How can you distinguish between language delay and ASD?

[nikos]

Wasn't quite sure how to title this. I've mentioned on the boards before that ds3 is being assessed for ASD. We have had the ADOS and DISCO questionnaire and in the words of the paed he 'doesn't tick many of the boxes for ASD' and 'he is a complex character'. His play therapist is also starting to doubt ASD as he has natural eye contact, a great desire to communicate. She also says 'he is a quandry'.
Ds has very good 1-1 support at his preschool and is coping really well, but probably wouldn't if he didn't. He interacts very well with his siblings but prefers to be on his own at preschool unless encouraged by support. He is a happy compliant boy unless out of his depth.
We are going for probably a diagnosis meeting in mid-November. I'm happy to have a provisional diagnosis of whatever if it gets him a statement and the support he needs for reception.
I suppose my concern is that if we treat it as ASD we might be missing something else. Anyone able to share experience/wisdom about this?

.

I think it's the million dollar question nikos, would also love to know as i have a child who is "atypical" for ASD, no repetitive behaviours, rigidities etc, his issues are mainly language based and I think the social interaction is largely influenced by that.
Sounds similar to your ds actually, other than he doesn't have pre school support but is definitely better at interacting with his brother or children known very well to him. Will be interested to see what others say, we are at the stage where we need a dx and I'm wondering what on earth it should be..

Thanks KT. I have a really supportive paed and I think she wants to give us what we need to get a statement. As ds's language has increased he is showing imaginative play and much much less negative behaviour. But he still struggles with interacting with large groups of children.

No idea really but this is what wikipedia says

en.wikipedia.org/wiki/Language_delay

I was told that ds would have been one of those children who was considered a little "quirky" years ago, and would never have been diagnosed with anything. Much like DH, come to think of it, who didn't talk intelligibly until he was 5, and wasn't bothered about playing with other children. He's fine as an adult though.

There is added pressure with the statement application though, I think our paed is looking down the same lines as yours, giving us a dx to help with the statement.

Hi,
Dd2 is being assesed for ASD, we were told by the comunity paed that she was on the spectrum and we just started to get used to the idea that she was ASD and then last week we were told by a speech therapist at dd's nursery that she may have a speech/language disorder. Aparently in the pre-school years it is very hard to tell. I hope you don't mind me asking what traits of ASD does he have?

DD's ASD traits

Dd2, flaps her arms, is non verbal (makes a few sounds ,ummm,ooo,ee)

She hums when she eats.

She is sensitive to sound, sometimes holds her ears.

Lines up toys in order of size and colour.

Has poor comunication, does'nt answer to her name and does'nt carry out tasks (ie, get your shoes)

Has no fear.

non ASD traits

Her eye contact can be good at times.

She's not a fussy eater

She can cope with change in routine.

She loves contact, cuddles and kisses.

Hi Marne,
Ds's ASD traits
Finds it very difficult to think abstractly
Avoids contact with unknown children
Prefers to talk quite logically
Not yet potty trained and doesn't dress himself as well as his age group would (he's just turned 4)
Think he does have receptive language issues

Non ASD traits
Never stimmed
Never lined up toys
Non fussy eater
Non rigid about routine
Normal eye contact and affection
Normal play with 2 slightly older siblings
Very curious about the world and people

thanks Nikos, your ds sounds simalar to dd1 (AS), she speeks logically, finds it hard to dress herself, had problems toilet training but dd1 loves routine.

Dd1 shows more asd traits than dd2 although dd2's traits are more worrying as she finds it hard to comunicate.

Dd1 has nnot got a statement but is doing realy well in reception (so far), im not sure if we will get her a statement, we will just wait and see how she gets on in the next few months.

Dd2 atends a special nursery and recieves speech therapy each week, what ever the outcome of her dx i am pretty sure she will need a statement if she goes to ms school, at the moment we don't know if she will go to MS, we should find out in March.

Going to pre-school/nursey realy helped dd1 get ready for school, we thought she would struggle with the social side but she seems to have alot of friends (most older than her), she does have times where she has small melt downs (if they give her a snack she does'nt like or if they ask her to do something she cant do).

Hi my Ds was assessed in the summer for ASD and we really had problems getting a diagnosis for him because he gives eye contact and is a very intelligent little boy who has learnt to mask his ASD traits.
The DX he recieved was atypical autism and he also has oppositional defiant disorder and is also being looked at for segmantic pragmatic disorder which basically means that he has a huge vocabulary but he doesnt understand it!

I think they look at social use of language - so eye contact (a red herring I know!), initiating conversation, hello/goodbye and non-verbal communication - pointing/waving etc.

TClang - what do you mean by "independent thought processes"? do you mean that he's got imaginary play that's not just replicating books/TV etc.

DS's current DX is language delay - and "probably not ASD"). Had he been seen at 36 months I think he would have been DXed with ASD. But by 49 months, when he did get seen, stimming and delayed echolalia (telly talk) were much much less. My gut feeling is that DS has Semantic Pragmatic Disorder (which these days would be classed as being an ASD), but it chops and changes.

I think in answer to your concern - it's much more likely to be the other way round - that if it's not treated as ASD your DS will be missing out rather than vice versa.

My DD sounds a lot like your DS and we have no official diagnosis beyond "neuro developmental delay, language delay and problems with social integration". However, no-one has ever mentioned ASD and I always assumed she's not because she's very flexible, no repetitive behaviours, loves changes in routine, busy environments / lots of people around her. She also had (has) problems with toilet training, lines toys up. Not much imaginative play, doesn't really have friends but interacts well with younger brother. I've never pushed for a diagnosis because it doesn't make a difference here in terms of help you receive (I'm in France).

Absolutely! Semantic pragmatic has been mentioned with us too, and I can really identify with nikos' description, our ASD traits (at 3.2) are -

• occasional ear holding
• occasional looking at objects from a funny angle - ie lying down and pushing a toy car
• eye contact sometimes patchy, generally ok
• odd language development, and poor receptive language although rapidly improving
• highly developed visual skills, reading words and numbers at 2.6
• self contained at preschool, will engage with other children but not for long, prefers to play alongside, or sometimes with younger children

But we also have on the non ASD front -

• no lining up of toys/other objects, or other compulsive behaviour
• appropriate symbolic play with toys, less so imaginative but it is sometimes there
• fully potty trained by day, sometimes also at night
• good adaptive skills
• no stimming, little echolalia
• no rigidity or need to stay in routine
• lots of affection and cuddles
• no physical symptoms, very co ordinated
• curiosity about world
• developing sense of humour

Plus a big family history with DH being non verbal and self contained until the age of 5...

Hi nikos

DS2 sounds the same as yours and KT14's ds.

Had a meeting with his nursery yesterday and he now has an IEP in place, mainly to help with conversation and social interaction.

He was assessed in the summer by a dev paed who ruled out 'classic' autism but could not rule out AS,although he felt that DS2 would not go down this route based on his behaviour at present .

Glad to hear I am not the other parent in limbo-land.

We seem to be currently entering a phase of increasing vocab/sentnace length and understanding so hopefully by Sep 2009 when he started school, he will be ok/nearly ok.

I have got to the point of thinking that DS2 is not on the ASD spectrum but is just a very late talker which causes other problems.

Sorry. Meant 'only parent' and 'starts school'

I would love to know the answer to this too. DS has an SLI which is becoming significantly less noticeable with age (and support). We have always been told he is too engaged to be ASD. I often wonder though. His esteemed (ex) SALT said it was just the severity of his language disorder which made him seem a bit quirky. Aged 3/4 he had a strong visual take on the world which was probably making up for his lack of verbal understanding.

He was very similar to your DS at that age Kt14. DH also non-verbal/self-contained until 4.

Out of curiousity, what is 'stimming'?

stimming is self stimulatory behaviour - can be verbal, with the need to repeat words, sounds or phrases, visual - flapping the hand in front of the eyes, or moving objects backwards and forwards, for example, or needing to touch, chew or smell objects.

And I think it was jimjams who mentioned the lying down thing in a thread the other day. It's something ds1 does sometimes when he's tired but I've seen NT children do it also, i think it's the regularity which makes it an ASD related behaviour.

sounds familiar, castlesintheair, would love to have some video footage of DH at ds' age, I think it might explain a great deal!