Problems using personal pronouns/determiners - always ASD?

[DesertOrchid]

DD (3.3) is being referred to early support due to a lack of social interaction with her peers. She has always been 'different' so I am on board with this because if there is a problem obviously the sooner we find out what, the better. I hope.

HV suspect ASD. But I'm not really sure, because she has no issues with routines, she plays very creatively, and sometimes seems to be OVER sensitive to my emotions rather than unable to read them (so when I have told her off, an experience which has to be done gently because she withdraws and retreats if it's overdone, when my smile comes back she will say 'oh, Mummy's happy again!' in relief) (My apologies if my layman's knowledge has me misunderstanding ASD).

However, she does have some red flags in that she doesn't express things about herself (like hunger, fear, illness etc), has never really shared anything with us that wasn't in a book (although she is starting to do this now), and she still doesn't talk about herself using 'I' or 'me' (it's by name or 'you') even though every other pronoun is grammatically sound. And when she is pretending to be a toy she DOES use I.

She is very sensitive to stimulus. In busy environments she is fine for a short period but is quickly tired out by them and needs some time alone to recharge

Certainly nothing to this point has stood out as an obvious possible dx. She does seem very bright, she definitely has a phenomenal memory, spoke early and talks in long sentences with lots of detail. She walked into our bedroom after I put up a new mirror and said 'A magnificent mirror!' The clear pronunciation and long sentences make the dodgy pronouns stand out even more, however.

So... is there anything other than an ASD that anyone knows of that can cause these kind of very specific expressive oddities? I really appreciate your help; I'm new to this and a bit nervous, so please be nice :-)

The long,detailed conversations and 'the magnificent mirror' immediately flag Aspergers to me as that would be exactly like my ds ,11, who was dx with Aspergers a year ago. Also the sensory issues and what you wrote about telling her off gently and she saying'oh mummy's happy again' would be fairly typical of ds also. Ds never had a problem with routines/structure and was very sociable and played creatively from a young age.However, your dd is exceptionally young as Aspergers does not normally become apparant until much later. I agree that it is ridiculous for the HV to be suggesting ASD without anything qualifying her to do so.I have no experience with the misuse of pronouns etc so cant help you there. Don't know if this is of any help to you or not ,but this is my experience.

Thanks everyone :-)

yuckything Sensory issues would I think be a part of it as she is very 'oral' - thumbsucking, puts odd things like burst balloons in her mouth, loves all sorts of food even quite strong flavours. Also she isn't potty-trained and doesn't appear to know when she needs to go yet. Thanks for the heads up on hyperlexia - I found the Great Ormond St page and that sounds really like her. She's been spelling words in the bath with sticky letters since she was two, reciting whole books since 18 months, LOVES words and poetry, very quick to make links between things. She is definitely very visual too and recognises the words on the herbs and spices as whole words, as well as 'seeing' things in unusual ways. She seems to understand almost everything but occasionally gets tangled up with more abstract things. And as I said the social side of language seems to be lacking (although she is great at please and thank you so she at least has good manners! ;-) ) I'm pleased to hear your DS grew out of the pronoun thing because if I'm honest it drives me mad!

zzzzz It's becoming increasingly clear to me that autism/AS/ASD/PPD etc (and in fact most other SNs!) present hugely differently in different people and to different levels of severity. I think that's partly my fear, actually - that we are not looking at something we can improve, but something that will get worse as she gets older and the gap with others widens. So that in particular I'm finding quite stressful. On the other hand there are many others who have significantly greater problems than we do with DD (who is funny, quick, increasingly affectionate, and pretty easy to manage) so I try to keep it all in perspective. Like you say, separating normal three-year-old behaviour from anything else is also really really hard!

In fairness to the HVs they have been on the ball and very supportive for a while now, ever since her 2.5 y check. They didn't suggest ASD, it was my inference from the questions they asked. I am an English teacher and for a time worked to create an SEN dept in my school where none really existed (that's a LONG story). I had two students on the spectrum and did various courses, so when the HV team started asking certain questions I knew what they were getting at - when I asked outright they did say 'well, it's one possibility, but it could be other things'.

penneyanne Do you mind if I ask what characteristics your DD has that led you to suspect AS? It's so much more useful hearing about real children rather than generic comments on checklists etc as everyone seems to disagree on what common factors exist.

I guess at this age from what you've all said it's impossible to know really - it could be any one of a number of things - bright with asynchronous development, somewhere on the spectrum of AS/ASD/PPD, sensory issues, hyperlexia - there are definitely a lot of possibilities and any of them could clearly present as part of ASD as well as independently.

No-one here will be able to say what is going on, but from what you have written I certainly wouldn't discount ASD.

Routine is not one of the dx criteria, nor is not playing correctly or being under sensitive to emotions. They are 'symptoms' of rigidity which can present other ways.

Playing 'creatively' I meant, not correctly.

Thanks - I know no-one here will be able to 'diagnose', I just wondered what other possibilities there might be so I feel a little more prepared. I don't want to anticipate discussion of an ASD and find myself floored by a reference to something completely different.

Well I would probably research a range of developmental disabilities inc. dyspraxia as well as ADHD and write out a list of everything you can think of examples for. This list will be very helpful for any diagnostic process.

Leningrad Sorry it's such hard work for you and your DS. Thanks for the good luck wishes. DD does tend to be anxious about some things (although not others - she started preschool last September and didn't bat an eyelid about going) but we are lucky in that she has always slept well.

Her creative play is definitely creative - she does re-use ideas and borrows from TV and books but she also invents new things, and it's different most days. Yesterday, for example, she turned a playmat upside down (so it was blue) and spread it on the kitchen floor and made all her toy mice swim across it, meeting jellyfish etc. I can join in and make suggestions and she will feed off those and take things in a new direction.

From what others have said though it seems that doesn't rule out ASD.

starlight Sorry, just to check I understand you correctly - do you mean make a list of different disabilities that have some features correspondent with her 'symptoms' and mark what shows up where?

(I have already collated a timeline of all her development milestones in different areas so hopefully that will be useful too)

Also (I really appreciate all this help by the way!) I have a number of bits of video of DD1 going back to babyhood - do you it would be useful to take some of those with us when we get an appointment? Or will they look at me like I'm crazy?

Not the actual disabilities, just the symptoms. It kind of gives you questions to respond to to paint a picture. I.e. ADHD might say 'problems concentrating' so you think 'yes, that is a problem in these circumstances' and write down examples. It doesn't mean that ADHD is on the cards but does bring up useful information.

Thanks starlight, that sounds a good idea, I'll do that. I can see how it might help me explain things more specifically.

leningrad It is the not playing with other children that is probably the main and most obvious concern (preschool described her introversion as 'extreme'), swiftly followed by a couple of things I think would qualify as sensory issues - she definitely seeks out oral stimulation (thumb sucking, nail biting, eating playdough, trying to drink saltwater out of the olive jar, putting balloons in her mouth, biting cardboard) and I have wondered whether the reason she doesn't communicate about toilet issues and feelings is because she finds them hard to recognise (interoceptive sensory issues, would that be right?). There are no behavioural issues that I can see that aren't typical of a three year old, apart from a tendency to get really annoyed or upset if you don't read the words accurately in her books. (Which is very weird, because sometimes if she can't remember it properly she is perfectly happy to paraphrase it herself). This also spills over into songs and is probably the best example of any rigid behaviour - she doesn't like songs having variant forms, unless it's obvious (like a comic version). So she cried her heart out when after stay and play the other week the goodbye song went 'goodbye everyone see you next week' instead of 'goodbye, see you next week'. But by the followng week she she was singing both versions herself.

She has made progress with people. Some while ago she would cry if another child got in her way or came close to her. Now she does play in parallel, and will hold hands with another child if that's what she's told to do. She will not join in with a group as a matter of course however, unless it's something she wants to do - if they are singing songs she doesn't like at preschool she'll go and read a book, and yet the report was on Friday that she sat and sang and did the actions for Twinkle Twinkle with everybody for the first time. She flatly refused to show them to me though!

I'm sorry, I've waffled on loads about her. I'm sure you have better things to do! It is really good to chat to others about it though.