What is the difference between mild and severe autism? Is my son mild or severe?

[Shootingstar2289]

Seems a bit of a 'daft' question but my son is 4 in a few weeks and awaiting a diagnosis for autism. I felt like I've been shrugged off for a few years being told 'it's just a general speech delay' and 'he will catch up'.

It's not until he was 3.5, professionals started to take notice.

1. My son is very speeches delayed. Literally only said a few words up until he was 3.5. Now he says hundreds of single words but only occasionally ps them together in 2 or 3 words. Usually sticks to one word only.

1. He is a VERY happy, giggly, affectionate child. He was a very smiley, content little baby. He was such a happy good baby. I could take him anywhere without a problem up until he was around 2..

He is often too clingy and I can't go for a wee without him stood next to me.

1. His behaviour can be very demanding now, especially in public. He's obessed with pressing buttons - ATMs, arcade machines, ticket machines, door opening buttons and often screams when I take him away. But this is improving and takes less notice to things like this now.

He is terrible for screaming when he doesn't get his own way. In public it can be bad in shops.

He runs off a lot.

When he was younger I used to take him to toddler group and he stood playing with the doors and the taps rather than play. He has a thing about opening and shutting doors and gates.

1. He doesn't play with children his age but loves company of adults and older children.

1. He is very clumsy.

1. At pre school he has improved a lot. He will sit still at story and snack time now but this took a while but he struggles to share toys etc. He is also hard to move from task to another.

1. He has no sense of danger whatsoever. He runs off and has attempted to run into roads but I'm always there to grab him. I try to explain but he doesn't understand everything and does it again.

1. At home he is very good! I can get on and do housework if he's sat playing, doing puzzles, colouring etc.

Although his speech is very delayed. He doesn't seem 'severe' in other areas related to autism. He can be very well behaved but it just takes one thing to upset him and he cries. But his tantrums never last too long.

He says please, thank you and sorry appropriately.

His eye contact has got better over time but still not the best.

But slt ( and I really mean a GOOD SlT here) can sometimes pin point exactly what's going on. In my toddlers case the asd news has come from nhs salt, indi salt agreed. Will see if that's the dx he gets very soon. Private slt in my case was a quick and cheap ( relatively!) answer to my questions. Not all mind, but it's been a game changer for both kids. The therapy side not so much as both boys can't be fixed

Can't be fixed as in a few sessions of slt isn't going to "normalise" them. Not that it's not worth perusing therapy...

In my case I had nhs slt say ds was six months "delayed" private said 3.5 years delay but in fact it was a language disorder. If I hadn't used her I'd still be waiting for ds to catch up, now I know he can't. £150 well spent as it's changed everything for us.

Also I was stupidly hoping the toddler was delayed / disordered but again slt saw more than that.

Indi slt if you can pay for a assessment did move things along for us. As for curing the lang disorder, shes been honest from the off that past 7 it's too late. But I do think the therapy helps to work around / with the disorder.

I'm not the type that looks for cures. I'm past that. But anything that helps.

That's all that anyone wants, some thing to help, some hope. As long as it's honest and eyes open that it's not a cure for all ( as in our case).

Cheaper than an ep and faster than waiting for a dx ( ds is 7 - still waiting for a asd test!). Or course in this for my 7 year old slt hasn't got us any closer to any asd type test. But it does all help to point in the right direction.

Maybe my son has the right type of disorder for therapy. Maybe I'm kidding myself.

Also his underlying condition I think is why he has the lang disorder. He's dyspraxic so unless someone figures out how rewire his brain there's never going to be fantastic improvements. But he can articulate his displeasure at life a lot beter now. Strangely that made me very happy last week. I had never heard him moan so much with so many new words

We have had the same experience as 2boys with regards to salt- privately. The nhs salt was excruciatingly bad, tests flawed, complete tick box attitude.
My ds is 6.5 and I'm not sure I believe that past 7 is too late to talk. Maybe it's wishful thinking on my part though

There is a big burst of brain development and pruning at the puberty stage; I am starting to see it with my son. People who say speech/language isn't going to improve after 7 probably just mean they themselves got nothing!

It probably is true that language development can start to drastically slow after 7 however.

By 11 it is nearly complete and there is not a lot of room for change without exceptional willingness by everyone, including the child, to really push it.

Need to distinguish between language as 'words' and language as 'patterns of communication'. Inbthe former we can obviously continue learning more quite easilly. In the latter it becomes significantly more difficult to adapt and change language patterns as we get older, often in line with manor developmental changes.

KS2 CAT scores are quite strong predictors or GCSE attainment, and it can be founds earlier too.

CLL (communication, language and literacy) scores in EYFSP (Early Years Foundation Stage Profile) are quite good predictors for literacy scores by the end of KS2.

Obviously they dont cause language scores or development, but they are good indicators of a child's environment for acquiring language and do indicate that language patterns become harder to change relatively early in life.

This is why it is better to learn a 2nd language very young, it is easier and also makes it easier for the brain to adapt to future new language patterns.

I think that what my slt said is that if ds hadn't made a miraculous improvement by 7 then in probability he would be disordered for life. I don't think anyone's development freezes. I don't have a great way with words as I'm dyslexic. So I guess what that means is that he has a disorder, it's life long as he's past the point of getting over it, but of course he can improve as what's the point of pursing any form of help otherwise. I don't believe any diagnosis is better or worse than another. I know highly intelligent ADHD kids who run out of school and don't sleep. Although they have better academic qualities to my son I'm not sure I would find that easier to live with. I doubt they envy my life much either.

'By 11 it is nearly complete and there is not a lot of room for change without exceptional willingness by everyone, including the child, to really push it.'

Why? Sorry but that makes absolutely no sense.

I have had more SALTs and SALT assessments and therapy than I can possibly remember, over a 7 year period. Child with typical ASD (but not the version that anyone has had their 2 hour twilight training in) and severe expressive disorder.

All SALT has been shite, except for the latest one, and all that has changed really is her admittance herself that it's all bollox really for a child like mine and the best we can do is work together with her knowledge of available resources and my knowledge of the functional difficulties. There is no evidence-base for what she suggests. It is trial and error.

However what we do is keep data and detailed records of the effect of the intervention, or rather I do, which feeds into the next strategy.

I doubt when we lose her there will be another anywhere near as good. At least our past record doesn't give me any hope.

*zzzz I also learnt a new language around 7 and I speak it fluently 11 years later. My SIL is Arab and decided to learn her husbands (DH's brother) language in her 30s. She speaks much much better than I do.

My own daughter has a language disorder, shes mastering English but I have every intention of teaching her our home language in the next year or two (so 6-7 years).

Our consultant has been involved in programmes where asd children with language disorders went on to learn 1 or 2 additional languages so I most definitely think that it can be "cured". As long as you give them the tools and there's motivation, I believe it can be done.

Hi Starlight

First there are obvious exceptions and variations.

The following explanation is broad brushstrokes, i am not a neuropsychologist, however a lot of the teating I perform and interventions I plan require some understanding of cognitive processing (as best we underatand it!).

It is commonly accepted that the brain becomes less 'plastic' as we get older. In other words, at a young age it develops amazingly fast due to the introduction of stimuli which it learns to process via pathways which become familiar. So the brain retains capacity to learn from new stimuli, however it will tend to default to certain gating habits to process that new stimuli.

So if you can retain multiple methods of learning at a young age, you tend to retain faster learning skills for your whole life, or at least as long as you continue the habit.

Communication and language, once embedded, are fairly core to our information processing and hence why literacy is such a correlating variable to all schooling.

So by age 11 (approximately of course) our communication processing is normally sp embedded that it is hard to change patterns of processing the language and acquiring new patterns unless the individual is very willing.

Plasticity is somewhat different to theory of mind.

Wtih theory of mind we were trying to explain a largely metaphysical concept of conciousness in others, so it was always going to struggle in a test environment.

With plasticity however we are attempting to name something that visibly happens, namely how the brain lights up and functions along familiar pathways to process certain types of tasks.

incidentally, this is part of how autism is now visible on an MRI which has largely debunked a lot of the myths about where autism comes from.

So while the term is a bit wooly, it does refer to an observable thing that science is trying to understand better.

Autistic people still develop pathways, they just do it in atypical ways, so plasticity certainly still applies.

This should not be interpretted as me saying we should give up trying at age 11 by the way! We are certainly products of our environment, and of course people can continue to learn at all ages. As we get older however it becomes more necessary to learn in familiar ways, which is where specialist teachers and caring parents make the difference in knowing children as individuals instead of averages.

:) was just trying to say that it is more of a firm thing than either of the two others you said!

The way a brain visibly learns is a lot firmer in terms of evidence than you seem to give it credit for. While we still dont know as much about the chemical processes that underping it, we can see the brain building, using and then continually reusing pathways for tasks.

Whether at or nt, the process is similar, where the pathways go is what varies to a greater degree in autism. For example, a student of mine described music visually. Outstanding composer, left us to go to the conservatoire.

We know the brain becomes less plastic as we get older. Statistical cutoffs are of course not applicable to individuals, as all individuals will of course develop at different rates and ways.

However the core principles of plasticity and slow down with age remain in the whole population, so it will always be true to say that teaching CLL at an older age is going to be harder than at a younger age, because pathways are more set at an older age.

If the pathways are not there at all at an older age, they are still harder to lay down.

None of this is a case for stopping trying, I would be out of work if it was! However I do believe in a ln honesty of expectation, aim high but achievable, because if you are surprised it makea it easy to continue extwnding those challenges. However if there is no quick response, having unobtainable targets is a killer for motivation.

Believe me, if someone tells me to refuse an opportunity to a young person just because there is no point I will be first in line inviting them to give me the sack!
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