3.3yo DS - nursery thinks he may have Aspergers...

[crokky]

Hello! Hoping someone can help...this is going to be a bit rambly and disjointed!

DS has been at a school nursery since turning 3. The head of nursery has suggested that he may have Aspergers. I am not sure whether I agree or disagree.

2 of my brothers have Aspergers, but this was diagnosed when they were in their late teens. I am only a bit older than my brothers so I can't really remember what they were like when they were 3. My mum thinks that my DS is quite different from my brothers when they were little and she is also not sure if she agrees or disagrees with the nursery.

I do know quite a bit about Aspergers practically because I grew up with my brothers and see them a lot now. I just can't really remember back to when they were as young as my DS is now.

Do they diagnose 3yos with Aspergers? Or do they wait until they are older? What are they looking for exactly in such a young child?

Also, could anyone tell me the difference between Aspergers and HFA please?

Thanks for any replies!

[bubblagirl]

aspergers and HFA is pretty much on same end of the spectrum my ds is HFA the way ti was explained to me was HFA has speech delay but aspergers doesn't but i've also learnt along the way its not necessarily true they are both same end of spectrum

but again for aspergers and HFA the children can all be so different with same dx

if you have concerns then go to gp who can refer you its common if autism is in family that somewhere another child will have autism too but not necessarily same dx as other in family

how is ds eye contact, does he need routine, does he socialise with other children have you had your own concerns?

[anonandlikeit]

Hi there, I think in Aspergers there tends to be normal or advanced early language development but in Autism there usually is an early language delay.
Even with good early vocabulary its the use of language in Aspergers that is still different from that of an NT child. Hope that makes sense

I'm no expert by the way, but thats as ds2's psych explained it to me. Ds2 has CP & ASD.

Do you feel you ds has any ASD type behaviours?

[crokky]

Thanks for the replies:

-DS's speech is quite behind. I would say at 3.3, it is about a year behind.
-His actual vocab is quite reasonable, but he isn't great at constructing sentences.
-He does flap his hands quite a bit, often when excited - I don't remember my brothers ever doing this but might have read that autistic children do this (?)
-Eye contact is fine, quite good really
-He doesn't need routine, but he will do things over and over again
-I have felt that his behaviour is a little different from other children, although this is hard to gauge as he has been at home with me until going to this nursery. The majority of children have been in a nursery sort of environment by this stage so it's very hard to tell - I would have perhaps thought that he was over excited/a little less developed than girls etc...not sure really

What does ASD stand for - is it autistic spectrum disorder?

[crokky]

I don't know, it perhaps doesn't feel like Aspergers to me - he loves other children and calls all of them "friends" and is really happy to play with them, even though they can become frustrated with him when they ask him to do something and he doesn't understand. My brothers were happy just with family - they didn't want any friends, but my DS is desperate for friends.

[bubblagirl]

oh he sounds adorable bless him ASD is autistic spectrum disorder

it could be worth you taking him to gp and saying that he does do these things especially for speech as speech and language can take ages to get

he sounds like he has some ASD traits yet my ds doesnt like children the way your ds does

it would be worth going though just for speech and understanding it could be all based on lack of understanding of language but would be worth taking further for your own peace of mind an dearly intervention is always best

write down your concerns and his actions and go to gp who can put forward the necessary things to start help for you

[coppertop]

Ds2 got a provisional diagnosis of AS at 2yrs and then it was made official when he was 3.

Ds1 was diagnosed with HFA at 3yrs old.

The friends issue can be a little confusing. Ds1 had no interest in other children at all at that age. Ds2 was actually quite popular with the other children. He had a 'best' friend and also had other children that he played with. On good days you would find it hard to guess that he had AS. On other days he would shut down and want to be left alone.

Ds2's most obvious differences at that age were probably:

• Hated loud noise, particularly the sound of other children singing.

• Difficulty understanding other people talking to him. His spoken language was better but with some quirks.

• No concept of personal space. (Ds1 was the exact opposite though and didn't like people getting too close)

• Raging meltdowns when things were 'wrong'.

• Dislike of change unless given lots of warning.

• No sense of danger.

[Peachy]

Just to confuse you ds's dx is HFA / As; ths is becuase it seemed he had speech issues but SALT only did the one visit and just hinted at them.

Although you can be fairly severely affected nonetheless. Try to explain- erm-

OK:

for a dx of AS you need the triad of impairments (on NAS website)

For HFA you need the triad plus speech delays

for autism you need triad + speech + clinically low IQ

there's also PDD-NOS which is related, and some Paeds now just refer to youneger children as having 'spectrum disorder' until they're a bit older.

So a child can be AS, have very severe sensory needs and low functioning attributes and be AS; DS3 (HFA ) presents as autistic despite a decent IQ becuase he can't always access it at all.

Autism in the low functioning range is always moderate to severe due to the low IQ as a baseline difficulty, but you can be severely impaired by other spectrum diagnoses.

Does that make sense? probably not, sorry.

Anyway.....


DS1was 6, ds3 5 (but we'd been given- and lost- verbal dx's a few times before then) but the move is to dx early in order to enable any help to be put in place, such as earlybird.

[Peachy]

DS1 has 'friends' but the other kids rarely know this! he does have one friend now, but I suspect it's a mutually beneficial relationship forged on not fitting in, as the child is from Thailand and still learning English. he's a lovely kid though and immensely great with ds1, so we are lpeased. DS1 even allows him in the house!

DS3 has friends- but theya re disposable, no real relationships (if one vansished tomorow he would not really care) and alrgely older females that want to mother him as he is very toddler like. he is everyones pal but nobodies confidante,if that makes sense?

[bubblagirl]

my ds is the same has friends but doesn't care if they are not around ata ll his happy being with me and himself but does enjoy others but doesn't ask after said friends doesn't seek them out will play if put together but his an observer who longs to understand how to play

[lingle]

Hi Crokky,

Can you arrange a meeting with nursery manager to find out a bit more about his individual profile as she sees it whilst emphasising that you're happy to contact whatever professionals she needs you to? It's important not to lose sight of his individual needs in the fog of acronyms and the "does he or doesn't he have X?" debate. Find out what his strengths are - is he doing jigsaws/scanning the room for information/drawn to numbers/enjoying singing/enjoying outside activities? What's he doing with the other children - ignoring/withdrawing?

90% of the help my lad gets at nursery he got from the nursery manager taking intiative within the first month using experience of past kids with varying kinds of SN. The other 10% came from the speech therapist coming in and refining their visual timetable.

Common help provided in nurseries/pre-school are (i) loads and loads of visual cues to back up language (ii)turn-taking practice in small groups (iii) possibly one-to-one language practice.

[mysonben]

Hi, i personally think it's a bit over the top from your ds'nursery head to come out with a dx of their own. After all they are working with lots of kiddies but they are not experts for dx. If the nursery senco had said it then it's a bit different, i'd trust it more.
The head should have let you know of any concerns they have with your ds of course but not in that way. My ds has mild asd ,he is 3 1/2y old , his nursery talked to me on several occasions about certain behaviours : ds playing alone a LOT, poor concentration, not overly responsive (they told me to get his hearing checked), ds not liking to join in shared activities with other chilfren,... but they never said 'we think he has ASD !'
My advice would be to go and see your gp for a referal with a paed to put your mind at rest.

[crokky]

Thanks for repsonses -

Coppertop - that is very helpful to know that your 2 DS's got differnt diagnoses even though they are so closely related.

Peachy - thanks for your explanation. Do you know how delayed the speech has to be for HFA? My brothers were diagnosed with Aspergers because their speech was not considered delayed enough (they could say just 3 words when they turned 3 - that is far more delayed than my DS's speech).

bubblagirl - thanks for the info re friends. Interesting because my DS does ask after friends (and teachers).

lingle - also in DS's case, the majority of help comes from the nursery manager as she seems extremely experienced.

mysonben - I didn't word my OP quite correctly I think - she didn't come out with it, what happened was that i knew his speech and behaviour were not as good as the other kids so I asked her if he needed speech therapy/extra help. She said he is OK without extra help as the staff are very attentive with him, but she thinks he would benefit from speech therapy. She didn't go down the ASD route, I really pressed her and she admitted that aspergers was her gut feeling, but she thought it woudl be best for him to have some speech therapy now and then see the ed psych for further help. And thanks for the description of your DS's behaviour at nursery. It is really helpful to read about behaviour of people's DCs.

The more I think about it, I do feel that he has some sort of ASD, but I just don't think that he has enough for a dianosis of Aspergers or HFA. Peachy, are any of those other things you mentioned sort of a bit more mild than Aspergers? A lot of the behavioural things that people have mentioned on this thread are just not exactly like DS. I can see his behaviour is not "normal" but it just doesn't quite fit either aspergers or HFA for me, although it is along those lines.

[mysonben]

Crokky, apologies i've jump the gun a bit quick.

I believe some people with Aspergers can be more mildly affected than others , not all people will be showing the same level of difficulties with certain behaviours, speech,... within each group on the autism spectrum. I think the more able a child/person is the more it can varies. I mean you may find more variations of behaviours ,symptoms,... in the aspaergers, or hfa than at the lowest end of the spectrum with low fonction autism, and even thou all children will evolve, change, progress, sometimes regress, so the variations can be quite wide. That's why it's called a spectrum ...they are all different in their own way.
The term PDD NOS would be used for a child who do not tick all of the boxes for autism.

My ds was dx with 'mild' asd, the paed added ds was somewhere on the end of the high fonction of the spectrum. I do not see all the sympotoms of autism in my ds and the ones i do see only pose some mild difficulties at the moment anyway.
I hope it makes sense!

[mysonben]

Here i will add a little more, When i went to pick up ds at nursery on wednesday, there he was hapilly playing with 2 other kids in the wendy house, he will join in with the running, squealing, laughing that outdoor playing is with nursery children. But he will struggle with more complex socialising like role playing in the home corner, where his play will be very basic ie:he'll pick up the fake phone and jargon down the receiver, or sit at the kitchen table and watch , will somtimes copies what the other kids are doing but he doesn't fully engage in the playing, although he is trying hard when we observe him he has a slight lost look on his face saying 'what am i supposed to do ?'also ds has not got the concept of sharing , he will snatch the toys and refuse to share anything at nursery.
That's a bit of a problem as they get a lot of screaming from him because of it.

I wrote this to try to show you that asd behaviours can be quite subtle indeed.

[crokky]

thanks for your help - I will look up about PDD NOS and see if it fits DS more. Thanks for saying about the mild difficulties and the playing as I can recognise that sort of thing in my DS more than the more obvious main things they say for aspergers.

[bubblagirl]

my ds is 4 and at 2 we took him for not speaking a lot only had about 10 single words by 3 was only talking in single words and understanding of language was at 2 yr olds level by 4 his language is nearly where it should be and understanding of language is improving hugely

he has atypical speech he cannot do a lot of speech sounds but apart from that nearly age appropriate this came on over night from 3.6 his sentences started at 2 words at 3 so we was roughly a yr behind on speech

he was dx with HFA at 3

he does have interest in other children but as is ay he'll ask after them if they are there and wants to know other childrens names etc but has no concept of play and tends to stand back and observe but he has 1-1 who helps and apparently he enjoys playing with other children with the help but isnt worried by playing by himself

it is hard when your unsure i felt my ds wasn't ASD and i was fitting him in all sorts of categories but it hasnt changed who he is and with the help its hardly noticeable at all that my ds is ASD he can play with help and interact he doesnt behave badly he is actually very quiet and calm he loves running so can interact with children by chasing etc he will play up if he doesnt get to do something of his own choice he'll get upset and try to push staff away from him

but they have now and next board and with this he is able to understand the structure of the day and gets on fine

[amberflower]

My DS sounds similar in some ways...i.e. he is very aware of other children, for example knows all his classmates' names and can tell you who plays with who, who is naughty etc etc, will always be pleased if we happen to meet one of his school friends outside of school ('oh look there's so and so, mummy, they're from my class, shall we go and say hello' - but won't actually instigate the saying hello unless I prompt him).

He does role play and interact and make up games but in the group environment would probably withdraw a little...he does more role play at home and loves copying what we do i.e. cooking, DIY etc and making up his own games, but at school I think would only role play if it was something like make believe car racing or 'goodies and baddies' type games, rather than the home corner. Mind you that could be just because he is a boy!

He does also have some friends at school although I think is generally a bit on the sidelines...very very happy to run around and play games in the playground but tends to be a bit more isolated in 'free play' time in the classroom, although interacts beautifully when it's a small group adult led activity and is described by his teacher as 'delightful' on a one to one basis. He is never disruptive or wilful, like your DS bubblagirl he too is very quiet and in the classroom just seems very shy. What breaks my heart is that already he is very aware that others make friends and interact more comfortably that he does and I am always getting comments like 'I played on my own today mummy because no-one wanted to be friends, I asked if I could join in a game but they said no'. That makes me more than anything else, I'd almost rather that he wasn't bothered in many ways.