ASD with no social communication issues?

[Areyoufree]

So my daughter has had an assessment with a speech and language therapist, and has no social communication problems. In fact, the report showed the opposite - her language was very advanced, using grammar beyond her age, and good awareness of other children. Could I be wrong about the possible ASD? Am not going to change the way I interact with her - techniques for ASD are definitely successful - but am now feeling quite confused. Although glad that maybe her social issues aren't as much of a problem as I thought!

Surely social and communication issues form part of an ASD diagnosis? I assume there has to be a significant deficit from that of an NT child for diagnostic purposes?

Meant to add, what exactly are the reasons you believe she's autistic?

Important aspects of report: able to understand and meet simple needs in other people, and other children. Passed test of abstract language comprehension. Used age appropriate expressive grammar.

Why do I think she has ASD? Shall try and keep it short. Childminder flagged issues from the age of 15 months. First she was concerned about her hearing, then said she struggled with change, then that was she fine with the other children, until a new child was introduced into the group, at which point she became extremely withdrawn. Finally, she said she had a tendency to play alongside rather than with other children. I dismissed everything - she's always been quirky, but I love that about her!

She's always had certain issues. From a very young age she would struggle with bed time, as she had to get everything perfect, or would have screaming hysterics. Her main thing was getting blankets flat on the floor. We regularly have issues with socks being bumpy. Bumpy socks can result in intense crying and hysterics. She gets these highly manic periods, where she regresses to baby talk, and is prone to violent, impulsive acts. She is very physical and rough - we have to try and keep her calm most of the time. She chews everything! Currently has a red, sore patch on her face from chewing her fingers. She has little to no imagination - takes things very literally, struggles with playing imagination games with other children. Is either in charge, or being told what to do with her friends. Plus, she has no sense of boundaries - is either unaware that a child is trying to play with her, or is overly physical. Had her first playdate recently, and she kept kissing the other girl on the cheek, which was not 100% appreciated!

Things got really difficult last year, which was when we started to suspect ASD. She was very difficult - the slightest thing would send her into a rage. There were mornings where I would walk into her room and ask if she wanted to come downstairs, and she would scream at me to stop talking and go away. Since using techniques for ASD, things have improved significantly. Normal parenting advice has never worked - being firm makes things worse.

I didn't keep that short. Sorry!

She's 5, by the way.

Did the SALT observe her in the school environment? I'm a bit confused about the "good awareness of other children" - was DD observed playing with other children or was that determined from asking questions? And the "able to understand and meet simple needs" was that considered to be to a age expected level? (sorry for the questions and please don't feel like you have to answer!)

I think a lot depends on the assessment conditions - some children do seek out/prefer 1:1 with an adult and aim to please iykwim. SALT can only report on what has been observed and assessed, if there was no/limited amount of time observing DD playing with her peers then it won't pick up on those issues. It is also possible DD doesn't have ASD and I'm by no means suggesting she does, but I can see where you are coming from with considering it with the behaviours you have observed. Are the sensory issues still problematic to daily life?

Has she be seen by a paediatrician? What do school say?

The awareness of other children bit was because she saw a child struggling to open the door, so got up to help her, without being asked. The school see no issues, but they also see a very different child - her teacher commented on the fact that she isn't a perfectionist, and doesn't get easily frustrated, which took me by surprise! My daughter can fly into an instant rage if she can't do something straight away - and hates being shown what to do. They say she is very quiet, well behaved, helpful - she sounds lovely!

She hasn't seen a paediatrician, because we couldn't get a referral without a letter from her preschool, although the doctor was happy to refer us. Her preschool didn't see a problem, even though they admitted her eye contact is poor, that she only really socialised with one person, and that she needed encouragement to leave the drawing table and visit all areas of the room.

She has good days and bad days. We are very careful to explain things clearly, make sure she knows exactly what is going to happen, and in what order, give countdowns before leaving the park - that sort of thing. Neglecting those will end in her lashing out. Her sensory issues are manageable - bumpy sock days are frustrating, and the bed time dramas intensely annoying, but not the end of the world. The one I worry about is her getting very upset before going to school. She has refused to go once before - which made me realise how powerless we are if she decides not to go! We are extremely fortunate in the fact that her school are willing to believe us and work with us on making life easier for her. Am fully aware that that is the main struggle - with or without a diagnosis - so we are incredibly lucky!

I doubt myself a lot, and worry that I am labeling her in my head, and maybe somehow encouraging this? Also, since researching ASD in females, I have been amazed at how many boxes I tick, so am also wondering whether she could have picked up behaviours from me (although, I have never struggled with socks!).

You are going to struggle to get a dx of ASD if the report says those things.
She won't meet the criteria.

It may be you need more time before reassessment. She may have strengths in that area because she is only five, her peers are only five so they all have immature S&C skills.

Her difficulties may become apparent as they all grow and develop?

Its not uncommon for children to get a dx at around 7 or 8. That doesn't mean anyone has been negligent, rather that it takes some time for the gaps to show clearly

@TheFirstMrsDV To be honest, I had pretty much given up on the idea of getting a diagnosis. It's very hard to get diagnosed in this area - have spoken to parents with children with far more additional needs than my DD who really had to fight to be taken seriously. Plus, as I say, her school are really good and helpful, so don't think a diagnosis would change much right now. Was just surprised that the SALT didn't see anything at all! I guess we will just have to wait and see - either things will settle down or stay the same, or they will escalate and any difficulties will become more apparent.

If your tactics are working and the school are being supportive without a diagnosis things sound like they are going pretty well.

I have been told all sorts of things about my DS by people who have only spent 45 minutes with him. Everything from a dx of severe learning disabilities to 'nothing wrong with him'.

So much depends on how our kids are on the day, what the environment is and how they feel about the person assessing them.

It sounds like you are doing the best things for your DD .

Aw, thanks! I think I just feel like a fraud a lot of the time already, so having a professional see absolutely no signs threw me into a bit of a tail spin! But, as you say, the techniques help, and the school are amazing, so we aren't doing too badly.