asks qusetions incessantly but often dosnt even listen for the answer to will continue to ask again and again. He talks to himself as well so its literally a haze of noise whenever hes around, he comes home from school with a verbal warning daily for talking. Ds has seen a speech therapist from age 4ish via the nursery continuing into school for dysfluency, ive only met her twice as it happens in school and i get periodic letters will little input. Ds is VERY dominering, he interupts constantly and appears very rude. He always wants his own way and is a nightmare out and about. He appears like a big toddler, touching everything and running off, asking for things and if told no just sitting down and refusing to move, any attempt to move him makes him go limp and heavy, and start screaming to get off him, he dosnt have any embarressment factor at all.

JustPondering Mon 05-Nov-12 15:07:50

porridgelover yes that would be helpful smile

DrWhoNeverTires the description of your DS sounds very much like my DS. Especially when out and about, he rolls around on the floor, grabs everything and comments on everybody, and he also has no embarrasment.

Well back from the paediatrician now, he has been referred to OT to assess his motor skills, and we are back to see the paediatrician in 3 months after she has got reports from school, speech therapy and OT. She said that he didn't strike her as having a communication disorder as he is very chatty and friendly. She also said she is going to see if school notice that he toe walks and watches TV upside down, I told her that that was unlikely as he only does it in front of the TV and TV is not watched at school.

He is also having a RAST test to see if he is still allergic to milk, as he was as a baby and his stools are still loose. He is also having a blood test to check for celiac disease and he has to do a stool sample to check for any bugs.

Ineedalife Mon 05-Nov-12 16:39:55

Hi just
I am glad that the paed took your concerns seriously. I just wanted to ask you about his imagination, Dd3 can give the impression of having a good imagination, especially when she is playing with her playmobil. However if you get close and listen to her she is actually replaying situations that she has been in or things she has seen on the tv. It is almost like echolalia through play.

If you dont already I would recommend keeping a diary, it was doing this that made the proffs sit up and listen to me about Dd3.

She was watching tv upside down the other day, but there is no way she would do it at school.

JustPondering Mon 05-Nov-12 17:43:17

I get the impression that she isn't taking my concerns seriously though, I get the feeling she thinks I am imaging things like toe-walking because he doesn't do it at school, I stupidly forgot to take my digital camera with videos on.

But never mind, at least he is seeing an occupational therapist, so we will see if there's any co-ordination problems there.

He does seem to have a very good imagination, he makes up stories all the time, and tells me that there's dragons under his bed and lions that live in our shed. He mostly plays with action figures like Ben 10 and Power rangers. He goes through mini obsessions with certain characters, currently it is ben 10 so he only plays with ben 10 figures and only wants to wear green jumpers and blue joggers.

Like the idea of a diary, will start one.

Ineedalife Mon 05-Nov-12 18:54:09

I am not sure that school would even notice toe walking tbh. Many teachers dont pick up subtle issues with in children in amongst all the other stuff going on.

Also many children are good at blending in at school especially if they dont display extreme behaviours.

It is good that he is going to be seen by an OT.

There is a big crossover with dyspraxia and ASD, I am sure Dd3 has dyspraxia alongside her ASD.

Hope you get on ok with the diary, I recorded any issues with behaviour, anxiety or general quirkiness. I also recorded what caused the issue (if I knew) and how I dealt with it.

It is great that you have video of him, get some more if you can to show that it happens regularly.

We had our OT appointment at home which was great because I could share info with them and I could see for myself where her difficulties lay.

Good lucksmile

DrWhoNeverTires Tue 06-Nov-12 10:16:14

sometimes it helps a little just to know you are not alone. Can i ask what the people around you friends, family etc think? for us family seem to think there is nothing wrong with ds but they only see him every few months briefly so really cant know but it dosnt help matters. Ds looks for the most part 'normal'

Ds also toe walks at home but all the time, when out he tends to run, skip, hop etc so hard to tell, not sure if he does it at school though. I was told by the OT about a year or so ago that it was to do with sensory seeking and he would need insoles if he didnt stop it soon but the new OT said it wasnt any issue and he would outgrow it hmm

JustPondering Tue 06-Nov-12 14:51:09

My sister thinks it is unbelievable that they think he is typical, she is here everyday though. I think the problem is that he doesn't toe-walk or spin or anything at school, although I have seen for myself that he runs into walls at school on purpose. School think he seems normal, although they have problems with him being rude, not listening and fidgeting. My friend who has a daughter with autism said she would eat her hat if my DS doesn't have autism.

I asked the peadiatrician why he would have to watch TV upside down if he was typical and she said maybe it is something he just does because he has a great imagination confused but when he does it he isn't even aware of it, he just goes into a trance and ends up upside down. I also asked her why does he never get dizzy when he spins but she didn't know. Hopefully the OT will be more helpful in that respect.

I think that is what my youngest will have to have insoles, or maybe special shoes he has ankles that roll inwards and he walks on his toes, we are to see a physio with him soon hopefully.

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