Sounds great, JJ. Hope you can help them with what you've doing
J is 7, has dx of autism. I'm surprised that it's not AS, as there were no speech delays, but I think CAMHS see him as too severe for AS dx, though he's not classic autism either. His ADOS score was apparently too high for AS. I'd categorise him as severe in terms of behaviour/ obsessions, but he has no learning difficulties in the traditional sense and does v well academically.
- Wants environment the same (an eg of this would be when ds1 wouldn't let us turn the lights off, or freaks when he gets home and my car has moved)
Yes - and wants to be in control of it - if HE wants to change it, he's fine with it
- Avoids change in daily routine
Yes - massive meltdown if it changes, even with warning. Again, wants to be in control (his defining feature)
- Has obsessions
Majorly. Lightswitches and plug switches, ever since he could crawl. Anything electrical. Music, TV, computers, lights.
- Doesn't understand the feelings of others
Improving, but others always come 2nd and he can't understand how his behaviour affects others.
5.Overreacts to noise
Yes, unless it's noise he's made. It's about control again. He wants his music etc. v loud, but will freak at a bell or a drill noise - hands over ears, meltdown etc.
6.Does not seek the company of others
No - he falls into the 'active but odd' category that Lorna Wing (I think) describes as distinct from the passive or aloof autistic child. He particularly seeks company of adults, but to do something for him, not with him usually.
7.Does not make eye contact
Makes it, but only on his terms, and it's odd. Either too close or not at all. Will make it when he's asking a question of someone but not when someone talks to him.
- Seems distant
Can do, but is also very affectionate. Distant if the contact is not on his terms.
- Engages in stereotypical behaviour
Yes, very repetitive.
10.Has problems in his/her eating routine
Horrifically! Won't eat much in terms of quantity or variety and has rigid 'rules' about food.
11. Has temper tantrums
Majorly. Has 1:1 or 2:1 support all the time at school and regularly requires restraint at school and home. Threatens to hit and has hit people with knives. Attacks children and adults. Runs off. Destroys things. Usually related to not having control or being asked to do something he doesn't want to do.
12. Has sleeping problems
Didn't used to. Now, nightmares and constant getting up to fiddle with lightswitches and taps.
13. Does not seek physical contact with others
No - he does; he's very affectionate. But only on his terms. Doesn't like to hug/kiss on demand. Is odd with his affection e.g. will kiss my eye with his nose which is interesting . He will only accept affection from a very small number of people. If others try (and sometimes even if the select few try) he will try and get away ASAP.
14. Does not get attached to a person
Is very attached (too attached) to me. Also gets very attached to toys and objects.
Will get very attached to adults at school - select ones - and will stalk them and want to be with them and talk to them all the time. He's very possessive of people - sees them as 'his' possessions.
15. Makes slumsy movments
Yep, but has motor skills delays and sensory problems which OT is addressing gradually.
16. Does not have self-care skills
Needs help with cutting up food, cleaning, wiping bottom etc.
17. Does not play with objects
Has started to more recently. But always in an odd, repetitive way - e.g. everything is a microphone (one of his obsessions)
18. Does not develop speech
Intelligibility was late, and still isn't great. But he has a very wide vocabulary and can be very articulate. Echolalia (delayed) has helped with that. He can parrot off videos that he's watched repeatedly and copies what adults say (both at the time and after, which can be interesting
19. Presents problems in his her physical appearance and health
Lots of bruises, which make him look like SS should be involved in more than a Disability Team capacity but nobody knows how hw gets them because he has a very high pain threshold and doesn't tell you if he's bumped himself.
20. Has hearing problems
Seems as if he has - EP has questioned hearing numerous times - but he actually has v good hearing - he just gets v distracted.
21. Does not have feelings
May not show them like other people, and may not understand them, and may express them too strongly, but of course he has feelings - which are expressed too strongly in the form of meltdowns.
22. Has hallucinations
Nope, but does have a hard time distinguishing reality and fantasy. E.g. his toys are real and have a voice which is theirs. And they hit him and hurt him and call him names