Is anyone the parent of a child with asd and not seeking a diagnosis?

[coodawoodashooda]

Not looking for a bun fight. Just trying to sort out my thinking. Anyone with any of their own insight that they'd be willing to share?

My DD’s school insisted on a psychiatrists diagnosis, not psychologists.

@WahineToa Interesting. My DS's diagnosis is from a clinical psychologist and SALT.

You see, I think in your current situation your ASD does “limit and impair everyday functioning”. If it didn’t you wouldn’t have to think about being limited to WFH because of your ASD. I think just because someone is functioning well in an environment they have found meets their needs well doesn’t mean their everyday functioning isn’t limited and impaired.

@AutiMum that all sounds bizarre. Both of my NT kids were/are speaking in fluent sentences before 2 - it’s not the norm but also not that uncommon. Just because some autistic people are intelligent does not mean that intelligence is a sign of autism 🤯

@AutiMum my 2 autistic DC were the same with Thomas. I am also autistic and as a result happen to have a very good long term memory, so I can still recite all the characters.

But loads of kids love Thomas and could tell you all the character names! Hardly unusual.

Obviously context is everything here but it sounds very odd to me.

@Ifyouknowyouknowyouknow I think the difference is the intensity, repetitiveness and restrictiveness of the special interest. The same with things like numbers, advanced speech, echolalia and hyperlexia. You have to take the specifics of the individual’s situation.

Yes, that’s why I said context is everything.

But @AutiMum didnt say the psychologist noted her son’s obsession with Thomas, but rather picked up on the fact that he knew all the character names. If that is all then it seems a bit of a stretch to me. Perhaps there was more to it than that though.

@ParrotPoppy

My DS doesn't have echolalia and doesn't have special interests. He has a wide range of interests, of which Thomas was one of them. Yes he intensely likes Minecraft, Roblox, Pokemon and would love to sit on his iPad all day, but he enjoys a wide range of topics and hobbies. His psychologist report also states he does not have repetitive or restrictive interests, she tried to ask him about one of his interests as part of the assessment and he wasn't interested in discussing it 😂

@Ifyouknowyouknowyouknow The psychologist specifically stated there was no evidence of 'obsessions'. The only early indication was high intelligence and that is literally all that his report states, plus all that was fed back to us in the feedback session. She said that being able to count to 100 before 2 is 'abnormally intelligent' plus the other ways he was clever.

It would be highly unusual for autism to be diagnosed by a psychiatrist. That is usual for ADHD.

Yes, two of my dc showed signs later but then looking back at their early development the signs were there.

autimum, I’m really interested, do you think a child with adhd would have those independence and organisational skills? The two I have couldn’t organise the proverbial. But I’m aware that they’re not all the same.

My DD knows the entire dialogue including sound effects of Coraline the movie, and episodes of certain comedy shows she likes. I’ve never seen anything like it, despite being around lots of different children who have the usual childhood TV or film obsessions. Even in her 20’s she still watches these things too, we ‘have’ to watch Coraline every birthday and often repeats the script word for word at the same time. It’s the intensity and knowledge of whatever the interest or obsession is that is really just, different. Noticeably.

Something for those with diagnosed children who they think don’t appear too challenged or affected at a young age, remember young children are often keen to please the adults and will ‘mask’ a lot, this takes enormous energy and concentration to do. A diagnosis early can stop this and allow them the freedom to be themselves and not feel like they need to keep masking. My DH calls it ‘assimilating’ and he and our DD laugh about it, but it’s quite sad when I think about it. That’s why I got cross at her teachers who would say ‘ oh but we see she can communicate properly so we are trying to get her to do that all the time’!!! No!! Don’t do this!! It’s exhausting and confusing!

It would be highly unusual for autism to be diagnosed by a psychiatrist

it’s really not. Quite a lot of parents I’ve spoken to have had psychiatrists diagnose their kids too and some schools insist on it. We had a private well respected clinic do it, our school paid for it.

In my region of Ireland the diagnostic process is very indepth, parent interview, SLT, o/t and psychology each assess the child, school /creche visit by psychology, contributions from teacher and then results from the team are collated to form a diagnosis or not.
Its very difficult to access services or help at school with a private psychological assessment.

I’m not an expert but it doesn’t sound like your son met the diagnostic criteria so I’m surprised he ended up with a diagnosis.

There would have been more to it though as it was part of a picture of the poster’s DS being “abnormally intelligent’. The decision isn’t made solely on the basis of knowing Thomas characters or early speech.

How is being abnormally intelligent in the absence of restrictive or repetitive interests relevant to a diagnosis of autism?

@WahineToa See, my DS doesn't have interests like this, or even close to this level of interest.

I can only go by what the psychologist report states, which is that he does not have restrictive or repetitive interests, but does have sensory differences (e.g. sensory seeking which manifests as hyperactivity) which is why he was diagnosed. Sensory differences was only recently added to the DSM-5 criteria for ASD, otherwise my son would not have been diagnosed.

I didn’t mention the absence of restrictive and repetitive behaviour in my last post, it focused solely on the “abnormally intelligent” part. Some signs of being “abnormally intelligent” can be an indicator of autism so yes it is relevant. To use two other examples, hyperlexia is often relevant to a diagnosis of autism as is young children with a presentation like what would have been diagnosed as Asperger Syndrome often being described as “Little Professors” in part because of their “abnormally intelligent” presentation.

Although, in the case of @AutiMum‘s DS he has sensory differences so he does have “restricted and repetitive patterns of behaviours, activities or interests” as that encompasses sensory differences.

@AutiMum

Was it a Psychologist, or an Educational Psychologist who did the assessment? There's a big difference in their roles and 'who diagnoses what'

For Children, Autism assessments were often carried out by a team and until this latest huge backlog, many still were.
The team consisted of Paed, Ed Psych, SaLT and OT. All of them interviewed the child in different settings, saw parental and schools input, then got together to review their observations and only then, if all agreed, a diagnosis of Autism would be given. The diagnostic reports were comprehensive.

Neither SaLT nor OT were able (qualified?) to diagnose autism but they could diagnose other conditions alone e.g. SaLT could diagnose Semantic Pragmatic Language Disorder and others, OT could diagnose Sensory Processing Disorder (in the time before it was incorporated into an autism diagnosis) and Dyspraxia among others.
Ed Psych was usually the one to diagnose dyslexia.

A Psychiatrist alone can diagnose ADHD etc. but that's because with that comes medication advice and prescription.

My DD is adult now, and adult diagnoses are carried out differently, so maybe things have changed.

@ParrotPoppy The only early characteristic that the psychologist highlighted was intelligence though, there was literally no other early factors. That's all she says in the report, 'in my opinion there was early developmental signs of ASD, as evidenced by an abnormally high intelligence.' Even nursery didn't point out anything different with his development, and he attended full time from ages 3 - 4 years.

Ours was a psychiatrist’s diagnosis at CAMHS - they were checking out for ADHD because often ASC and ADHD are found together, but DC doesn’t have ADHD.
I would definitely concur with the thing about a good environment with a lack of aversive stimuli can make ASC almost imperceptible. I believe that’s what we should be aiming for and why a diagnosis is so helpful. It’s much easier to ask for accommodations if you have one.

@BlankTimes My DS was seen by a Clinical Psychologist and SALT, that is all. He wasn't seen at school or at home, only in the office for an hour for the ADOS assessment. Then there was a questionnaire filled in by both myself and school (he didn't meet the criteria from the school one), and an early developmental interview with me where the Clinical Psychologist asked a series of questions, lasting approximately an hour.

Nursery not picking it up doesn’t necessarily mean anything. Many schools don’t ‘see’ it.

Nursery thought one of mine had normal imaginative play, what they didn’t pick up on was it was scripted replays of real life events they played out time and again. Even when I pointed out they didn’t see it straight away.

Sorry I know this probably seems
overly pedantic, but hyperlexia without comprehension is an indicator of ASD, not just the ability to read at a young age. Being a “little professor” is a description of a child with the kind of restrictive intense interest and potentially also the overly formal communication style that are also part of the diagnostic criteria, not just being bright and knowing some facts.

I don’t think it’s fair or correct or helpful to people with autism or people with high intelligence to conflate the two things and it’s worrying that this language was used by someone conducting a diagnostic assessment.