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?

In a strange way, what often convinces me that ds1 may be on the spectrum, at the very mildest end, is having ds2 and the way he is so different.

I sometimes think that the very fact that I am wondering about ds1, and that there is anything, however mild, there to wonder about at all, probably means he is on the spectrum. His language development and interaction are definitely atypical, and his obvious capabilities in numeracy and literacy are inconsistent with his speech development. (But then, this could also be explained by a lang disorder.. arrgh)

The ASD Senco was very clear that his intent to communicate and share attention, (and he demonstrated this in a number of ways, not just with objects of personal interest), was the main factor which made her feel he may not fall within the spectrum.

But - as we have found a school which offers 4:1 staff pupil ratios anyway, and he won't need a statement as he currently gets as much time as he needs from SEN experienced staff, I am not pushing for the dx which will tell me either way. I simply don't feel I need to know at the moment, as for us, it won't actually change anything. If there were some great resources we could access by diagnosing his condition, or things started to deteriorate, we'd probably be thinking otherwise. I just don't feel I want the stress and uncertainty of assessment and dx unless it becomes absolutely necessary.

And thanks cyber, ds is always clomping about in my Uggs, it's not a set up pic!!

and cyber, as a total aside, I've discovered you can waterproof uggs with a special spray from Clarks btw (it was you who asked me about that weeks ago wasn't it, sorry if not!!??)

I think I get what you mean tclanger. Another paradox with ds1, he reads my expression and tone for praise and anger brilliantly, a raised eyebrow can be all it takes to stop him doing something (occasionally, that is, wouldn't it be great if that were all it took the rest of the time too?!)
but - he can sometimes laugh or seem oblivious if someone's upset around him.

Interesting post Amber.

I read a book about a completely different area, psychosis, called "Madness Explained". It took a historical view of diagnosis of the psychotic illnesses (or should that be "illnesses") and it was such an eye-opener. Dodgy data from the 1930s still underpins a lot of medical "knowledge" about psychosis, and how we describe and classify it.

I haven't read anything similar historical about ASD but I bet the book's out there somewhere.... and I'm still so so dubious about borderline cases (not about the existence of ASD, but about whether there is really a border at all).

Just got the go ahead for some 1:1 support at ds1's preschool. £12 per day. That's not going to go very far is it? It seems we can't use it all over a couple of sessions (having someone for a whole morning and then half a morning) although that would make more sense to me.

Just also submitted application for school next year. Went for the small school in the end, hope it is the right decision. It's a church school so we may not even get in as the boys aren't christened.

ds1 doing lots of ear holding this week but he's been unwell. Also a little bit of jargon today, I hadn't noticed that the jargon had almost stopped until it started again (does that make sense?) So slightly worried.

On the bright side, chatted to his new SALT on the phone and she seems absolutely lovely. Dealing with lots of families in the same is it or isn't it ASD situation. Typically ds1 was ill on the day of his appointment so it's been cancelled for a second time. So frustrating!!

kettle - if you could get one of the health pros involved to write in, is there a box on the application form about needing to go to a particular school for health/social reasons? there was for my LEA.

btw DS echolalia etc always gets a lot worse when he is coming down with something, then is fine once he is over it, so I wouldn't worry too much.

glad that things are coming together re 1:1 and SALT.

thanks total and tclanger, I mentioned on the application that we were under SENCO observation and that their observations showed that the school could be particularly good for helping ds without the need of a statement. Hopefully that might swing it.

It is a bit concerning that our lack of actual church attendance could scupper it all though. Hopefully the head will support us. I'm actually a little amazed that primary schools can still discriminate on religious grounds but that's a whole other thread!

I'm reviving this thread yet again! Bit of a lightbulb moment for me this morning. I've realised ds is fine in totally familiar situations, he knows what to expect, is comfortable and relaxed. He's also fine in totally unfamiliar situations, he stays with us and follows our lead.

It's when we try to change a familiar situation that we can sometimes, not always, have issues. If I collect him from playgroup and he's expecting to go straight to the car, but I stay behind for a few minutes to chat to the staff, for example, it throws him and he can have a tantrum. I really wonder how much that's due to his age, and the onset of terrible three's, or whether there's a deeper underlying reason for it, such as inflexibility of thought.

Hmmm. This comes after a fortnight where a couple of professionals have told me they are doubtful he is on the spectrum.

I'ld say that you could argue that either way - as a language problem without ASD (insofar as that exists I sometimes wonder!)could lead to "controlling" behaviour - i.e. DS might think - well it's hard enough for me trying to understand what people are saying, now they change the rules of a situation I thought I understood.

in the sort of situation you describe, I would try and explain very very simply what's going to happen "mummy talk, then car, OK", or "car soon, car very soon".

kettlechip -sounds like a problem waiting - there are lots of things you can do. (big egg timers, wait buttons, wait cards). It's very common - not sure it's inflexibility of thought as such- more a problem processing time. DS1 spends a lot of time trying to rush everyone onto the next thing in a sequence- but is better if he can see time visually (via wait buttons or an egg timers or countdown clocks etc).

thanks JJ and total, yes he can be really impatient in certain situations. We have it in the car when we're at traffic lights which are on green, yet we can't move for some reason. Or when he has his shoes and coat on but we're not ready to leave the house.
Maybe I could make some traffic light flash cards to illustrate red for stop, amber for get ready, and green for go. The difficulty is the flash point for him is so quick in certain situations, it's difficult to have time to get the explanation in sometimes.

Yes all sounds very familiar. Ds1 is OK at traffic lights now but couldn't cope with red ones for a long time. We used to count when waiting at lights as that seemed to help. He can't really tolerate his school bus breaking down or traffic jams.

Wait buttons would be easier to make than traffic light cards although same idea. Get a PECS strip, then get some big flat beads (threading types good) or connect 4 counters or something like that. Stick some velcro on the back then show '3 waits' (3 buttons), third of the way through take off one button to give 2 waits and so on.