Or is my hyperlexic 3 year old actually neither ….

[ForWorthyTiger]

Autistic OR ADHD?

First of all, I know we can’t armchair diagnose, but I’m wracking my brains right now with my puzzle of a 3 year old little boy.

Theres my gut mum feeling that he’s without a doubt hyperlexic, hence excellent decoding skills but communication difficulties and poor comprehension. That all makes perfect sense. He fits the description for hyperlexia on almost every single front apart from the fact that he is more a sensory seeker than avoider. He also follows the trajectory; regression at around 18 months, early letter / number / shape recognition (could count, recite alphabet and recognise individual letters and shapes at 18 months - 2 years) then started being able to sight read at 2.5 (could well have been able to before this) and now is starting to develop language is a gestalt learning style. Not a lot of functional communication going on but some is starting to emerge now he is 3.5.

But here’s what always gets me, why is hyperlexia not in the DSM?? Especially given that dyslexia is! It’s a learning style to my knowledge that benefits from a specific range of interventions and supports, rather different to that of autism (without hyperlexia) or ADHD. It is often also shoehorned onto a broader diagnoses as I understand onto ASD when accompanied with communication differences or what they tend to call ‘speech delay’. But my worry is that if my son gets a diagnoses of ASD, of which doesn’t entirely fit him in my opinion, in school they will concentrate on that and not the hyperlexia.

If anything I feel like he skews more ADHD as he does not crave order, or sameness or routine, but enjoys novelty, movement and sensory input. And maybe what makes him ‘appear’ autistic is actually the fact that his communication difficulties very much make him behave autistic-like?

I have to admit I was never the type to think that a hyperlexic child like mine wasn’t also ergo autistic but the more he grows and develops the more I doubt it. I was the first one to raise concerns about autism or certainly the signs of atypical development in my son when he had his first developmental review at which I was promptly dismissed given that he was seemingly engaged doing all the typical things at the time, but something niggled at the back of my mind, and of course I am right in that he’s without a doubt neurodivergent, but all I can see in him is hyperlexia but not necessarily an actual diagnosable condition such as ASD or ADHD, or even AuDHD as they just don’t seem to ‘fit’.

Intervention / therapy wise nothing that is recommended for autism or ADHD has been super effective but approaches used for hyperlexia have.

Has anyone else experienced this at all??

I am 99.9% sure my son is hyperlexic. He's 7 now, and in primary 3. (We are in Scotland)

He's been able to read, solve puzzles etc since age 2. He also had a speech delay and seen a speech & language therapist.

We entertained the Autisim route - but his S&L therapist said there wasn't "enough" to encourage a diagnosis as far as she was concerned, and if we wanted to pursue a diagnosis we'd have to go down the paediatric route. After much thought, we declined.

DS is in mainstream school, and is excelling in both literacy and numeracy. He has friends, albeit not the most popular boy in the class. In all honesty, I still don't know if my son is autistic or not. But I don't feel a diagnosis would make a blind bit of difference.

We're very lucky. His mainstream school is extremely supportive of all his little quirks and niches.

Hyperlexia is not well recognised like dyslexia so I understand your furstrations.

I don't really have an end to this response but just wanted to share with you the similarities

@ForWorthyTiger in the nicest possible way, you have a long road ahead if you're going to take it upon yourself to diagnose/not diagnose your own child. I understand that you are concerned and wish to be the best advocate for him, but it seems to me like you can't see the wood from the trees at the moment. Please protect your mental health and the ability to care for your son properly by dealing with what he is presenting with right now.

As it stands, the help of a good speech and language therapist and weekly sessions would be enormously helpful.

He is displaying significant communication and developmental issues and while you don't believe he ticks an ASD box, it's important to remember that so many ND's can co-exist with others, that your child is only three, and that oftentimes, difficulties can only become apparent as their world becomes more challenging. I have no doubt that a diagnosis will come but rather than all this focus on hyperlexia, you need to prioritise what will help him and address his needs currently. Speech and language therapy would be a good start.

Your point being?
My son was diagnosed as autistic when he was 3 . That was in the 1990s when far fewer were diagnosed, but children tended to be diagnosed at a younger age, possibly because it was only children with more 'severe' autism who were diagnosed.

I think there must be something big missing in your understanding or description of the situation.

You describe your child as being easy, calm, no metdowns, ahead with reading at age 3.

What would justify 1:1 support?

Do they run off, self harm, have no sense of danger, harm other children regularly, smear faeces, have pica... these are the sorts of things that would perhaps lead to 1:1 support being considered at this age.

There's lots in your posts that indicate possible autism. There's nothing that seems to indicate any sigbificant extra support being needed at this stage.

He sounds like my nephew.

Nephew now 12. Not remotely autistic just really, really clever. Popular at school, very talented at music, sociable, polite, welll behaved. He is happy, relaxed, does well at and enjoys school & various hobbies.

Still has a very "sensory" side!

Maybe you already have a list or its worth writing a list of all his traits/ symptoms whatever you want to call them and posting here or cross referencing online with autism as I and most people reading your comments aren't seeing this clash that you are so maybe you've missed details.

Your list will be useful for when he has his assessment anyway as they ask a very thorough questionnaire about the child's very early childhood.

I've got to say the reasons you've listed here are exactly why my children had EHCPs and 1:1s in nursery. I was really surprised when OP said her nursery were going for it.

People picking apart the OP's comment about EHCP for 1:1 - I would strongly suspect that either:

• the nursery don't fully understand the scope of EHCPs and the level of support that children typically get. This isn't completely unreasonable, because many nursery's initiate the needs assessments but never see the final EHCP because the child is at school by that time.

or:

• OP misunderstood the nursery explaining. I often tell parents that it should allow their child to receive extra support, and they interpret this as meaning 1:1. It's completely understandable

My son had a 1-1 arranged by his speech therapist for pre school. He was there I think about two weeks before she started as it all wasn't quite sorted by the time he started. He didn't have much awareness of danger but it was mainly due to his communication issues.

My daughter is hyperlexic, she was sight reading very competently at 2. At 6 had a reading age of 10, I suspected ND and at 4 years she absolutely presented as Autistic. As time goes on, I'm not sure what to think.