autism question again

[maggiems]

Can I ask a few autism questions? I have been looking back at older messages relating to this issue and have found myself getting more confused that I was already. I had mentioned some concerns a while ago but had recently decided that there was no way that one of my nearly 4 twins ,Ds2 was even mildly autistic as he is sociable and communicative , but sometimes when I see some of the messages I get a bit paranoid again.
My questions are : I had always thought that if a child plays in a imaginative way that this would imply that they were not autistic as it is one of the areas that an impairment has to occur . I thought that autistic children couldnt play imaginatively because they couldn?t put themselves in another persons shoes. Yet I saw on some previous responses to messages that those who responded felt that autistic children can play imaginatively and pretend to be other people . How does this work? I had been concerned that my DS2 didn?t play as imaginatively as DS1 who narrates stories non stop. However DS2 roleplays and turns sticks into fishing rods etc and used things like toy phones from an early age .I was happy that he was playing imaginatively more and more and then I see that you can be autistic even if you do this? I think I started to think , well what is imaginative play? Is an example where you turn something that resembles something else into that thing, like a stick into a gun or does the fact that it has the shape of a gun to begin with, mean that its not really imaginative play , its just a child noticing a resemblance?

I am also curious about Aspergers. Whats the difference between HFA and Aspergers? Is it that language develops better in someone with AS? I noted that AS is not normally diagnosed until a child is 7 or 8. Is it not noticed because language develops ok and the other signs such as lack of social abilities and communication skills are still there but less so than a person with classic autism? Also would a child with AS also not do the pointing thing or would they develop this skill later on in a spontaneous way or would it be something that would have to be taught. DS2 was about 19 months when he started pointing and I think he may have done it with the while hand for a while. However soon he was pointing things out with his index finger

My last question is would an autistic/as child normally be non communicative and unsociable with adults as well? I know that the big issue is how a child deals with his peers but would an AS/autistic child be more likely to have problems conversing with adults as well? My DS2 didn?t play with other children as early as his twin but now initiates play more

Sorry for the number of questions. They have been niggling at me for a while and I would be interested in hearing what people think. My worries stem from when he was a baby/young toddler and have not been able to shift them completely.Sorry for hijacking the SN board.

[coppertop]

I think the difference between my boys' imaginative play and that of other children is that the games never seem to develop any further. Ds2 (2.3yrs) will have a pretend tea party now that he has been taught how. He will pour pretend tea into cups and pretend to drink it. The game never goes further than this though. There is no made-up story about teddy turning up and wanting a biscuit or dolly going home etc. It follows a strict script - pour tea, pick up cup, pretend to drink, put cup down. Ds1 (nearly 5) can spend ages pretending to be spiderman. He will run and jump and pretend to shoot webs but again that's where it ends. He doesn't say "You be the Green Goblin and I'll pretend to try and knock you off your glider" or pretend to chase imaginary criminals.

Ds1 is classed as HFA because his language developed late. If ds2 gets a written dx it will probably be for AS as although he had to be taught how to point etc he started using language by 2yrs old. A lot seems to depend on the Paed and how strictly they follow the criteria.

Both of my boys interacted with adults long before they showed any interest in children. At pre-school ds1 started by communicating with no-one, then with the staff and then eventually with the other children. Ds2 can be very sociable when he wants to. His eye contact isn't that great but he does a lot of smiling and giggling and will attempt to show people the lights at every opportunity.

[RnB]

Message withdrawn

[binkie]

What about co-operative play, where children build on each other's imaginations? Does your ds2 do that at all? Though at not quite 4 he might be a bit young to say, I suppose.

It's one of the strongest things against my ds (who's otherwise got a question mark over him) being AS - he enjoys joint make-believe, where you're all members of a pod of whales, or crew of a ship, or running an ice-cream cafe. He's certainly happiest with a familiar theme, but within that he does seem to be able to go with the flow of a shared game. He's just 6, by the way.

[macwoozy]

My ds was first diagnosed with HFA when he was 3, but just lately he's being labelled as Aspergers. His communicative speech was non existent when 3, but now his speech is above average. So that area of diagnosis confuses me as well.

Likewise, I often have to question his imaginative play, my ds also has never pretended to feed his teddy, or even have a pretend conversation with it. His pretend play is also very repetitive, he's latest thing is dressing up in his policemans outfit, and handcuffing us and taking us back to the 'police station' but it ends there, it never varies.

My ds is very sociable with other children in areas such as parks, in fact he doesn't understand when he's not welcome, but in places such as shops, he hates being greeted by anyone, children as well as adults.

He's now 5.

[beccaboo]

My ds is 3yrs 5mths and was dx-ed in Jan with ASD. He seems to have quite a good imagination, and often pretends to be a monster, dinosaur etc. He also like pretending to be a doctor/fireman.

He has a little village playset and he will play for ages with the characters - they have accidents, go to bed, drive their cars and have conversations with each other. I was amazed the other day to see him acting out something that had happened to us in real life - our car had broken down, and he has three little characters pushing a toy car onto the 'pavement'.

I think what dinosaur says about social imagination is right though, ds never puts his toys to bed/plays mummies & daddies/feeds them etc. He CAN do it if told to, but wouldn't choose to do it. He also finds it hard to expand a game past the first stage or add his own elements into it, and finds it almost impossible to include another child in a game. He finds adults easier to deal with - our paed told me this is often the case because kids find other kids unpredictable, whereas adults are more reasonable and easier to 'manage'.

The HFA/AS thing seems to be a very murky area. It seems to depend on the person making the dx as much as anything, there's such a fine line. Our dx is 'ASD', which covers the whole spectrum including autism, AS, PDD etc.

I think they want to wait and see how things develop before giving us a more precise verdict. But I was told that he wouldn't be given a 'high functioning' label at the moment because he still has some language problems. I would have thought that without the language problems he would have been AS? Confusing!

[maggiems]

Thank you for your responses. I'm glad even the experts find it confusing. MY DS pretends to be other people like a doctor/monster etc. He will say things like "You be a monster too Mummy" or tell his twin to . He talks to his toys too, not a lot but not really less than his twin. He does put teddies to bed and I think spontaneously, although with twins its hard to know if he has seen his twin doing it too. He does seem to join in with DS1's stories. For example one might say lets go to the sweetie shop and they will pretend to go around the garden on the bikes and then get off and pretend the house is the sweetie shop and I have to be the "shop lady" . DS2 is actually the more sociable twin. He has always been really friendly to people and people actually comment on how friendly he is, even the nursery school. However as I said DS2 played directly with other children at an earlier age. However even as early as last year when they were just 3 I can remember DS2 asking another child to some into our caravan to play when we were on holidays . At that stage both boys had little exposure to other kids.Now the boys intercat well with each other and have lots of conversations mainly about their favourite topic, cars. I am probably over analysing everything. Everyone else would think I was completely daft if they knew my worries

[maggiems]

I was re reading this again and I suppose I?m still a bit confused about the ?social? imagination thing. I suppose I don?t understand how pretending to be a policeman is not that imaginative but putting a teddy to bed is? Is it that pretending to be a policeman is likely to be something that a child has seen on TV but that putting a teddy to bed is more creative and social? I remember reading a message where someone said that their child rarely played out an imaginary scene unless asked or unless the event had actually happened to them in the past. Its quite difficult to work out whats really imaginative! I also remember reading an article about imaginative play where it was divided into different areas depending on age. It said that very young children are not capable to making a stick anything other than something it closely resembled as their imaginations at an early age restricts them and they can only work with what they see. As they get older they can attach meaning to objects and be more inventive. However I would have thought that most children , even older ones would be more likely to turn a stick into a fishing rod rather than a car. Dinosour,, do you think that seeing resemblances in things and turning that thing into the thing that it resembles is anyway imaginative?. I remember Jimjams saying to someone that if their child could turn a stick into a gun , then that was a good sign. Maybe its just the beginning of imaginative play? Another thing he does is pretend he has keys to start a car or turns an imaginary timer on an oven . He would also bring me an imaginary plate of food to me . Is that good? Oh dear rambling again

[sophy]

With my DS, 6, with mild Aspergers, his obsession was trains. He could play for hours with his train set, acting out episodes of Thomas the Tank Engine he had seen on TV with dialogue almost verbatim, giving the appearance of imaginative play, but wasn't able to invent any new adventures. A girl from his school came round the other day and wanted to play 'princesses' where he was the prince and had to rescue her from the dragon, and he hated it, in fact refused to do it! At his music group when he was younger he would refuse to pretend to be a rabbit going to sleep, for example. He has never enjoyed dressing up and pretending to be something else. But could spend three hours painting a cardboard box to make it into a train. And he can play imaginatively if guided by an adult in a familiar scenario, i.e. a pretend birthday party. But he wouldn't be able to do it on his own. hope that makes sense.

[Davros]

Very interesting thread and all very confusing! One thing I've said on MN before is that I've noticed that at least two people I know with AS have VERY vivid imaginations to the point of being "inappropriate", i.e. difficulty separating fantasy from reality. Sorry if this doesn't help!

[Saker]

I have found this very interesting too, especially as the ASD question mark hangs over my ds2. I am interested in the thing about social imagination - would the individuals you describe with very vivid imaginations have that sort of imagination Davros?

[onlyjoking9329]

the difference between AS annd high funtioning autism.... i went to an autism conference once and a speaker addressed this very question and she said the difference is...the spelling, uummm i am not so sure, to get a DX of AS then there has to have been no language delay whereas with high functioning autism there will have been a delay in speech.

[Jimjams]

It is confusing. Ros Blackburn says that AS and autism are so dfferent they shouuldn't even be lumped together! They do share a lot of issues eg sensory problems etc- but I don't think many are tightly diagnosed iyswim. One valid point I thougt Ros had was she said that people with autism basically didn;t care one bit what other people thought, whereas people with AS cared too much. Which I thought was possibly a rather true generalisation and quite interesting.

[monica2]

Hi maggiems I can understand you being confused but I would not get too hung up on the whole imaginary play issue. The diagnostic criteria for AS does not make any reference to specific imaginary play, however one of the qualitative abnormalities are lack of spontaneous seeking to share enjoyment/interests with other people (lack of showing/bringing/pointing out to other people objects of interest to the individual). Lack of imagination also refers to a number of other things such as lack of theory of mind (ability to infer other people's mental states (thoughts, beliefs,desires,intentions etc.) and the ability to use this information to interpret and respond appropriately. A person with AS may be more motivated to do this but still has difficulties in this area. ASD people can learn in a rote way how to react/play etc. and I think it is important to remember that these difficulties are described as IMPAIRMENTS for diagnostic purposes and are not absent all together.

There have been many studies into the differences between HFA and AS the outcome being that they are more the same than they are different. AS is less likely to be diagnosed for children whose early development was not consistent with classic autism. A label of ASD is only really a tool to access the help needed for the child IMO and many areas still do not have the knowledge/training to provide services for AS individuals which is why some clinicians diagnose HFA.

I hope this is of some help and I have not confused you further, I would suggest keeping a diary of any of your concerns for the October meeting so you that are able to give as many specific examples as possible.

[YAH]

DS1 actually showed imaginative play during his diagnosis assessment. (He walked a doll up the stairs in the dolls house). However, this did not constitute imaginative play as there was a poster close by showing 'Winnie the Pooh' walking up stairs, and therefore DS1 was just copying what he saw. Lots of children with autism have imaginative play, but it tends to be either obvious (using a resource in a predictable way), or learnt, (copying others). We were told that this does not constitute 'true immaginative play'. So it is certainly very confusing.

[maggiems]

Thanks for all your informative responses. Although its all a bit confusing I think i have a better idea of what its all about. I noticed DS1 talking to his toy tiger this morning and from your messages I now know that this is good stuff.Thank you Monica2 for reminding me not to focus too much on one specific area and that the issue of pointing is so important. Just one last question. Would a child with either AS or ASD sometimes learn to point appropriately without intervention , ie maybe later than average but without being taught. My DS2 was a bit later than normal but when he did so , he did it properly . Thankfully i didnt know at the time that this was an important factor
Monica2, I dont know what you mean about the October meeting . I assume you got me mixed up with someone else.

[Davros]

Saker, I'll tell you what the two people I know are like.
The first is the son of a good friend who was dx ASD when he was very young but has been reclassified as AS, confusing as the first dx was due to poor language developmemt so can he be AS???? I don't see a lot of him but the last I heard was that he had his own imaginary planet and it has its own language. I heard him talking about it and speaking in the "language", all very sweet and entertaining but actually a bit scary! He was also very interested in different parts of the world, the atlas, where people are from, what language they speak.
My sister who is 48 has always had a problem with separating fantasy from reality. She will hear or read something that happened to someone and the next thing you know you are hearing a modified version of it as if it happened to her. We just used to think she was a bloody liar but we now know she genuinely believes what she's saying. its usually something minor like so and so said X to her and she told they Y (usually in no uncertain terms!) or she'll get an idea about something and starts talking about it as if she knows about it. I don't really have any contact with her so this is going back 5 years or so but she was always like it.
I am going to an NAS meeting on Saturday (lucky me) so I might ask some of the very experienced people there about it (Mike Stanton will prob be there and possibly Lorna Wing but she's a bit scary too!)

[Saker]

Davros, I think that's very interesting. However could the planet be a bit like the Lord of the Rings type of story or Star trek type things, where every detail has to tie up and it's almost a scientific exercise in creating it perfectly. For example would he be able to imagine how the people on that planet are feeling, what they might say if one of them died etc etc. I really don't know and I'm not saying it's not imagination, but whether it's the same sort of imagination as a child pretending her doll has hurt its knee or something like that.

With your sister, it might be less to do with imagination than her ability to process and sort information properly? What you describe my brother used to at the age of about 8 or 9 although often he would make up a story that he would like to happen rather than get it from someone else, and then seem to forget that it wasn't real. I think that's common with children but they should grow out of it. I really have no evidence to support my wild hypotheses and you have loads more experience of autistic people than me, but it is very interesting.

In the case of my ds2, his imaginative play can be quite limited and he can get quite stuck on certain ideas. At the moment, everyone and everything has to fall into the water. However, he does have certain social aspects to his play, he takes his doll in the pushchair to the zoo, his animals take turns at jumping in the water and he describes them as friends, mummies and daddies and babies etc. But his imaginative play is definitely not up to his peers so I guess it could still be described as impaired.

[beccaboo]

Maggiems, what is it about your ds that is worrying you? Are there specific things, or do you just have a gut feeling that there's something different about him? I guess you are in an unusual position because you have a twin to compare him to.

[Davros]

Saker, the boy with the imaginary planet was only about 5 when I heard him talking about it! But he was very rigid about it and I found him a bit annoying
You're right about my sister, its that silly sort-of attention seeking thing that children do and is probably somewhat experimental but she hasn't grown out of it and she doesn't seem to know that its not really true!
It is all very interesting and I've mentioned these two before as I find that often people assume that someone with "imagination" is not on the spectrum but, again, its the level of inappropriateness in that area like many other.

[Saker]

Wow, I'm impressed by the 5y old who could invent his own language - I assumed he was in his teens . But there is a certain type of bloke who likes the Lord of the Rings type of thing and it's a bit like knowing every detail about a certain type of car or something. I'm not explaining myself very well. I love novels and stories but I hated Lord of the Rings (well what I read of it ) and it's because there is no characterisation or emotion, clever as it is.

I didn't mean children necessarily do it for attention. But I think for children the line between real and imaginary is very blurred. I suppose as processing and memory mature this becomes less the case. I only meant that perhaps that doesn't happen as well in an autistic individual so they have more trouble sorting out reality and imaginary.

Either way it's clearly a very difficult area and not at all clear cut.

[Jimjams]

HI christie

Ros Blackburn is amazing!

[Chocol8]

This is an interesting one and I have learnt so much just reading this thread.

My ds has a dx of AS and could speak really well from a very early age - parents and friends used to say all the time "doesn't he speak posh/well/like a grown up". I never really noticed it until he started school and heard his peers.

He does seem to have imaginative play (and tucks his teddies into bed every night without fail) and does seem to empathise with them sometimes too.

It has been mentioned by CAMH that he may not be AS due to his empathy, but besides this he ticks the AS boxes in every other respect.

He does not seem to recognise reality from fantasy either, often getting confused over dramas/soaps and reality programmes. He will check to see if they are actors although he is still confused by this and often asks. He does seem to prefer adult company to his peers as adults will listen and respond instead of ignoring him.

Thanks for the thread - very interesting.