AIBI to ask if this behaviour can be neurotypical?

[Ihaveneedofwaternear]

My DS(6) is waiting to be seen by the pediatrician due to quite severe motor and verbal tics that come and go. He's been seen before for ASD assessment when he was 4 (nursery expressed concerns about play, endless counting/lining up, lack of interest in peers etc), but he was too young to say and after he started school there were no concerns so I turned down the follow-up appointment (which I feel bad about now).

It would be CAMHS who would see him for autism diagnosis, not the paediatrician. I'm wondering if we should stay on the list for the paediatrician or go to CAHMS instead.

I'm wondering because I was saying to my friend that I don't feel like he could be autistic because I think the way he can use language/communicate isn't something a child on the autistic spectrum could do. Maybe this is a terribly old-fashioned, stereotypical way to think about it, I feel embarrassed that I might offend people by saying this, but I thought impaired social communication was a big part of the diagnosis. My friend said I should think about it the other way - are the things he does something a neurotypical child would do?

I find this really hard to judge because he is my eldest. So I'm wondering, do neurotypical kids get obsessed with one thing and talk about, do, or watch only that thing until the next thing comes along? I feel like this is actually fairly common for kids.

Example of his interests have been the alphabet, numbers (this was CONSTANT for about two years, and he's still massively into numbers), stacking cups, dominoes (lining up/building), space. It can also be watching one show/film (or even one episode of a show), and listening to the same album or song over and over. At the minute he's into Minecraft and pi. He's been writing the digits of pi out and repeating them the last few days.

Does this sound like something your neurotypical child would do, anyone got any examples of their kids behaving like this? I also think he might stim/show some sensory seeking behaviour? Can this be the case in neurotypical children? Sorry if any of this sounds really ignorant.

When I write this stuff out I know it sounds really obviously neurodivergent, but then there are so many things he can do (change routine, no massive problems with clothes or food, apart from not liking wet/mixed food, he can do imaginary play, even if he doesn't tend to).

He is quite an anxious child, which is my main concerns, and I just want to get him the right support from the right place because waiting lists are long!

What parts of language and communication are you referring to that you do not think an Autistic child would be able to 'use'?
My twins are both Autistic; it is often remarked in school how 'advanced' their vocabulary is and how well they express themselves.
You do sound as though you'd benefit from researching different presentations of Autism.

I can’t think of any neurotypical 6 year olds who enjoying writing out pi on repeat. Lots of children with what would have been called Aspergers, can often have very advanced language/ reading skills. The difficulties there experience with social communication are more subtle - understanding irony/ sarcasm, nuance for example.

He sounds lovely though! And an ASD diagnosis won’t change that, just hopefully help him understand himself better and for his school to support him better.

There does sound like there are traits of neurodivegent behaviour.
For what it's worth my 6 year old autistic daughter adores imaginative play is very sociable and while her speech was delayed it is just slightly below average now.
She has no problem with change in routines and will wear anything.

My ASD DD has no issues with food, clothes, doesn't need routine and has great communication. She's still Autistic.
The CAHMS waiting list is years long.

He is, he's absolutely gorgeous and I could eat him for dinner. I just meant that he uses sarcasm (or tries to, and he understands it), he can use language inventively (e.g. pretending to his younger brother that he was going to bed when he was really allowed to stay up later), he can pick up on subtleties from my tone, etc. Sorry if my comments are ignorant @Crazycatlady79

He is a very advanced reader for his age, and several school years ahead in Maths.

Thanks for those examples, I think that's what I might need to hear. I think my understanding of what autism is and how it presents is really off the mark...

It's quite normal for children to have things they're really interested in, or favourite films/books that they want all the time. It's impossible to say whether yous son's interests are unusually extreme without knowing him. I think your use of the word CONSTANT indicates that they might be more extreme than is common in NT children.

Do these extreme interests form a part of a more broad range of interests are they bordering on obsessions?

Sounds a lot like my eldest who has been diagnosed level 1 autistic. He was fascinated by the alphabet, shapes and numbers from a young age and knew his alphabet at 2 years old. Counted everything (preferred to count fence posts over seeing the animals at a zoo at age 3), he still loves numbers and is advanced for his age with numbers/maths. He also does not like most mixed or wet foods. Food cant be touching on his plate. He communicates well (slight speech issue with the letter s and calls everyone 'he'/doesn't seem to be able to tell boys and girls apart). He wants to play with other children but the issue is he wants it to be his way, he wants to be in control, he wants to always be first (sounds very neurotypical but combined with other symptoms enabled us to get a diagnosis). He can struggle with working out what facial expressions can mean. He has sensory issues, hypersensitive to pain, doesnt like labels in clothes, wont wear socks with holes in (or the start of holes). Dominoes is one of his favourite toys too. Mine is almost 7.

So depending on how yours socialises they could have level 1 autism.

I'm wondering because I was saying to my friend that I don't feel like he could be autistic because I think the way he can use language/communicate isn't something a child on the autistic spectrum could do.

If you had a conversation with my eldest child, I think it would take you a while to realise he’s autistic. It’s becoming more ‘evident’ as he gets older because his topic of conversation and speaking mannerisms are becoming more echolalic and not maturing like his peers, but at 6 you’d have had a harder time if you follow stereotypes of autism.

So I'm wondering, do neurotypical kids get obsessed with one thing and talk about, do, or watch only that thing until the next thing comes along? I feel like this is actually fairly common for kids.

You need to look into what a hyperfocus is. And no, NT kids do not get obsessive (which I take it to mean he will not move away from his special interests for other things).

Example of his interests have been the alphabet, numbers (this was CONSTANT for about two years, and he's still massively into numbers), stacking cups, dominoes (lining up/building), space. It can also be watching one show/film (or even one episode of a show), and listening to the same album or song over and over. At the minute he's into Minecraft and pi. He's been writing the digits of pi out and repeating them the last few days.

I wouldn’t diagnose your son online, but these are almost identical to my own children’s special interests. Numbers are a form of stimming for some autistic children, the pattern and repetition is soothing. As are other forms of repetition.

Personally I would ask for a paediatric consultation over CAHMs, especially considering his age. But there’s certainly enough evidence of ASD traits in my opinion/experience.

I’m not sure when or where you child was diagnosed, but ‘levels’ are not given as they’re considered inappropriate, much like the term ‘high functioning’ which is also out of date.

Oh and mine is usually okay with change in routine as long as he is forewarned (he has been able to read the time for well over 1.5years now so no cheating him by trying to switch a little early though 😅

My DD’s language skills scored at a 18 year old level at the age of 4. She was diagnosed with Aspergers (now diagnosed as high functioning autism). She’s now 20 and at university. Yes it’s possible and the interest you mention are typical ND interests.

In Sweden about a year ago, his paperwork states levels and I find using levels far more appropriate than high/low functioning.

This.

Can he talk to others about their interests too, or does he think his interests are not important?

Does he talk at you, or to you?

Autistic grown up with an autistic child here and our communication is absolutely fine. Both above average intelligence. Both obsessed with special interests both incapable of eeading social cues. Both overwhelmed by stimulation. He sounds like he warrants further investigation.

I have 2 neurodiverse children and work in neurodiversity support. Autism is a spectrum because the impairment can be so relatively mild that unless you really knew the person, you wouldn't see anything different, or it can be an individual who needs help with absolutely everything. And the whole range in between.

It sounds like your ds would certainly benefit from assessment, if nothing else so those working with him can have a thorough understanding of him and his needs. It may be in a good day, you wouldn't see him as any different to his peers, just a little quirky in his interests. But on a bad day he may struggle to articulate his needs and anxieties and spiral into meltdown.

Dd2(12) has social communication disorder and just doesn't get how to interact with her peers appropriately. Social language baffles her. Routines are essential and change results in explosive outbursts.

Ds1(14)'s version of imaginative play was to act out his favourite episodes of his favourite tv programme. Even now Thomas the tank engine is engraved into my brain!

The people I work with vary so much. It took 1 person an hour to feel comfortable enough to converse freely with me. They don't know how to end a conversation. Another is incredibly eloquent but unable to pick up on anything other than a direct instruction. Inference is impossible.

So, there are so many different things it's whether it would be in his interest to pursue assessment. And knowing the state of secondary schools, while this is a way off, this is something you are going to want to know before then. Unless you plan on homeschooling. Secondary schools can be awful places for nd kids who don't know why they don't fit in with their peers. By doing the research now, you'll be in a stronger place to fight for his needs as he gets older.

Hi @Ihaveneedofwaternear
This might be of interest.

exceptionalindividuals.com/about-us/blog/6-common-myths-about-autism/

Autism is simply autism. You can have autism with a learning difficulty, autism with a spectrum of needs but there isn’t such a thing as ‘level 1’ ASD. I still can’t believe there are people (especially in the medical community) who think that autism is a scale from ‘very autistic’ to ‘just a touch ASD’. It’s so undermining. But that’s digressing.

Despite the insistence of many over recent years to say ASD is ASD, most practitioners and professionals working with children prefer and understand different functioning abilities, the levels (if you like) and high functioning was appropriate and important and well understood

In other countries they refer to these and I suspect it wont be long i this country before the language changes to reflect the differences again.

The term ‘functioning’ is completely inappropriate, especially when it comes to children because it’s based on the idea of how much you can achieve academically. It completely disregards what autism actually is, and it’s the very reason why those diagnosed with ‘high functioning’ autism are highly likely to have a burnout/MH breakdown by their 30s/40s and actually slide fully down the imaginary scale into ‘low functioning’ adult.

Is he struggling in life? If he is not struggling in three particular areas (triad of impairment) then he wouldn’t need a diagnosis.

Kids are all different and yes being obsessed with certain things can be in the realm of typical as well.

He could also be high IQ, which can present in a similar way, of course he can also be both

There is a subtle difference with my DC and I don't think many people would notice one is ASD, very imaginative and great language skills but there are several subtle sensory things and an awkwardness about his social communication. I wondered age 4/5 but didn't see enough signs (that I knew of) and we got diagnosis through CAMHS aged 7 (once we were in the process and discussing behaviours then it became even clearer and more obvious and I now notice loads of things that I didn't think of before). I would get into system and investigate - good to know in case of future issues and has given me the confidence to parent differently in the way that works best for him but that others can judge

Neuro typical children can indeed become hyper obsessed with one movie or one song or toy for example. The tics could even be Tourette's.

Does he hold a conversation with you and understand your point of view if it's different from his?

The traits aren't quite as straightforward as they sound. You say your son has intense interests. Does he talk to you and his siblings about them a lot - even when you're not really interested? This is a lack of social skill which is much more noticeable outside of the home. Is his language very formal or advanced for his age? Does he have an accent? I always thought that my daughter was fine with change until I realised that her being crazily hyper before any trip away wasn't excitement but a form of anxiety. She can cope with all sorts of change but once she has plans she really struggles when they get changed.

But the levels refer to their needs? Level 1 low support needs, level 2 medium, level 3 high support needs. There needs to be a way when communicating with schools and medical staff etc. to communicate their level of needs, whether by saying level 1/2/3, low/medium/high support or detailing at length all of their nuances. I don't use the outdated functioning terms and will often just say he is autistic (at the dentist for example as well as on mn usually) but in this case felt the OP needed it to be clear that there are levels of autistic communication and they should not completely rule out ASD due to a misconception that all ASD requires difficulty with language/communication.