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Should I be concerned about this child


Marie131
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I am worried about my 6 y/o.  I don't know if it's b/c I am over-sensitive to this stuff b/c we are going through testing with our oldest (for ASD) or if my concerns are warranted.  I would really appreciate feedback.

 

I'll list my concerns in bullet form, I hate paying special attention to all his flaws b/c he is a great kid.  But I have to be honest about my concerns w/out sugar coating them.

  •  Hyper-active - he acts as if he is being driven by a motor.  No doubt.  Little control over his behavior.  Sometimes does wild things b/c he gets over-the-top silly and can't quit. 
  • Easily distractible - takes forever to eat a meal or dress himself. 
  • can be very mean and lacking empathy - hurts people intentionally (and is unprovoked)
  • Speaks very loudly.  Had his hearing checked b/c of it (and his inability to listen).  His hearing is fine
  • Frequently interrupts and never stops chattering
  • has trouble making friends - his Sunday School teacher approached me and told me that he keeps to himself and works alone at a table despite attempts to have him join the group.
  • Little control over his emotions
  • Has trouble making eye contact (maybe b/c he's always moving??)
  • Does not own up to his own actions and blames others for his wrong-doings
  • for several months he's had a nose twitch and made a strange throaty gulping sound.  Dr prescribed meds for allergy.  Meds haven't helped.  I'm wondering if it is a tic.

Right now I'm feeling like the words wild and out of control sum him up pretty well.  He has always been a pretty good kid, but once he turned 4 he became very difficult.  I've been waiting for him to outgrow this, but he's not.

 

Today he did something really over the top and it was the last straw for me. 

 

But he is a nice kid.  A fun kid.  A lego kid who can spend hours upon hours constructing.  He's a bright kid.  No doubt about that.  He is gifted in language and has always been advanced in that sense, though I'm not sure I would call him "gifted" in general.

 

So..what do I do?  Could this be *something*?  Am I over-analyzing?  Help!

 

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I am worried about my 6 y/o.  I don't know if it's b/c I am over-sensitive to this stuff b/c we are going through testing with our oldest (for ASD) or if my concerns are warranted.  I would really appreciate feedback.

 

I'll list my concerns in bullet form, I hate paying special attention to all his flaws b/c he is a great kid.  But I have to be honest about my concerns w/out sugar coating them.

  •  Hyper-active - he acts as if he is being driven by a motor.  No doubt.  Little control over his behavior.  Sometimes does wild things b/c he gets over-the-top silly and can't quit. 
  • Easily distractible - takes forever to eat a meal or dress himself. 
  • can be very mean and lacking empathy - hurts people intentionally (and is unprovoked)
  • Speaks very loudly.  Had his hearing checked b/c of it (and his inability to listen).  His hearing is fine
  • Frequently interrupts and never stops chattering
  • has trouble making friends - his Sunday School teacher approached me and told me that he keeps to himself and works alone at a table despite attempts to have him join the group.
  • Little control over his emotions
  • Has trouble making eye contact (maybe b/c he's always moving??)
  • Does not own up to his own actions and blames others for his wrong-doings
  • for several months he's had a nose twitch and made a strange throaty gulping sound.  Dr prescribed meds for allergy.  Meds haven't helped.  I'm wondering if it is a tic.

Right now I'm feeling like the words wild and out of control sum him up pretty well.  He has always been a pretty good kid, but once he turned 4 he became very difficult.  I've been waiting for him to outgrow this, but he's not.

 

Today he did something really over the top and it was the last straw for me. 

 

But he is a nice kid.  A fun kid.  A lego kid who can spend hours upon hours constructing.  He's a bright kid.  No doubt about that.  He is gifted in language and has always been advanced in that sense, though I'm not sure I would call him "gifted" in general.

 

So..what do I do?  Could this be *something*?  Am I over-analyzing?  Help!

 

ADHD sounds possible, but so does Asperger's. The biggest difference between the two would probably be the source of the behavior. For instance, you said that he is hurting feelings. If that is true, it might be inhibition problems with ADHD. Or, if you've told him he's being rude, and he just doesn't agree with you, that could be Asperger's. My Aspie once bit a kid while in line for the bathroom because he said he needed to go worse than the other child. He wasn't trying to be mean--he seemed to see it as problem solving. He was pretty horrified after he realized he'd been mean. My son also would not always know why he acted out. Sometimes he knew that he was being excluded or not keeping up, and he would act out. It would be inappropriate because another child would know to move on to another situation. Sometimes the other kids would be subtle about being mean, and the teacher or other adult wouldn't know. My son would feel bad, but not know why, so he'd act out in some odd way, and his behavior would be the only behavior in the group that was considered inappropriate--the other kids knew to hide their inappropriate behavior or were mature enough to put up with someone else's irritating behavior up to a point. My son also doesn't see facial expressions the same way--I can be furious, and he can't see it on my face (it's plain as day). I didn't know this until I asked him--he was piecing things together from other information and getting it right from time to time. So, arguments would really get out of scale because he wouldn't respond to low-level irritation on the part of others.

 

The tics could be sensory or a need to stim. Some kids have tics without being on the spectrum (one of mine does). This is a really informal thing to try, and it may not be quite on target, but if you offer a different outlet for sensory stuff that he likes, and he stops the tics, it's probably sensory. If he doesn't stop, it might be a tic, or it might be a spectrum stim. Our Aspie has tic-like behavior that is present only when he is tired, nervous, or meeting someone new (face rubbing, rubbing his palms on his thighs). He also has vocal stims, some of which disappear when his sensory needs are met. All of it can fall under repetitive behaviors or sensory stuff based on context.

 

Sensory stuff can present as ADHD symptoms even if the child doesn't have ADHD. Our Aspie acts ADHD, but only when his sensory needs are not met (or he's anxious).

 

Eye contact is a big one for spectrum kids. We thought my son had pretty good eye-contact, but that's because he does have decent eye-contact with us. Not so much with others, but we weren't there to see it.

 

ADHD is a diagnosis of exclusion, meaning that you rule out everything else before calling it ADHD. It's not often diagnosed that way IRL. You might want to have him evaluated to see what else could be causing these behaviors. It's not unusual for kids on the spectrum who have less obvious symptoms to be diagnosed later (even in their early teens) because they are better at compensating. For a long time, it might look like ADHD, etc. until more symptoms emerge.

 

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Oh, and ADHD can go along with ASD. No trying to convince you he is on the spectrum; just trying to convince you to not overlook the possibility. Our son would have met an ADHD diagnosis just fine, but it wouldn't have been the whole story. And unless the sensory stuff had been addressed, we would not have had success treating it as ADHD.

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Oh, and ADHD can go along with ASD. No trying to convince you he is on the spectrum; just trying to convince you to not overlook the possibility. Our son would have met an ADHD diagnosis just fine, but it wouldn't have been the whole story. And unless the sensory stuff had been addressed, we would not have had success treating it as ADHD.

 

Thanks  for chiming in with your thoughts.  The thought of ASD has been on my mind simply because his brother is being evaluated for it and I know these things often run in families. 

 

In fact, I am almost wondering if it is.  Many times he will do something mean (hit his brother, kick the cat) and he won`t know why he does these things.  Or if he gets into a fight with his brother he is unable to communicate what happened or why he reacted in certain ways.  He also has never been very good at communicating his feelings.

 

He doesn`t seem to have sensory issues like his older brother.  Maybe he does and I just haven`t clued in.  I`ll keep an eye out for it.

 

He does do some repetitive movements, no hand flapping, but he does spin.  He likes to repeat lines from movies over and over.

 

But on the other hand, he is very different from his brother whom we are evaluating for ASD.  He is more willing to try new things and participate in group sports, where his brother just won`t do it.  He seems to be more social too, but he is less empathetic.

 

Regardless of what it could be, it sounds like further investigation is warranted and I`m not just being an overly worried mother.  I think I should probably bring this up with his doctor.

 

I`m interested in your suggestion regarding the tics, I am wondering what kind of sensory outlet you would suggest.  I want to give this a try since it seems we can't find a cause for them.

 

 

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Thanks  for chiming in with your thoughts.  The thought of ASD has been on my mind simply because his brother is being evaluated for it and I know these things often run in families. 

 

In fact, I am almost wondering if it is.  Many times he will do something mean (hit his brother, kick the cat) and he won`t know why he does these things.  Or if he gets into a fight with his brother he is unable to communicate what happened or why he reacted in certain ways.  He also has never been very good at communicating his feelings.

 

He doesn`t seem to have sensory issues like his older brother.  Maybe he does and I just haven`t clued in.  I`ll keep an eye out for it.

 

He does do some repetitive movements, no hand flapping, but he does spin.  He likes to repeat lines from movies over and over.

 

But on the other hand, he is very different from his brother whom we are evaluating for ASD.  He is more willing to try new things and participate in group sports, where his brother just won`t do it.  He seems to be more social too, but he is less empathetic.

 

Regardless of what it could be, it sounds like further investigation is warranted and I`m not just being an overly worried mother.  I think I should probably bring this up with his doctor.

 

I`m interested in your suggestion regarding the tics, I am wondering what kind of sensory outlet you would suggest.  I want to give this a try since it seems we can't find a cause for them.

 

When our psychologist first suggested that our son might have Asperger's, we kind of dismissed it because he wasn't like other kids we knew who were on the spectrum. :-) I've heard that's really common! The saying goes, "if you've met one kid with ASD, you've met one kid with ASD."

 

Our son needs a lot of heavy lifting, pushing, and pulling. He's a seeker for these things, but he sometimes avoids other things. We didn't realize he was seeking these behaviors--we thought he was just a hard worker who liked chores. (He'd make a fantastic farmhand!) Our psychologist also said that sensory and anxiety are two sides of the same coin. Our son has some anxiety, but in his case, it looks like avoidance, crankiness, acting out, big fits, etc. He doesn't have any really big negative reactions to sensory stuff, except when someone reaches for him from behind (then it's fight or flight response). He can often hide it really well. I had not heard of sensory issues until I read The Mislabeled Child, and then a lightbulb came on. I looked into it more and saw that he has always gravitated toward dragging heavy stuff around and that he loves the pressure on his body when he swims. He also likes pressure on his joints (squatting, jumping, pedaling a bike). He does not like to have his head back for any reason, esp. in the pool (gravitational insecurity). He will sometimes make himself lean his head back under controlled circumstances. Oh, and he has a STRONG vaso-vagal reaction (prompts fainting, seeing stars, etc.).

 

The Out of Sync child has some checklists for sensory seeking, avoiding, and combination behaviors. For some kids, it's spinning (or hating it). Some are chewers. They are all different. Some kids either love it all or hate it all, and for some kids, it's just one or two things, but it's intense. Also, for some kids it's more of an under-responsiveness or over-responsiveness to stimulation--anything from ignoring when they need to pee to having either freaky high or low pain tolerance (or both low and high depending on the day!). When my son doesn't get enough sensory input of the right kind, or he is tired, in addition to being ADHD-like, he starts falling out of chairs, falling on the floor, bumping into walls. Sometimes it's being silly, and sometimes he's mad when he does it. He also gets really loud and clunky. It's not so much being clumsy and just unaware that he's slamming the door off its hinges, slamming his books on the table, or stepping right on top of a pile of toys. I've read some firsthand accounts from adults with sensory issues, and some of them feel as though they actually lose contact between their bodies and brains or like a feeling of numbness in some part of their senses.

 

He likes to retreat to his room and sit on his bed when he is overwhelmed or having a meltdown. He also sometimes seems like an intense introvert, but he's actually a pretty outgoing introvert if he's not in a big crowd--crowds, lights, etc. tire him out. When he was a toddler (just over a year old), we went to a huge family event (60+ people) at my parents' house. After a while, he tried to find a spot alone and quiet. He went all the way from the front yard to the backyard, going through the whole house in-between. When he couldn't find a quiet spot, he made a disgusted noise and went to the quietest spot he could find. He has always been that way--even in the womb. He'd go to sleep when he got overwhelmed by noise while I was pregnant with him. He'd literally conk out inside of me and not move for several hours if it was noisy. If he gets too much stimulation, he will often retreat to Legos in his room or something like that. Anything that lets him putter quietly with his hands (even sorting his toys and putting them away sometimes). Over time, he has voluntarily started to opt out of overly stimulating events now that he can see how it affects him.

 

For my son's vocal stims (usually music), sometimes putting on music will help him--he'll stop making noises. Other times, he keeps right on going, and then we give him lots of sensory. Other times, it's just fun--he'll read a story out loud with an accent (recently Australian to mimic our babysitter). Sometimes it's animal noises, complete with behavior. So, if it's sensory, adding input can help him. Sometimes it's just Asperger's having fun in a quirky way that feels good to him.

 

If nothing helps, you might ask about how tics relate to ASD. I think they are fairly commonly co-existing. My littler kiddo has some tics--a blinky eye, some stuttering, repeating his words back to himself (palilalia), and they are soothing to him somehow. He doesn't show any other signs of ASD. His tics increase with anxiety or tiredness. He has some control over them, but sometimes he likes them--particularly blinking his eye. I've heard that giving in to tics feels like scratching an itch. My husband said he did this kind of thing when he was little too, and it went away on its own.

 

Sorry to dump so much information. Other than a couple of big symptoms like the heavy lifting, my son's symptoms for sensory are subtle enough that we could dismiss individual symptoms as some other problem until we pile them all up. I wanted to give you a broad picture in case your son is that way too.

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  • 2 weeks later...

I think I googled a lot after I read about sensory issues in The Mislabeled Child, and the lights came on about what kinds of activities our son might like/avoid. Then, I used The Out of Sync Child to get more information.

 

I've requested these books from the library, thanks for suggesting them :)

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Thank you, that link is helpful too.  It seems there could be some issues going on.  I had a second Sunday School teacher talk to me today concerned about him isolating himself from the other kids :(

 

Ugh, why can't parenting just be easy...

 

Your reply makes me remember that my oldest was very much like this in the early years. We only found out she had CAPD when she was 16. When she was young, I thought about ADHD a lot, but testing doesn't show that's what she has. CAPD may be something to think about getting him tested for. You will only want a pediatric audiologist familiar with it. CAPD can go along with other processing glitches, not always serious enough for a dx but enough to cause frustration. Before that, though, ruling out AS would be helpful. 

 

I'm sorry it's hard. Like you, I have four, and it seems like there's always something going on with one of them. Thankfully, we have place like this to get information and support.

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Your reply makes me remember that my oldest was very much like this in the early years. We only found out she had CAPD when she was 16. When she was young, I thought about ADHD a lot, but testing doesn't show that's what she has. CAPD may be something to think about getting him tested for. You will only want a pediatric audiologist familiar with it. CAPD can go along with other processing glitches, not always serious enough for a dx but enough to cause frustration. Before that, though, ruling out AS would be helpful. 

 

I'm sorry it's hard. Like you, I have four, and it seems like there's always something going on with one of them. Thankfully, we have place like this to get information and support.

 

Good thought.

 

At age 6, you will likely be able to get a wide screening that covers CAPD as well as some other auditory and speech issues--you will not be able to get formal CAPD testing. My kids have a screening done as part of the evaluation process. My older one (the Aspie) passed with flying colors even though CAPD is often comorbid. My little guy tests as probably having CAPD, but an audiologist will not test until he's at least 7, and 8 or 9 is more common. It does have a lot of overlapping symptoms, but I thought you should know that a minimal screening is probably the best you're going to get at this point for CAPD. Apparently the testing requires a great deal of work on the part of the child, so they don't test early. Even if the child is compliant and focused enough to sit through the testing, they don't have enough norms/data to compare to how other six year olds with normal auditory processing respond to the test.

 

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Good thought.

 

At age 6, you will likely be able to get a wide screening that covers CAPD as well as some other auditory and speech issues--you will not be able to get formal CAPD testing. My kids have a screening done as part of the evaluation process. My older one (the Aspie) passed with flying colors even though CAPD is often comorbid. My little guy tests as probably having CAPD, but an audiologist will not test until he's at least 7, and 8 or 9 is more common. It does have a lot of overlapping symptoms, but I thought you should know that a minimal screening is probably the best you're going to get at this point for CAPD. Apparently the testing requires a great deal of work on the part of the child, so they don't test early. Even if the child is compliant and focused enough to sit through the testing, they don't have enough norms/data to compare to how other six year olds with normal auditory processing respond to the test.

 

 

Right. There's a lot of natural variation when it comes to when the auditory system matures. And the testing is rigorous, requiring extended concentration.

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So, I am now 30, and technically not on spectrum, however both my mother and my brother are quite significantly. My father worked all the time (probably because my mother and brother were both on spectrum) so I was raised by two people who, though wonderful, lack basic skills. I wasn't feral, but never learned societal skills. In the end, I wound up having LOTS of learned behaviors that appear on the spectrum. It drives my husband crazy sometimes; he calls me Nell. For Example:

 

My executive function is low. (My mom would purchase new undies for us instead of doing the laundry; my brother didn't drive till he was over 24. I had almost no modeling)

 

I don't imply and I have very little concept of when people are implying. (No one I talked to for my youngest years, or my real conversation building years has this skill. For high school I was independent study and accelerated college so I missed it almost completely. People were implying everywhere and I was oblivious.)

 

My empathy is high, but I have difficulty picking up on other's emotions. If you say, "I feel discontent" I can nurture like crazy, but I have difficulty distinguishing that you are frustrated. It is also difficult for me to figure out emotions from long narratives. I can, but it is touch and go. I really need some one to openly state their emotions. (My house had meltdowns or hermits. I am now learning tone with my own voice, but this is the hardest of them all)

 

I get overwhelmed with tasks people see as really normal. However, since recognizing this, I can personally break the task down into tiny increments which I then feel confident about. Once the increments have been practiced a bit, the entire task can be done easily without overwhelming. (Low executive functioning again)

 

I have no idea what many normal phrases mean and thus have trouble with judgement calls. 'Sort the laundry' was an interesting one my husband used early on in our relationship. Did he want me to sort by color? Clothing item? Body part it was used with? Material? Hue? Weather condition? (No one ever taught me how to do laundry. I read the lid of the washer when I really needed clothes for school)

 

I HATE surprises. They make me have emotional panic attacks because I do not know how to act appropriately. (meltdowns and hermits again)

 

I am brutally honest, because I do not understand why we lie all the time as a society. (Black and white, hyper logical thinking and a complete lack of empathy was all I was exposed to when I was younger. Grey is hard for me. On the plus side, I have learned to never take offense to anything.)

 

Anyway, I say all this because your son might not be on spectrum at all if he has someone he is learning behavior from. The difference between me and someone on Spectrum is that once you let me know, I am golden. One book on executive function and it was 180 in three weeks with organizational and household tasks. I am just unaware due to living in a very odd household, then living on my own, then working/going to school/being a single mom. I never fit in, but I wasn't my brother either. My son has really helped. He openly tells me things like ,"Mom, you sound aggressive when you speed your voice up like that. The words get all clippy." See if your son can adapt once he knows what to do or how to do it. It is important to explain that just because someone else might behave this way, doesn't mean it is effective.

 

If he can adapt well, autism is probably not the issue. Most criteria do not take family modeling into the picture. Many kindergarten through second graders who have siblings on spectrum have provisional IEP's just to see if through intervention adaptation can occur. (I used to be an elementary SpEd para.) It isn't always the case, but at least 60 percent if the time the sibling was imitating the other family member.

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Anyway, I say all this because your son might not be on spectrum at all if he has someone he is learning behavior from. The difference between me and someone on Spectrum is that once you let me know, I am golden. One book on executive function and it was 180 in three weeks with organizational and household tasks. I am just unaware due to living in a very odd household, then living on my own, then working/going to school/being a single mom. I never fit in, but I wasn't my brother either. My son has really helped. He openly tells me things like ,"Mom, you sound aggressive when you speed your voice up like that. The words get all clippy." See if your son can adapt once he knows what to do or how to do it. It is important to explain that just because someone else might behave this way, doesn't mean it is effective.

 

If he can adapt well, autism is probably not the issue. Most criteria do not take family modeling into the picture. Many kindergarten through second graders who have siblings on spectrum have provisional IEP's just to see if through intervention adaptation can occur. (I used to be an elementary SpEd para.) It isn't always the case, but at least 60 percent if the time the sibling was imitating the other family member.

 

Interesting that you should mention it b/c I often do wonder if his behaviors are learned.  However, he is very different from his brother in many ways so it's hard to know.  I also feel like I don't know what normal childhood behavior is since my yard stick isn't typical.

 

My dh wants to get him in to see the doc.  I suppose if anything it will ease my concerns, or justify them.  I just don't know.

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It is a hard decision.  For what it is worth, my brother was not directly identified when he was younger due to it being like 20 years ago and we lived in a small, conservtive mill town.  As he has gotten older, it has gotten much worse.  At this point, interventions are hard.  You may want to know just so that you can intervene now, when he is still maleable (even though it probably doesn't seem very maleable when change occurs in your house without him getting warning).  I can't say it would have been the greatest experience having to deal with all the issues when I was a teen/pre-teen, because I know I was overly self conscious then.  However, there are times now when I will read something and go, 'Well why couldn't someone have just said something?!"

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  • 3 weeks later...

This sounds SO much like my 5yo dd. other than the tics which I have not noticed. But they may be there. She also has serious behavioral issues that we can't get on top of. Over the top meltdowns when things don't go the way she expected. Outbursts from small things. And so many things that must be just so. I have not yet had her evaluated but I've been considering it for a long time. I've even thought a few times of posting about it just as you have.

 

I hope you find some answers. Please update if you can. I am interested to know what you find out. Though I suppose I should be starting the process of evaluation now too.

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Thanks, CPSTAnne.  I will update and feel free to update too.  I'd like to know how things go w/ you too. 

 

I had a discussion w/ one of the SE people at our school and she agreed that we are seeing some red flags but suggests that we wait until after our first son's assessment is complete before proceeding w/ this next guy as it could be the same thing just presenting in a different way.  She also pointed out some sensory issues that I wasn't even aware of.  Our resource teacher has also noticed a change in his behavior and ways of relating so I feel reassured that I'm not nuts.  My family is always downplaying the situation and suggesting it's something as simple as being a middle child, but I don't think so. 

 

I'm meeting w/ a new NP tomorrow so I will probably let her know that I'm concerned.  Our oldest son's assessment is next month so we will go from there.

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  • 2 weeks later...

Update:  I took my kiddo to meet our new doctor.  She got to experience him full throttle.  She dx his vocal sound as a tic and is sending us to a ped for further evaluation to see if an assessment is recommended.  If the wait is anything like it was w/ our older son, we'll be seeing the ped in about 3 months.  She asked me to compose a list of concerns, which we did.  It all has an ASD flavor. We'll see what our ped has to say.

 

I'm feeling exhausted and overwhelmed. 

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Update:  I took my kiddo to meet our new doctor.  She got to experience him full throttle.  She dx his vocal sound as a tic and is sending us to a ped for further evaluation to see if an assessment is recommended.  If the wait is anything like it was w/ our older son, we'll be seeing the ped in about 3 months.  She asked me to compose a list of concerns, which we did.  It all has an ASD flavor. We'll see what our ped has to say.

 

I'm feeling exhausted and overwhelmed. 

 

:grouphug: Thanks for continuing to update us.

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  • 4 months later...

Saw the ped and she thinks it's ASD. She said ADHD doesn't strike her at all.  My oldest son has recently been dx ASD, ADHD and a LD of written expression.  There might be giftedness in there too.  I haven't got the full results from the cognitive testing but there has been some eluding to that as well.  Anyways, we're being sent for an assessment for this guy and genetic testing for the family.

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