School has raised concerns about ASD (or possibly ADHD) - what happens next?

[CurrerBell]

Hi all, I'm new here. My DS is 5 and in Reception class. I've struggled with his behaviour, well, always. He is a bright and affectionate little boy, but very unco-operative when we ask him to do anything he doesn't want to do. He has frequent bouts of 'silly' behaviour (as we call it), where he freaks out or throws himself around - or just zones out and ignores us.

He seemed to settle into school ok, but he is now more frequently struggling to do what the teachers expect of him, or displaying 'inappropriate behaviour'. The school nurse has now said there may be some signs of mild ASD (which I have wondered about since he was 2...), and she has referred him to a paediatrician for assessment.

I don't really know what happens next... what do the assessments involve? I know we don't have a diagnosis yet (and may not get one) but I want to know how best to help him cope with school. Is it possible he may have some Asperger's traits without having the full syndrome - and what might that mean in terms of school support? I am feeling a bit overwhelmed really so any advice would be very much appreciated.

interested to see what answers you get as we have been told by preschool they have concerns about our Ds.

Did he/does he have speech delay? I have been informed that an absence of speech delay rules out Aspergers.
My own DD (aged 3.5) is being assessed for ASD. She will be evaulated by the preschool ed psychologist and SALT next month.
She sees a community paed who will order an ASD assessment if the above proessionals consider it appropriate.
Our DD only meets some of the ASD criteria unless we (her family and school) are not noticing rigid thought processes.
This may be possible and we don't know what we're supposed to be noticing IYSWIM?

btw, DD has severe speech delay, approximately 12 months behind.

Thanks for the replies. DS had no speech delay. All his development has seemed normal, except his challenging behaviour.

LeninGrad - wow, I had never heard of PDA but have just googled it, and it does sounds like DS... possibly more so than Asperger's. The main 'symptom' I would describe with his behaviour really is demand avoidance. For example, when his swimming instructor asks him to do anything, he just point blank refuses, to the extent that he tunes her out and stops responding. Then later in the lesson, he realises that the thing she asked him to do is a fun thing, and he wants to do it then.... It's like he wants to do everything on his own terms.

He does have friends and enjoys playing with them. He is great during 'free play' when he can do what he wants, but struggles with structured/group activities. His teacher said the difficult behaviour is occurring more now that the school day is becoming more structured and they are expecting more of him.

DS is very articulate although finds it hard to talk about emotions (especially sadness - he claims nothing makes him sad). His understanding of maths and technical stuff (eg cogs, Technical Lego) is very advanced, and I think that's partly what made the school nurse wonder about Asperger's. A couple of people have commented on him taking things literally, but we hadn't really noticed (I'm pretty literal myself). He tends to move around a lot and be quite jittery / jerky. His teachers have commented on his lack of spatial awareness - he can inadvertently hurt others by throwing himself around.

He has a strong sense of fairness and can be quite caring towards others (especially his younger sister). He doesn't have obsessions or prefer to play alone - quite the opposite, in fact - he is forever demanding my attention and won't leave me alone! He also has good eye contact - except when we've asked him to do something, when it's like his personality flips.

LeninGrad, that is so helpful. I always thought greater structure at school would be better for DS, but it seems to have the opposite effect. It makes sense now.

He will sometimes do something unquestioningly if he feels it is 'set in stone' rather than a demand - ie he knows that we take our shoes off when we enter the house. But if I ask him to put his shoes on to go out, his whole body goes limp and he says 'can't do it'. I have a whole strategy of games to get him to do little everyday things - it is exhausting. At least I know now he is doing it out of anxiety, rather than just to challenge my boundaries.

It's funny how caring DS is towards his sister and younger children. He likes to teach her things and watches out for her if she gets into trouble. He also loves being given responsibilities, such as being the 'special helper' or pouring drinks at snack time. Not sure if this fits with PDA... He wants to do things on his own terms I think and be in control?

My DD is 5 and also in foundation and also had been having lots of behavioural issues refusing to do things, hitting out etc. She has ADHD and dyspraxia a lot of the issues you describe sound similar to my DD.

She has a statement and a full-time 1-1 teaching assistant. Initially the EP had suggested ASD or Aspergers but this has since been discounted. Quite a few symptoms of ASD are consistant with ADHD and dyspraxia there is so much cross over.

We had to change schools and were prescribed meds to help handle her behaviour but instead went down the supplement route giving her Omega, zinc, magnesium and multi vitamin we also changed her diet and cut out sugar and the difference has been amazing.

Thanks HolyCalmityJane. I have been reading up on ADHD and DS does tick many of the boxes. He is very impulsive and can be hyperactive. However he can concentrate for hours on his Lego...

I'm not sure about dyspraxia - he has good motor control normally but gets overexcited sometimes and throws himself around (and doesn't think of the consequences). That is interesting about your DD's diet - I will have a think about that.

LeninGrad, yes I still brush DS's teeth for him too (once I've got him to co-operate with standing still). Definitely a good idea to pick your battles... I can occasionally get him to get his shoes on, but it takes a long time and often involves a lot of crying as he says his shoes or socks 'don't feel right' (but I think he's trying to avoid doing it more than anything).

While reading up on PDA I found a support forum here. A mother was saying she gets her son to do something by putting on a silly voice or speaking through something else (eg a soft toy) - so it distances 'her' from the demand. I tried it this morning and it really worked! DS often speaks through his favourite toy so he likes using his imagination in this way. I might use it to try and talk about emotions too...