Please or to access all these features

Behaviour/development

Talk to others about child development and behaviour stages here. You can find more information on our development calendar.

Autism or not?

32 replies

Figamol · 07/10/2014 19:42

Hi all,

Ive posted this on the special needs board too but it seems quiet there, so sorry for the duplicate.

Earlier this year the leader of my sons (now 27mths) mother and baby playgroup insisted I should take him to see someone, after spending nearly a year with us. I knew he had obsessions, was really difficult to engage and still hadn't said his first word at 23mths but was shocked at how strongly she felt about it so I set about doing something. She is also a qualified toddler autism screener.

We live abroad in a private health system so its pretty easy to access the specialists you need to by yourself.

So I addressed what bothered me most and thats the language delay. I though that this was DS main problem and wanted to shrug off the other concerns as actually he is very sociable and happy. However on the first appt with her I was shocked he spent the whole time obsessively playing with one cupboard door, never reacted to his name, wouldn't engage in ANYTHING. It was awful and upsetting to watch. But I realized that actually he is like this at home, its just he is number 3 child in as many years so it has always suited us that he's always played by himself. The speech therapist said she wasn't taking on anymore patients but felt so strongly about him needing help that she wouldn't let me leave without bringing him back for more treatment. Of course I agreed.

In 3 months he's made GREAT progress, there is much more eye contact and hand pointing, not many more words, and he has found enjoyment in engaging. At home he continues to ignore his name and plays obsessively with cars and anything with a door on it. He recently started creche and they've pulled me aside everyday complaining he is so difficult to engage, doesn't understand basic instructions and that they shout at him all morning and he just laughs at them. The rest of the time he is in a corner on his favorite train set or castle.

In addition to this at home he has never slept through the night, he screams with night terrors. He always has runny stools. Taking him out anywhere where he spots a lift, or automatic doors can turn into a 20 minute battle to get him away. Unlike my other kids I cannot distract him to focus on anything else and he will scream and scream till we get back to the lifts and doors.

So I hunt out THE best autism specialist. She was wonderful and warm and knowledgeable so we were delighted to have found someone that wanted to help get to the bottom of it. We had a first meeting where we tell her what everyone has been saying and she says she saw some red flags whilst he was playing and that they would video him and do the ADOS test.

Today we went to the Speech therapist where he engaged a little, but also was obsessive as usual about his one picture and sat under the table for the majority and shivered with terror touching playdoh.

We went to the ADOS test after and where she had brought a wonderful guy who just blew me away with his ability to get him engaged. He responded so well and there were smiles and eye contact and pointing. I was desperately confused. I was delighted to see this little side of him was in there but so sad we barely see it. She said she's on the fence right now about a diagnosis but will score the video and call me on Monday.

My problem is this. We were in an empty room with what was effectively his own personal clown with toys that he likes, bubbles etc. It was not representative of the struggles we deal with in his daily life. There were no doors, no toys with doors, no busy environment that makes him seek out comfort. No awful dinner time struggles as he REFUSES to eat without a distraction like a car or an iPad. We went to Disney and he only wanted to play with doors to the point where the struggles were physical. His sisters birthday party this weekend, he was in meltdown at the stimulation but I put him by a sliding door and he played with it and calmed down.

I don't want to come across as wanting him to get a diagnosis. But the little boy I saw today is not who we deal with and I know he will get great scores and not be diagnosed. She said herself she will take into account what we've told her and she'll call the speech therapist to get a bigger picture. But now I just struggle with the idea that perhaps its just us as useless parents that aren't able to find the little boy they did and that all of this has been fuss over nothing. Which I would find hugely embarrassing. I find it really difficult to know my mind anymore, Ive got friends that say he's fine and professionals that think he needs help. I find Im always trying to analyze him and its exhausting. She asked me if I have a gut instinct that something is wrong and I said I just don't know anymore, that I know he is different but is it a problem. Im not sure.

Has anyone else been through this and found their child was different during the ADOS and didn't represent the bigger picture. How did you deal with this?

OP posts:
Tapdancingelephant · 07/10/2014 19:56

Gosh what a difficult time for you all.

Please, please, PLEASE do not blame yourself or think you are awful parents for not being able to 'find' the boy they did. As you rightly point out, they weren't playing on the same field as you, and didn't have to take him away from doors/get him to eat/put the toy car down etc etc. you are doing everything you can, and have been brilliant at taking on board what people he noticed about your ds, and been marvellously proactive in trying to get help for him.

You are in the hardest bit. I bet there is a tiny part of you that would love for it to be your fault, as then you could 'fix it' more easily, by going on am parenting course, or learning from the experts what to do. And another part of you is probably terrified that tey won't see enough, and you'll be left in limbo. I've been there. I chased diagnosis for my dd1 for nearly 2 years, and still walked out from the appt where she was diagnosed and burst into tears - a mix of relief and fright.

You are doing so well, and doing the best you
Can for your ds. He is so young to be so close to dx, so well done. Keep strong. If the expert doesn't score him highly enough on the ADOS, then point out your concerns - one of the advantages of the private system is a better dialogue between professionals and clients, ime. Start taking videos of the things which concern you - it is much harder to argue with solid evidence like that.

Figamol · 07/10/2014 20:05

Thank you for taking the time to reply. He is number 3 in as many years, and there is an almost certainty that none of them get the time they need from me. I do believe if he has it it could be my fault, the specialist kindly shared research that the fact he was conceived so quickly after number 2 (3 months post labour) increases the risk a lot. She wasn't saying it to place blame, just sharing an interesting study. I just knew when I was pregnant that my poor DS could not be getting what he needed, I felt so weak and guilty the whole pregnancy.

This specialist believes massively in early intervention so if she feels he needs help, he will get it quickly. But you're right, the limbo thing would be the hardest to deal with. The speech therapist (who the specialist knows and respects) is convinced there is a problem but hasn't specifically said what as said its not her place. But the ADOS today was spectacularly different to how he usually is. Do I just accept the probable conclusion that he is not on the spectrum or do I fight? I respect the specialist so much I would believe her opinion.

OP posts:
Elfina · 07/10/2014 20:13

The ADOS can only be scored how how he performs on te day, but it is not diagnostic in and of itself. Other factors will be taken into account

Tauriel1 · 07/10/2014 20:20

Hi.
You know your child best and you see him in a variety of settings and situations.

In my experience which is personal not professional, he sounds like he has autism but possibly too young for formal diagnosis. Eye contact is not an indicator like people make out, I have met many children with autism who give good eye contact and engage with others.

Tauriel1 · 07/10/2014 20:21

Oh and you are NOT useless

Figamol · 07/10/2014 20:21

Ok, the way she presented it to me was that it was considered THE conclusive test. I guess I will only know when she calls on Monday as to whether or not what we've told her has been taken into account. Its just so very important, as to get the services we would need means we'd have to move into their district (there are none where we are) which means a massive expense to us as houses and everything there are SOOO much more.But of course we'd be prepared to do it. We just have to get this right. I don't want to put us all through a move if everyone is sat on the fence about him. Sorry, I could probably chat all night about this x

OP posts:
NewInformation · 07/10/2014 20:22

The thing is, it's not just you who cannot engage your ds, is it? You've had child are settings (who see a LOT of children, across a whole range of behaviours), and another professional who works with children with difficulties.

It might be that your ds has some delays and developmental difficulties but isn't on the spectrum. If ou don't think he ADOS is scored accurately, though, then yes in your situation I would push my case.

And whilst I do understand whatnot are saying re : third child in 3 years and not feeling as though you have your ds the best start in life, I would just say this: be kind to yourself. This is a shock for you, and it can be like a grieving process - grieving for te child you thought you would have. All a parent can ever do is the best at any given moment in a specific set of circumstances. You didn't deliberately do anything which 'caused' this. (I do understand those feelings, btw, as I do occasionally have similar thoughts myself). But do take some time for yourself, and do try to look forwards not back. What has been has happened and cannot be changed. The future is still waiting. And here is lots that can be done.

As a small point of hope - at 23 months my dd1 had absolutely no skills at all. Didn't play with anything, wasn't interested in a single thing. At all. She was a very classic case of autism - shut away and silent.

She is 10 now, and is so very far from that toddler that it is hard to believe it is the same child. She will always be severely autistic, but the future is looking very different to how it looked all those years ago.

Parietal · 07/10/2014 20:28

From your description, I'd expect some kind of autism spectrum diagnosis. ADOS is an indicator and the clinician should take other factors into account. If you are unsure of what she will say, take a video clip (even in your phone) of the day to day things that worry you to the next appointment.

If it is autism, it is NOT your fault. Birth spacing has very little to do with it. Autism is just the bad luck of particular combinations of genes - no one knows which. So don't feel guilty.

Figamol · 15/10/2014 21:43

Thanks so much for all the support. She called to say he scored mild to moderate overall with the ADOS and the questionnaire/evaluations. She confirmed to me that whilst he performed well she could see what we were trying to tell her and that I wasn't going crazy. He'll be put in a one on one centre from next month on an early intervention programme. I feel nothing but relief for now, I can stop analyzing him so much. She's not putting a label on him, says it could either explode or disappear around his 3rd birthday so lets just get on with treating the symptoms for now. She really is a wonderful Doctor and we're very lucky to have found someone so level headed.

OP posts:
Eva50 · 16/10/2014 08:20

I'm so glad for you that your little boy is getting the help he needs. None of this is your fault. You have done so well getting help for him and whether he goes on to a diagnosis or things improve you are doing your very best for him which is all any of us can do.

Frusso · 17/10/2014 19:05

This reply has been deleted

Message withdrawn at poster's request.

Trick0rTreatSmellYourFeet · 17/10/2014 19:17

It sounds really hard for you. You're definitely not useless. I remember trying to wrestle the HV's stapler from my son at his 18 month check-up. He would not relinquish it! She was insistent that he give it back (because a stapler is dangerous, and I remember in my ground down state, having lost perspective, I wished she'd just let him have it and stop making an issue of it!)

You mention your son's obsessions with particular items, and you mention that he is more sociable than is considered to be typical for a child with autism, so an autism spectrum disorder such as Pathalogical Demand Avoidance Syndrome or ODD might be worth your googling.

My son used to be obsessed with cups. From about nine months he would hold mugs by the handle. Real china mugs! People used to disapprove, but if I took the mug(s) from him he literally wouldn't stop crying until he got them back.

concernedaboutheboy · 18/10/2014 11:59

Hearing is also the very first thing to come into my mind when I read your description.

Figamol · 18/10/2014 19:05

Thank you, I'll google those and read up, I think the more time he spends in the program the clearer things will become.

He's had both his ears and eyes fully tested by specialists. I was wondering about his hearing too, but I know he hears tiny non human noises and reacts so I was never that worried. I did wonder about the eyes as theres a lot of blinking and focus on whats directly in front of him but after thorough tests she said he was fine.

It has been hard, but I feel like now someone else knows what we're dealing with, its best foot forward and the load is a different one to look after

OP posts:
fanjoforthemammaries7850 · 18/10/2014 19:12

In my experience they don't just diagnose based on their observations, you will be taken through a pretty detailed questionnaire.

It does sound a lot like ASD to me although of course I can't diagnose on here.

fanjoforthemammaries7850 · 18/10/2014 19:13

Children with ASD can be sociable and make eye contact etc.

Frusso · 18/10/2014 19:15

This reply has been deleted

Message withdrawn at poster's request.

Figamol · 18/10/2014 19:52

Thats good to know. Thats what confuses me the most, he is sociable when you can get him. He has a very sunny disposition and has hugs and giggles for everyone. If you didn't spend a lot of time with him or know what you were looking for I think you wouldn't know.

One of the hardest things has been dealing with my friends reactions, they seem to think Im doing him a disservice by getting him 'labelled'. Obviously I think thats tosh, am I not supposed to listen to 3 professionals all say theres something up because I should be bothered what other people think. Thats been pretty upsetting as someone who is open, now I have to keep quite quiet about whats going on.

OP posts:
fanjoforthemammaries7850 · 18/10/2014 19:54

It is really good he interacts, it gives you a lot of potential for working on any issues he has.

Ignore your friends, you are actually doing him a great favour.

Frusso · 18/10/2014 20:05

This reply has been deleted

Message withdrawn at poster's request.

Figamol · 18/10/2014 22:36

Wow thank you, that really helps x

OP posts:
Figamol · 18/10/2014 22:37

She sounds wonderful :)

OP posts:
Frusso · 18/10/2014 22:38

This reply has been deleted

Message withdrawn at poster's request.

Trick0rTreatSmellMyFeet · 19/10/2014 00:01

It's not a disservice to get a label. Use the label to your advantage. It's a KEY to access the services that can help him.

wrt hearing, when my son could hear a pin drop in the next room, helpful people were suggesting I got his hearing tested! I mean, it was tested, several times.

Trick0rTreatSmellMyFeet · 19/10/2014 00:03

Another item that my son was obsessed with was glasses and glasses cases.