ASD or FASD?

[roundwindow]

Hi all, don't know if anyone's got any experience/knowledge on this but I'm tying myself up in knots so here goes:

We've been concerned about DS1(5) for a couple of years now... he's under the community paed and on the SN register at school (SA plus). We don't have any kind of dx as yet but paed has idenitfied a definite developmental delay and social communication difficulties. He's really struggling at school, way behind with literacy etc. (which we don't care about at all with him being so young, we're pretty sure he's a bright boy ) is generally quite anxious and really not making friends and mixing with other children very well.

At home we're dealing with various behavioural difficulties which seem to go in phases (currently going through a bit of a tricky patch) which include meltdowns, obsessive behaviours, toileting difficulties, impulsiveness, sensory issues, etc.

We're lucky/unlucky enough to have a couple of medical professionals in the family all of whom seem pretty certain that he's on the spectrum but our own paed here is quite keen to hold off on labelling, which we're fine with given that he is still so young.

anyway, like many parents in our position, I've spent hours and hours trawling the internet and have found great solace/support in recognising many of dh's traits and the fallout they cause faced by others, mainly by parents of children with ASDs. And I've been doing lots of soul searching as to what may have caused these difficulties: is there any family history of autism? is it significant that he was deprived of oxygen at birth? is it because I was a miserable wreck for the first few months of his life?

I don't quite know what led me to persue it, but I've been reading up about Fetal alcohol spectrum disorders. And to my horror I discover that so many of the behavioural/learning difficulties diagnostic criteria fit DS to a tee. The thing is, though, they're so similar to ASD traits, I just don't really know what makes one distinct from another.

I didn't abstain from alcohol during pregnancy (wish wish wish I had now ) but I'm pretty sure I did stay within what were then the government guidlines, 1-2 units, once or twice a week. I remember my GP telling me at my 12 week booking in appointment 'the odd glass of wine is fine'. At the time I was working and socialising in quite a boozy environment and the idea of just abstaining completely didn't seem to occur to anyone. So I do remember having the odd half pint or friday night glass of cava in the office here and there, once I'd stopped feeling sick. It's weird, because I was also a smoker but the need to STOP smoking completely once I was pregnant was utterly clear cut, so that's what I did. I now just wish it had been the same with alcohol.

Anyway, I'm now feeling utterly wretched about the whole thing and as I say tying myself completely up in knots . I know I can't change things one way or the other now but sometimes when I see my DS struggling on with life in a world that seems so at odds with who he is my heart breaks. And now I'm feeling like this could all be my own stupid fault.

Does anyone have any knowledge/experience/ideas on this? Sorry for being so rambly but I'm feeling quite vulnerable today.

Must admit I had thought that with FASD there were very distinctive physical features - eg underweight, and a distinctive facial characteristic. I drank the odd glass thru both pregs - but that's not how FASD is caused - in my understanding FAS is caused by pregnant women mainlining vodka every day throughout pregnancy, a very different ball game!. I think ASD is such a wide spectrum that it's poss your DS has autistic traits, or even aspergers, but doesn't have the full range. I don't personally think though that it's ever too early to diagnose, as with a diagnosis comes a bit more understanding at school (sometimes!) and maybe extra help. Sometimes LEA sponspored paeds don't want to firm up on a diagnosis as it would mean funding commitments for the borough. It could be aspergers too - does he have speech delay. NB FWIW, I am firmly in the camp that autism is genetic, not caused by birth problems or the odd glass of wine. But then I have a fairly clear family history going on, plus my boy had no MMR. Not sure if any of this helps, but I wanted to reply

Oh Roundwindow-don't do this to yourself!You know you did all that the majority of us do, and no more.
I certainly did not abstain during my first pregnancy-particularly since I didn't know I was expecting for 16 weeks(long story)and was on a perma hol in Greece.My DD is now a 15 year old predicted straight As at GCSE.

Your DS sounds a wonderfully challenging boy and you sound a normal(!) Mum, with normal worries...and of course in todays society we want everything that happens, to do so for a reason.IT DOESN'T.
Hope you get loads of love and support from all Mumsnet members

I have taught numerous children with FAS and they did all look very similar - should be something a paed might pick up on, I would have thought, if there was any suspicion that it could be that. Plus, the parents of the children I've known with FAS drank excessively, not amounts like you describe.

I think SN brings its own guilt. I am very aware (as ex keeps pointing out) that it's my family's genes which have 'caused' the autism in J. I'm also aware that my stress in pregnancy wasn't ideal and I wish I'd walked away from the ex then rather than go through all of that. Didn't really know it could be harmful to the baby . So blaming yourself and feeling guilty is normal and sometimes, like in my stress example, there's something to it, slightly, and sometimes, like in my genes examples, it's not something where blame even comes into it. But FWIW, it doesn't sound likely to me that what you did would have caused your ds's problems and I hope you can find it in you to stop blaming yourself.

I would raise it with paed so you can feel you've had it looked at and ruled out, for your own peace of mind.

x

Thank you so much for the lovely, supportive replies. I know I should really step away from the googling, that's good advice, good idea to raise it with the paed as well. One day I think I need to accept that even if I do get 'all the answers' about DS's condition, nothing's going to make it go away. But I'm not quite there yet.

On which note: givememoresleep you say you've taught children with FAS and they all look similar... can you describe how they looked? I'm now wondering if there's anything the Paed might have been looking out for/picked up on. I imagine this is a very sensitive area for professionals to raise with parents...

roundwindow - in a previous life i was a Sw with children and families and all our FAS babies were born to mummies who were chronic alcoholics - really heavy drinkers - so i think its highly unlikely your alcohol use is to blame - babies had little elfin faces, wide bridge between the eyes and quite flat here - also low birth weight, very often failure to thrive, unsettled difficult babies. don't beat yourself up and check it out with paed - good luck

As kerpob says, elfin heads - very distinctive shape, as the foetus just lies head down (drunk) all the time so its head sort of squashes against the mother's pelvis. It's very very obvious, in my experience. Plus very underweight, flattened features.

I can't imagine a paed wouldn't spot something.

Please raise it yourself if you are worried. I want you to get some reassurance.

Dont do it to yourself! I dont smoke or drink, I had a very healthy diet during the pregnancy and I was active as well. Yet my daughter (4.5) has the same sympoms as your DS.
The pead, child psychologist and specialist health visitor diagnosed her with complex social communication behaviour. Shes on school action plus, she gets speech and language therapy every week. She has a lot of symptoms of ASD, yet they didnt specify what excatly she has. Well have to go back to the child development team in July/August to see if things improved. The teachers at her school said, she makes more sense when she talks and now shes engaging with other children. Im always hoping, things will improve and shell be like other normal children.

please don't torment yourself like this, at the time you were PG the government guidelines allowed for modest drinking anyway. I agree with the other ladies about speaking to a paed about this as I am sure that will reassure you.