ASD and EP assessment

[KOKOagainandagain]

DS has not been diagnosed with ASD. He has auditory processing difficulties and when I had his hearing checked the ENT SR went off on one asking why I was there, saying that APD was the latest fashionable label for autism. He said that DS was autistic but that I was lucky because he was 'quiet' and that it was difficult but Mum was the best resource . I thought he was talking crap but now I am concerned.

Is it possible that undiagnosed autism can manifest as dylexia, dyscalculia, dyspraxia, auditory processing difficulties, inattentive ADHD, extreme sensitivity to clothes/bedding (tags, seams, too rough etc) and to touch (says hugs hurt) screams blue murder over the slightest bump, multiple tics, anxiety etc? Would the EP assessment suggested ASD? Is it worth getting a SALT assessment? Which assessments, if any, do I need and where should I go.

When he was a baby he was bloody hard work and unrewarding. My face used to ache from smiling so much but he never smiled until he was well over 6 months. As a toddler he started having tantrums that continue to date. He would never join in playing with other children and was very much a velcro child. He would demand to be taken to a playpark but then refuse to use any equipment if there was another child nearby. However he seemed to be meeting his developmental targets and there were no S&L concerns.

He does seem to care about friendships at school but they seem to be around interests. Also he can appear rude as he ignores teachers/friends that say hello or goodbye to him. At the moment he is obsessed with scooters and has lost interest in previous friends who only care about playing World of Warfare. He has transferred schools in the past and does not maintain friendships - he simply had no interest in them when not at the same school even though we lived in the same house.

His use of language appears quite sophisticated and witty but I can recognise the comments from particular TV programmes that he watches obsessively. He does not seem to mind watching the programme over and over - he spots continuity errors in the Simpsons! In his writing at school I can recognise plots from TV. I can be sat next to him on the sofa, watching the same TV programme and he will turn to me and report what was just said. He talks continuously so that he has to be interrupted when I need to speak. He talks at me in monologues that always begin 'what happened was ..' he will then talk non-stop.

Is there a typical WISC profile - I had assumed that it couldn't be ASD because he has a very spiky profile in both verbal and performance?

Sorry I have to go now as DS is obsessing about his inability to drop-in! (scootering lingo)

Is it possible that undiagnosed autism can manifest as dylexia, dyscalculia, dyspraxia, auditory processing difficulties, inattentive ADHD, extreme sensitivity to clothes/bedding (tags, seams, too rough etc) and to touch (says hugs hurt) screams blue murder over the slightest bump, multiple tics, anxiety etc?

Yes

Seriously so similar to DS1. u had the word complex yet? DS1 just diagnosed with Aspergers last week. It's taken a long time, and we've been for a 2nd opinion only then did he get diagnosed. Our psych thought DS1 would get a spiky profile however he didn't only low on information processing, but average elsewhere. If you haven't already go to GP ask for a referral to CAMHS, where we live you have to get a referral to Community paediatrician first - only then can you get a referral to CAMHS. write a list, as many lists as you need. take pictures and take the evidence with you. If, like DS1 they can appear NT for an amount of time then knowing your luck they will choose to do it under assessments and appointments. Good Psychiatrists etc can see through this. Good luck

Have you ever actually seen a developmental paediatrician, or actually anyone who does assess and diagnose spectrum disorders? Has he ever been properly assessed across the board? Or just piecemeal for the specific issues mentioned?

But yes, to your actual question. But you know that.

I'm guessing your original list is the one currently in use to describe Ds. If this is the case, what support is he getting? It's entirely possible that a re-dx will make no difference at all to his needs or support requirements, and will simply clarify and simplify his dx from a form filling pov. (and there's nothing wrong with that. It would also give you a new level of understanding)

There is so much overlap with this stuff that it is often difficult to separate out the different strands. Ds1 is currently ADHD with aspergers traits (sensory and social) and anxieties. But it's kind of a current descriptor, a ball park dx. We've had suggestions of asd, PDA, odd, etc prior to this one.

He was initially seen by a comm paed about five years ago and was referred back last year when the tics began to manifest. She did ADHD screening and has referred to APD at GOSH but has not mentioned ASD. She said CAMHS would not probably not accept a referral as the anxiety/stress/tics were secondary to learning difficulties. He scored 2b (writing), 2a (reading) and 3 (maths) at KS1 in year 2 but has only made a maximum 'progress' of 2 sub-levels in four/five years. He has only recently been dx with dsylexia etc. He has had an IEP for the past four years and is on Action+. Despite around 40 interventions (not all at the same time ) he has not met his original targets - especially independent working. We are currently applying for assessment for SA. If the assessment is granted, will they assess for ASD?

Jerbil he does the silent (seriously so) but 'normal' in all assessments and also in school. He is considered to be extremely shy and has problems even responding to direct questions and so drs think I am mad when I mention about his constant talking. Slightly concerned about recording him at home - tried this when school disbelieved the tantrums and their response was to make an emergency referral to the SS!

madwomanintheattic all assessments have been piece-meal and we only got those through extreme persistence and eventually getting a private EP report. The support he is getting is all about english/maths - the LEA learning support advisor told me that they are only interested in maths/english progress and it did not matter what other problems existed as long as it did not make a measureable difference.

Is a development paed different to the comm paed?

Interesting that you mentioned a spikey profile because that is the term a lot of proffs use when they are referring to children with ASD.

Dd3 has a spikey profile and Asd, she uses very mature language but has great difficulties with social communication.

I think you need a reassessment for your Ds, if you dont want to video him, try keeping a diary. Include the behaviour/ issue you think is outside the normal range, what caused it(if you know) and how you dealt with it, to show that you are constant.

My diary made the proffs sit up and take note. They had tried to discharge Dd3 on more than one occasion.

There is a difference between a comm paed and developmental paed. The dev paed specialises in developmental issues. The comm paed is a general paed.

Good luck

Sorry for the typos, constant should have been consistant

OMG! I took a video in of DS1 when I was attempting to get him dressed. They never did that but they did believe what he was like then.

Thanks - read the threads, keep a diary, make a list, get a referral. Simples!

Definitely get a referral(private if you have to) to a child psych. Lots of the things you have written remind me of my ds-he is 12 with Aspergers. Claw has a thread going where the same thing has just happened her yesterday-she sent photos to the school of her ds and the school have called in SS. . I cant remember the exact name of it but its the one that reads "Star,Wet,Agnes and all you other helpful mums" or something similar. Good luck!

Get him back to the Paediatrician and ask for a full autism assessment e.g. ADOS. How can they rule ASD out so casually? . Only a Paed is qualified to diagnose. You could pursue a prvate diagnosis and then bring that to the NHS and demand that they follow it up. I know plenty of people who have done this.

Btw - you can get a referral to CAMHS for learning disability-related emotional/social/behavioural issues. The person that said otherwise is talking crap. If you feel it is relevant, pursue it again via your GP.

Press on with Statutory Assessment, but do pursue diagnosis first and foremost, as if you do get a Statement it is really important that it properly addresses your DS's genuine difficulties, is clear and robust in identifying what they are and that the support he needs is accurately described, specified and quanitified.

Good luck!