Could asd be diagnosed from these behavioural traits?

[tryingtoleave]

DS1 (2.10) started a nursery program two mornings a week at the beginning of the year. The staff commented that he screams when he is angry or frustrated, but said it wasn't too much of a problem because he was just two. But now, when we returned after Easter, they said he was almost three and it was no longer appropriate and I should get him assessed. They seemed pretty certain that he was asd, or had 'asd traits' because of the screaming, also that he sometimes gets destructive and tips things over (he does this at home too - we call it rampaging - he'll throw and tip everything within reach), he doesn't listen if they reprimand him (same at home), and that he flaps his hands (just a little, if he is very upset). I could add that it is very difficult to get him to leave anywhere - I usually have to carry him out kicking and screaming. He also sometimes repeats what other children say.

On the other hand, his speech is excellent (I think, as a proud mummy), he is very sociable with children and adults, very affectionate, I think he plays imaginatively (his scenarios are a bit repetitive - i.e., cars going to the beach, trains getting stuck in the snow, but it does seem to be playing). So could he still be diagnosed as ASD? I think I'm just trying to prepare myself for the possibility of a dx.

Thanks for reading all that.

My short answer is yes probably

Ask your health visitor to refer him to a paedatrician.

He sounds very similar to my ds who has a dx of ASD aspergers - which doesnt mean your ds has but it is a possibility

hth

We have an appointment already, in two weeks. I'm just constantly flipping from complete denial to resignation.

My tip prepare yourself for loads of questions about your pregnancy, the birth, his early development, how he is now

You wont get a dx at the appointment merely suggestions by the paed about your ds

I rememeber hugging a big teddy to hide the fact I was bricking it when the pead tactfully told me what I already knew

Please dont feel you need to be in denial or resignation.

Its true my ds struggles in all sorts of ways but aspergers is a huge part of who he is - without it he wouldnt be my son tbh

hth

Whatever happens at the appointment, remember he's still your little boy and that won't change whatever a paediatrician says to you! Hope that paed is helpful and takes your concerns on board.

Forgot to say, don't forget to write everything down before you see the paed because sometimes you can get stressed or upset when you see them and forget stuff (my DD isn't ASD, but language impaired but the assessment process is quite similar).

I think what I'm struggling to understand is why that behaviour makes him any more than a difficult toddler? I can completly recognise and accept that he has problematic behaviour but not the implications of the behaviour. Is it just a warning that there is worse to come?

Btw, thanks BD - I think he's so much my little boy that I do just accept his behaviour.

tryingtoleave,

warning - this is a minority viewpoint.

By all means go to the appointments but I would try not to get too hung up on the "has he got ASD" question and focus on figuring out why he has these behavioural problems. The kind of answers you need are much more specific. They might be: "It's because he doesn't understand language as well as he seems to" or "It's because he doesn't understand turn-taking yet" or "It's because he desperately needs an unchanging routine because the world frightens him" etc, etc. Those things might actually point you in a good direction. The staff might need to simplify their language, or to give him more warning that there is going to be a change (Do you warn him enough before you leave somewhere?) or to introduce a more visual timetable. Whereas "it's because he has ASD" is only really good for confirming that it's not "naughtiness" or mum's fault or being spoilt. It might help the nursery staff be more constructive.

Repeating what other children say is a strong sign of not understanding them as well as he seems to. Post again if you want to talk more.

I understand what you mean lingle, and I think we definitely need some help with his behaviour, whatever happens. Obviously the time for thinking that it is just a phase that will pass is over. We always warn him of changes coming up, but it just seems to give him more time to work up opposition.

He usually repeats with children he doesn't know (met in a park or wherever), so I think it is a sign that he isn't quite sure what is expected with them. He is better with children he is familiar with - he plays more constructively with them.

He is actually not at all into routines or rituals. It is actually quite hard to enforce a routine because he is so oppositional (if that is a word).

Hello tryingtoleave! I think it's good that things are moving quickly and you have an appt soon. We had an ASD dx for my DS (3) last week and tbh it was a huge relief, not so much because I 'needed to know', but because it means DS's problems (language mostly, he's not really into routines either) are finally being addressed properly. So I second lingle: dx or no dx is secondary to identifying the areas of difficulty and addressing them. Good luck, let us know how it goes

Thanks sc13.

I'm going to bed now, but I'd appreciate any more explanations on why these behaviours are such markers for asd.

"Obviously the time for thinking that it is just a phase that will pass is over"

Well nearly three is quite early to think that but you know your own child don't you?

My son's problems (language +withdrawn at nursery) are being addressed so I'm not seeking a DX at present. But it does sound like a DX might help nursery "hire" the NHS/educational professionals who could perhaps get to the bottom of his frustrations.

I love your name

Yes he could be...perhaps...

He sounds very much like my boy at that age too (minus the screaming bit).
The problems with leaving and stopping anything and starting another (transition...or 'passage from one form, state, style, or place to another')particularly rings bells. It would take us a veeeeerrrry looonnnng tiiiimmmme to get out of anyhere with ds or indeed just things like making him stop playing and put his coat on could bring on a session.
Speech was always excellent for my boy too (he spoke amazingly early ...i thought it was normal at the time).
The scenarios he plays out are very similar too. Ds's invarably involved vehicles and a journey.
Ds doesn't hand flap...but he does pace..which is his form of stimming

ds wasn't really a routines or ritual obsessed toddler either...but some of these behaviours have become more apparent as he got older (particularly at about 8) and was going through a stressful time.

Ds is nearly 12 now and has aspergers and dyspraxia dx. He is in ms secondary school...he is doing well in his life atm.

Can i just say how i agree that it is absolutley fab that you are getting an assessment and (hopefully)help now. You have nothing to lose from getting him assessed have you? he can't mistakenly be diagnosed btw. The earlier you can get help for your boy...the better. You need time to come to terms with it too (it can take a while ...don't deny your feelings or rush it).

He sounds very like my 6 year old. ds is social (although he only has one real friend that he "likes") but he can chat away to adults an dchildren happily. However he apears to get very, very frustrated at lots o fthings (several times a day) which cause him to go into intense "rages" where he is shaking with frustration/anger and hits out at anyone who approaches. He also runs in front of cars (he claims that as he has done this lots of times and not been run over then it must be safe). He is okay at school - seems to like the more ordered environment - but we contacted the family advisory team who have now mentioned Aspergers to us. We had written it off as "not him" becasue he does seem to have some social skills and is very caring to his little brother so I am interested to read that you can be social and still have AS as I can see where the lady was coming from now. I was reading this thread becasue our dd is being assessed in july as she can not make friends and her language and speak is very adult and often very inappropriate. I'm findin git hard to work out whr eth problem lies though as we can not invite any of her class mates to our house becasue of ds who will not tolerate them (we have tried finding alternative activities for him but for various reasons (mainly that we live out in the sticks) this has not worked so any visit that seh has had from a school friend has ended in disaster). anyway was very interested to read your post

From what I've gleaned, yes, a child can be fairly sociable in certain environments yet still have ASD.
But don't abandon common sense here - if s/he's not sociable at all, s/he clearly has a far more serious problem than if his/her relationships within his intimate family are appropriate, warm, intimate and typical, with only other children or strangers presenting a challenge.
I think (but have no expertise) that there are various kinds of ASD that don't bear much resemblance to each other.

Whether or not he is, once he's 3 the staff:child ratio will change from (I think) 1:4 to 1:8 or even 1:13, so whatever the cause its probably better to get to the bottom of it before then and might be why the nursery are pushing you. My son's nursery picked up increased frustration eg if he's stacking blocks and they fall down he now kicks out and that he doesn't listen if reprimanded - but he has lots of other ASD symptoms of regression, loss speech / social skills too. You probably need to ask nursery to record what had happened just before his outbursts to see if they can identify a trigger - the obvious ones being hungry / tired etc If he doesn't respond to being told off, does he respond to positive praise? You could try and work out a reward system you implement at home and nursery eg a sticker for each hour he behaves - that might help you identify if its a behaviour issue or a language / understanding issue. Most non ASD children would respond to praise + consistent use of time out etc (think Supernanny), if this sort of thing doesn't work then that might be evidence it was something more than just a stroppy toddler.

Thank you everyone - so much to think about.

It's not all transitions he has trouble with - just the ones he doesn't want to do. So it's easy to get him out of the house in the morning to go to singing, or to his friends or even to 'playschool' as we call his nursery. But almost impossible to get him to leave. The big problem at playschool is they have a toy library and he runs out of his classroom when I arrive straight to the library and I can't get him to leave peacefully unless I get him a toy (which I will only do once a fortnight). When we go for a walk he gets very difficult on the way home and I end up having to carry him or drag him for the last part (very difficult as I have his sister in a sling). He often responds to bribery - icecream is his weak point - but not if he is really fixated on the other thing he wants. He also responds reasonably well to immediate threats - eg 'if you pour sand on anyone I will take your bucket away'. I have never tried time out because I can't see how I could enforce it with him - especially now with a baby to look after. When he was younger and he was hitting or biting (he's stopped that) I would walk away from him and that seemed to upset him and stop him. When he screams (it is usually one short, sharp screech)I say 'what is the problem, ds, use your words' and he can usually explain. We praise lots. I'm not sure if that has done anything for his behaviour. He tends just to praise us back - 'good cutting the cheese, mummy - good smiling, baby'. Is that odd?.

Lingle, I really did think I knew him till this and I was quite relaxed about his behaviour. If anything I was probably way too soft and relaxed, thinking it would pass. And a lot of bad behaviour has gone - he no longer bites other children or jumps on them and he can sit still now in a group. But I can see he might be worse at nursery. I was watching him desperately trying to get the teacher's attention as she read a book to a group of children. He wanted to answer all the questions and she was trying to include the other children. He was getting so frustrated he was jumping up and down and flapping his arms - behaviour I've never seen at home.

Thanks Juliaw. It is a different system here, so it is already quite a high ratio. 3 staff for 15-20 children and he will stay in this group for the rest of the year. I was hoping he could go to full time preschool next year though, so I guess it is important for me to know what he will be able to cope with.

That sounds very tough catkinq.

When was your son diagnosed, troutpout? Was it because of those behaviours?

I wonder what other games little boys play besides cars and trains going on a journey? Sometimes I think it's my fault for not leading more interesting play but I can't think of much.

Also, DS is always asking me 'what's he doing?' about everything - people, cars, animals. Is that ASD behaviour?

Tryingtoleave,

You were the expert on this child before nursery made these comments and you still are. And if he turns out to have ASD you will be even more the sole expert! I think the picture you paint of his progress at home is very encouraging. His behaviour at home sounds well within normal bounds to me. He is outgrowing many of his difficulties.

Hmm, you have a baby as well - might that make it hard to be as consistent as you'd like on the discpline side? It's so tricky once another child's involved. How is he on the things where you are 100% consistent eg having a seat belt on? bedtime? (I bet you are really strict about that as you have a baby!).

Perhaps reconsider the routine of taking a toy from the toy library once a fortnight. Every day or not at all would be better. Or stop visiting it altogether for a while and go do something nice instead (but something different each day so you don't develop an alternative problem). Staff could stop him running into the library. To him "once a fortnight" might just seem like you being inconsistent.

The praising back sounds lovely if done when you/baby have pleased him.

Re nursery sounds like turn taking and relative lack of attention is a huge problem for him. There is a programme called "Time to Talk" where you get turn-taking practice. He probably needs something like this.

Lingle, I think we've been quite soft on the discipline. Whatever else ds is, he is difficult and controlling (like most members of my family and dh's). And we lean towards a more attachment parenting approach. So, we've taken the approach of picking our battles, trying to ignore bad behaviour and waiting. I've never much liked the idea of time out and felt it was wrong for ds (as well as being difficult), but I know I'm in a minority with that. Maybe we need to change our approach... We have become stricter I think since dd was born (5 months ago), as it made his behaviour seem harder to deal with.

Bedtime was a struggle for a long time until we stopped his afternoon nap. He didn't really object to going to bed, it just took forever for him to go to sleep and we had to stay with him. Now dh tells him stories for about 15 minutes and he's asleep around 7. He doesn't mind the seatbelt - has actually reminded me if I forget (my baby brain) and is good about his hat after a few fights in the summer.

I know you're right about the toy library - I was thinking that myself. I might go for the easy option and let him get a toy each time. He got one today and it was sooo pleasant leaving and it keeps him busy once we get back in the house too.

Why don't you want a dx, Lingle? Is it just that you don't think it is helpful? Or do you have other objections? I've thought before this, although not knowing much about it, that there is too much labelling with conditions. I hope that doesn't offend anyone - I really don't know much about it.

Tryingtoleave, I second lingle on you knowing your child best. It can be unsettling (I know it was for me) when someone else notices things about your child that seemed 'normal' to you and then calls them 'asd traits'. But the thing is, ASD is a very big church - even if your DS had a dx, he would still be very much an individual that you know better than any doctor or specialist ever would. I think you're doing a very good job of observing your child's behaviour and thinking of various strategies to use with him. The not wanting to leave when he's out sounds very much like my DS - if it was up to him I think he'd roam the streets until the early hours of the morning...

"Why don't you want a dx, Lingle?"

I feel a bit scared to reply without really thinking it through carefully because I do not want to upset anyone. I'm not saying anyone would flame me - people are far too nice! But many of us on this board with "borderline" kids have found it really helpful to embrace an ASD label. I'll be queuing up for a DX if my son's problems get worse of if I find he's missing out on the help offered.

To to keep it simple - DS2 is virtually a carbon copy of DS1. But DS1 has outgrown all his difficulties. I am truly in awe of of his social skills.

This link will give you a further idea. it's by a leading authority on autism.

www.icdl.com/distance/webRadio/documents/2-26-2004.pdf

I also think that in a borderline/uncertain case you have to weigh up the disruption within the family, including wider family, against the benefits (which in my case are "none" at present, as confirmed by the paediatrician). Sometimes there might be a grandma or auntie who could offer great insight into helping with quirks (because the apple never falls far from the tree does it?) but who isn't "on board" with the modern "ASD" terminology and therefore gets told she is "in denial" when she exercises what she thinks is common sense and says the grandchild she knows intimately doesn't "have autism" (which she understands to be something that would affect her own relationship with the child. Allies and expertise can be lost here because of terminology.

Hi guys,
Don't want to butt in so will post and run... thought may be if I shared a little of how DS behaves it might help.

DS1 5.8, also first started displaying these behaviours when he was 2. We all thought he was just bored at nursery and not being stretched enough. As he got older we realised that his behaviour was not the same as other children his age. Definietly have the transition issue and he can have a major paddy about the tiniest of things and anytime he doesn't get his own way or what he wants when he wants it.

I find the biggest help for us is to have a routine and stick to it so DS knows exactly what to expect. We give loads of warning. Tell him what's happening next all the time (he asks all the time anyway!) and then give 10, 5, 2 and 1 minute warnings. Agree that bribes do work, as does distraction, but for us I try not to bribe to often as it almost immediately becomes an expectation. We've also taught him how to calm himself down, take deep breaths count to 10 and we use the time out as time for him to calm down, think about his behaviour etc. It works for us because he too hates the lack of attention.

He has 1 to 1 at school which is teaching him to take turns and to listen to other people and play their games/do as the teacher says instead of what he wants to do all the time. These are things he can do he just hasn't learnt how. They are not natural for him.

I wanted a DX so the school would understand his needs and he wouldn't be labelled a naughty child but a child who needs a little understanding and as some children need extra help with maths, he needs extra help with social communication.

He has the most amazing imagination, is very social and has lots of friends. He is a joy and everyday he says or does something that amazes me.

Yes I agree that some people will disagree with a DX (my Mum and Dad are only just beginning to believe that DS1 is on the Autistic Spectrum) but to be honest as lonjg as you are happy that your DS is getting what he needs, that is the most important thing.

Hope this helps.

BR

Thanks, BR. I don't want to be rude, but the way you describe it, it sounds like your ds's only problem is with self-control? Why does that make him ASD? I really really don't want to offend anyone, but this is what I'm really struggling with. How an affectionate, verbal child like mine or yours can be considered to have what I thought was a social communication problem. Or am I wrong in my understanding of what ASD is?

I found that article interesting, Lingle, and reassuring (whether DS is ASD or not). Any more links?