ASD and LD's

[paranoid2]

MY Ds has a diagnosis of Dyspraxia with attention problems and auditory and sensory processing problems. He was assessed by an EP a few years ago and many of his results were in the moderate learning difficulty category although the EP said the results could be taken with a pinch of salt as he was very unfocussed and she said he may be capable of more. Roll forward a few years and he is doing Ok at school. Reading and spellings ahead of where he should be and maths about 1 to 1.5 years behind . Non verbal reasoning tests show that he is slightly above his age, anything with verbal instruction is a struggle, although things have improved recently.
According to school there is a large discrepancy between what he knows and how he applies what he knows. They have raised the possibility of him being ASD due to a number of things , namely his organisation and processing skills, sensory issues, i.e. inability to filter out noises , him being consumed with detail and inability to see the big picture, taking things a bit literally, getting anxious about not getting things right when presented with things like mental maths and making things more complicated than they are. He is very good visually and has a great memory in this respect.
He seems to think a lot about things like films he has seen and will obviously be reciting lines in his head as he will sometimes say ?What does X mean? This used to be displayed as scripting when he was younger but he seems to be more able to internalise things like that more. Very good at absorbing facts. Does have some specific interests which seem to consume him but not that much different to DS1 who is obsessed with football although DS2 interests tend to be a bit different to what you would normally see in a 10 year old boy.

However he is very sociable and communicative and no meltowns or other behavioural issues.
I have wondered about ASD for years . It?s frightening to see my threads from about 7 years ago here (under a different name) but no professional to this point has ever mentioned it. I have raised it a couple of times with

At this stage I?m not as bothered as I once would have been as he has what symptoms he has and whether there is a name or not is not that relevant. He has a statement so I don?t think a diagnosis would get him extra help. However I?ve been wondering about this for so long that I think for my peace of mind as much as any thing else I need to know.

After that ramble I think my questions are ? is it possible to be ASD and be sociable and communicative. Sometimes I think his symptoms can be covered by his other issues as there is so much overlap between conditions. On other days I think some of those traits that are deemed to be part of the other conditions could in fact be present because many of the children with them are also ASD.

Can I also ask about LD?s. For those of you with children with LD?s as well as autism do you think that the LD?s are part of the autism or something different? From what I have read it would seem to me that children with autism and LD?s tend to be on the lower end of the spectrum. Would it be possible to have MLD but be on the higher end of the spectrum or do you think that possibly a child with HFA that has problems learning could have some specific aspects of autism which may cause a barrier to learning but overall be high functioning in other ways.

Not sure if any of this makes sense but as usual not sure what boxes DS fits into

Thanks for getting this far.

Well my ds hasn't got MLD (I don't think) but he does have ASD and central to that are difficulties learning due to the condition iyswim.

In order to get a statement your child has to have LDs too. In order to get ds the provision that is appropriate for him I have to make it clear that he doesn't have LDs i.e. he is capable with the right support.

So quite frankly I have no idea what it all means, how it works and over time I have learned not to care. My ds is my ds with his own profile of needs.

I think many of the difficulties are due to the context or the way that education is presented.

I think though that in many ways LD are seperate from dx of ASD. I think and hope that the new dx criteria will sort it all out a bit.

I think Peachy might be a good one to ask about this, although I suspect that the more you know the less you know iyswim.

Thanks Starlight.

I'm not really sure if DS has MLD or not. His academic results dont really put him in that category. He is in a MLD unit but working on his own as he is way ahead of the other children, but then sometimes its simple things that throw him, like the way something is phrased , particularly in relation to Maths. He is like a rabbit in the headlights sometimes, he knows something really well but sometimes panics and he cant regulate himself to get to a place where he can retrieve what he knows if that makes any sense

a child with HFA that has problems learning could have some specific aspects of autism which may cause a barrier to learning but overall be high functioning in other ways.

I can only go on my own limited knowledge and experience of course, so this is imho, but I think what you describe could easily be possible. Many symptoms or characteristics of ASD itself can in themselves be barriers to learning, even without 'learning difficulties' (which I think are classified as either specific lds such as dyslexia or low IQ). Eg concentration, motivation - often a difficulty with ASD children but on their own wouldn't be classed as a LD.

And yes it is absolutely possible to have a dx of ASD and be sociable and communicative - my ds is a case in point. It is just that (particularly with communication) it can be impaired/unusual, eg doesn't actually know when to shut the fuck up stop talking.

Btw I fully agree with you that it is not the 'label' that matters, it is the difficulties and symptoms that matter. But this is only my own feeling relating to my/ds's situation.

Have just read your second post properly - what you say about ds's difficulties retrieving information is (I believe) seen amongst ASD children too - processing and sequencing difficulties. Often manifests in being v disorganised too.

Thank you Bialystock, interesting to hear about your DS. DS2 tends to talk about what interests him a lot but on the other hand he is very adept at knowing when he is boring us and will always say when my body language tells him "Am I boring you" which seems to be the opposite of what a child with ASD does, although I know its by no means an exact science.He is very eager to please and to be seen as "good" and wants to fit in and in fact embarrassed when his brother reveals his "non typical interests for a ten year old" to others at school. This seems non ASD'ish ie caring what others think but maybe his desire to please and be good is a sort of ASD trait in its own way , ie its a sort of rigidity of thought . I think Starlight might be right, the more I know, the more I dont know!

My son has moderate LDs and ASD and is sociable and communicative.. his communication is impaired (as in he talks his obsessions, no understanding of social cues, body language, how and when to shut up!!) but not absent.

He is generally functioning about 3 years behind academically but with the odd skill in odd topics..ie he can multiply numbers in his head, but he can't write it down or tell you how he got the answer, and he can remember every date he is ever told and work out the day of the week to go with it, but can't tie his laces or remember what he had for lunch!

My son wasn't formally diagnosed with ASD ( he was with the LDs) until he was 9, simply because he wasn't aloof and doesn't have behaviour problems (although he has a lot of anxiety) but when I finally asked him to be referred he was assessed and the dx came quickly..the psychiatrists had NO doubt he was autistic, as he has the triad of impairments.

For me it helped because I knew he wasn't 'just' MLD and felt it would help him educationally to have his rigidity of thinking and anxiety formally recognised.. and also the ASD label IS useful as they head towards the end of school.. my son is 14 and he will have more options post 16 because he already has the dx ...sad that this is necessary, but such is the system:(

DD is very sociable and has some friends.But she is def Aspie and has a dx. Like others she doesn't know when to STFU . Also doesn't understand social cues (like being bored with excessant talking/interrupting)

DD does have a high IQ and like Medusa's son can do mental maths in her head, and struggles as to how she got the answer. Also has an excellent memory for dates etc, but struggles to remember day to day stuff (like bus pass/lunch money/shoes etc)

She is also highly anxious.

Slight tangent, but how (and on what criteria) does a child get dx with LDs?

Thanks to all who have replied to date, interesting about the maths, Although DS2 struggles with maths he can sometimes do mental maths but cant explain how he gets the answers. Its like when he is forced to think about something he cant do it. Its a bit like that with his motor skills also. He can do somersaults in the water no problem but suddenly when he is asked to do them in a more formal way, ie at the top of the pool when turning he loses all ability to perform as he has to think about doing it at a particular time.

Bialy - not really sure about the LD diagnosis. I believe an Ep can make a diagnosis of specific LD's such as dyslexia but not so sure about MLD . As i said previously the EP stated in her report that some results were in the MLD category but didnt give a diagnosis. When I mentioned to the paed that i didnt think DS2 met the criteria for MLD she said that overall functioning needed to be taken into consideration also and one report by an EP could not be viewed in isolation. Nothing further happened in relation to this

My son had very significant general delays from birth Bialystockandbloom.. failed to meet milestones, walked very later, didn't speak til he was 4 so the LD label was applied early. Quantifying what degree of LDs is a bit trickier as most schools/psychs don't go on IQ testing but more on functioning levels plus schools use P scales for those below national curriculum levels.

I work in a special school.. school and SLD pupils are not expected to achieve above level 2 of the NC by age 14 (so about ability of 7 yr old) MLD pupils should have higher attainment levels .. but will still be working at several years behind their peers across the board (not an isolated learning problem such as dyslexia) and again, general functioning ability is also important.... those with more than mild LDs are likely to be impaired socially and in independence skills:)

Thank you. Sorry, one more question, what does the M stand for in MLD? Moderate?

Sorry for hijack OP.

Yes. Though in theory it could stand for mild, in usual parlance LDs are classed as MLD (moderate LDs) SLD (severe) and PMLD (profound and multiple LDs.. usually with severe physical disabilities) Of course you also get 'complex LDs' and specific LDs too. Clear as mud isn't it!

Ah yes, crystal clear, thanks

possibly a child with HFA that has problems learning could have some specific aspects of autism which may cause a barrier to learning but overall be high functioning in other ways
Yes this absolutely true of DS (4). He has classic autism, moderate-severe in some ways. But his IQ (which is what I understand the LD in MLD stands for) is within normal range. We have been told entry to the MLD school (is unofficially) an IQ below 70.

So DS's autism is a barrier to learning in many many ways, but all his difficulties are consistent with autism and there is no need to look for another / additional label eg MLD.

But the barriers to learning are high eg no motivation, inability to concentrate or even look at a person or book for any length of time, lack of social interest in others which means he doesn't copy other children or learn from them, only responds to direct teaching - doesn't absorb new learning it has to be specifically broken down and taught, doesn't learn in a group situation (yet) only 1:1, struggles to process chunks of language, his language development is more than delayed its not following a normal pattern so if he learns new words he drops old ones / confuses them with old ones and every bit of language has to be taught individually. I expect he will (if he keeps getting the good provision we have now) continue to learn and in 5-10 years will have made strides in lots of these areas and will end up being higher up the spectrum and more HF than he appears now.
He is above his peers in areas that involve rote learning and memory (all the academic stuff like phonics, reading etc) but lacks understanding its more a case of learning patterns than functional use of words.

I think many of these conditions overlap - dyspraxia, sensory processing etc etc. In other countries you might have got a PDD diagnosis sometimes called atypical autism as not ticking the social box. I thinks its also possible to have a higher than average number of autistic traits but not tip over into a level where you merit a diagnosis as its not that disabling. I can think of a boy who ticks loads of the boxes but is very social and I think of him as having traits eg he takes language too literally, walks on his toes, motor and co-ordination difficulties, blurts things out inappropriately, his voice is way too loud, he learns language based things slower, but he is very very social.

I would think in future we will have MRI scans that show which bits of the brain are affected and we can see if its a bit of autism or the whole bundle and also whether it is only autism, or other things eg dyspraxia, LD as well

IQ tests are notoriously inaccurate for those with language processing difficulties as they tend to be language based. So usually they underestimate true IQ

Thanks for your post Agnes. Everything you say is what I think, ie he probably doesn?t tick all the boxes but would have been given a diagnosis of PDD ? NOS if we lived elsewhere.

Also I believe your point about IQ testing is valid because although the WISC has a non verbal component to it, the test is still quite language based.

He is actually going to be tested by the EP again shortly prior to transition to secondary and I have asked for a non verbal IQ test to be used as well as the WISC , but I think that this is unlikely . His OT has recommended this also due to his auditory and sensory processing difficulties