Autism eval questions

[courtney.byrum]

I'm looking over DS5's evals through the school district and am trying to determine whether we should follow up with his ped and ask for a referral (and to who...) based on his PDD Behavior Inventory (PDDBI) results.

 

He scored within the autistic range for Repetitivie, Ritualistic, and Pragmatic Language Composite as well as on the Approach/Withdrawal Problems Composite. His Language scores and the overall Autism composite were in the non-autistic range. He also scored non-Autistic on the CARS (childhood autism rating scale). For the 2 composite he scored barely into the 40-60 point range of average autistic children.

 

So what type of dr is best to evaluate for autism? We can go to a variety of locations but wasn't sure if a neuropsych or developmental ped (or something else entirely) would be best. We're seeing his pediatrician tomorrow about the low muscle tone the APE person noticed in his lower legs so I can ask then for the referral.

 

Thanks in advance for reading my book, lol

[Misty]

My daughters were diagnosed by a child psychologist, but a pediatric neurologist or developmental pediatrician can also diagnose.

[courtney.byrum]

Thanks :) I plan to search our insurance tonight to see who is covered.

[sbgrace]

Low muscle tone? Does he have any other issues--health or developmental?

[courtney.byrum]

Low muscle tone? Does he have any other issues--health or developmental?

 

He has always been 'behind' in gross motor areas but never enough that he could receive services. She thinks that the low tone is the cause of some of his delays and odd gait patterns.

 

At around 3 there were some concerns about whether he had a tethered spinal cord - oddly I don't really remember what the concerns were, but he was referred to a neurosurgeon who did an exam and an MRI. The MRI showed he did not have a tethered cord but beyond that I don't know.

 

We are being referred to a neurologist at Children's Hospital Oakland for the low muscle tone. This is oddly similar to my DD who we took to Stanford about 1 1/2-2 yrs ago for the same thing --- we did know she had low tone though her's is one sided and most likely due to her premature birth, we opted not to do an MRI since the cause was suspected and wouldn't have changed anything in regards to her therapy.

 

Sorry for the book in answer to your simple question, lol. Is there anything about the low tone that made you ask that??

 

I didn't mention that the school psych does think that some of the 'autistic-like' signs are just from him being gifted so she didn't feel we needed to really be concerned other than some social skills programs.

[Mom22ns]

Do you think he has a problem or do you think that he is just gifted?

 

To me, the spread of his scores sounds like Aspergers. An aspie, by definition has no language delays, but has social delays and usually perseverative behaviors. They also have normal to high intelligence.

 

The best judge is the parent. If you are concerned ask your pediatrician for the referral. All of the Drs mentioned in this thread can do an evaluation and give a diagnosis.

 

As the parent of a gifted ASD child, I will say it was very helpful to know what I was dealing with and it helped me deal with it in ways that fit him. I was initially by the schools that he was just gifted. They changed their tune once we got outside experts who disagreed. Ds benefitted more than I can express from the therapies and interventions offered by our school district once they got on board, so it was well worth it. YMMV.

[butterfly113]

I would agree with the other posters, and that a neuro or developmental pedi could diagnose. We saw several of the same signs as you in our ds when he was in preschool and early elementary grades. Because he was so gifted and scored academically way above others, the issues were skirted and marked due to that and a maturity thing. ;-/

Now at the age of 10, he is a clearly a brilliant aspie. :-) He was diagnosed last fall at age 9. Looking back over the years and through the summer, some things were just not making sense to me... there was still 'something.' :-) So I found this checklist online, went through it with dh and took it to ds' pediatrician. We were refered to a developmental pediatrician. He agreed Aspergers, yet had a complete neuro psychological testing/evaluation done. We also had a pragmatic language test done through a speech pathologist. Recently we have had an OT eval which revealed sensory integration/proccessing disorder and dyspraxia. (gross motor and incoordination issues).

Had I known more a few years ago, I could have started this process sooner. Yet this is the plan God has had for us. With that, in just 6 months of speech therapy and CBT (cognitive behavior therapy) we have made huge strides.

Here is a link to those checklists I mentioned.

 

http://school.familyeducation.com/learning-disabilities/behavior/56323.html

 

Scroll down and there are several checklists for various aspects. These are printable! :-)

 

These checklists gave me something 'concrete' to take to the pediatrician and go from there. Much of what you have shared could be on the spectrum, yet a formal diagnosis would best tell you exactly what is going on obviously. You are your child's best advocate. :lol:Trust your instincts and your heart.

[courtney.byrum]

Thanks for the input! Those checklists will be very useful as well. I will fill them out (and have DH do so too) and see what they show. We will definitely be seeing a neurologist for the low tone so I will bring it up at that apt as well as make a new one with his ped for a referral.

[butterfly113]

:grouphug: HUGS :grouphug: to you in this journey. :001_smile:

[sbgrace]

I actually asked because low tone is almost always brain related or metabolic. And when you run into low tone together with other things (in this case possible autism) I'd want to look into metabolics since they are often treated. However, my knowledge of the metabolic stuff that often causes low tone and autism like symptoms (very common in certain conditions affecting fat metabolism or mitochondrial function) they also include other health issues.

 

I made a post about signs of metabolics on the link below if you want to look and see if anything fits. http://www.mothering.com/discussions/showthread.php?t=734501 If for some reason the link doesn't work or you have questions feel free to send me a message.

 

He has always been 'behind' in gross motor areas but never enough that he could receive services. She thinks that the low tone is the cause of some of his delays and odd gait patterns.

 

At around 3 there were some concerns about whether he had a tethered spinal cord - oddly I don't really remember what the concerns were, but he was referred to a neurosurgeon who did an exam and an MRI. The MRI showed he did not have a tethered cord but beyond that I don't know.

 

We are being referred to a neurologist at Children's Hospital Oakland for the low muscle tone. This is oddly similar to my DD who we took to Stanford about 1 1/2-2 yrs ago for the same thing --- we did know she had low tone though her's is one sided and most likely due to her premature birth, we opted not to do an MRI since the cause was suspected and wouldn't have changed anything in regards to her therapy.

 

Sorry for the book in answer to your simple question, lol. Is there anything about the low tone that made you ask that??

 

I didn't mention that the school psych does think that some of the 'autistic-like' signs are just from him being gifted so she didn't feel we needed to really be concerned other than some social skills programs.

Edited April 22, 2010 by sbgrace

[courtney.byrum]

Thanks for the info. I will have to go read your post that you linked.

 

Is this something a neurologist would look into? For my daughter they do believe the low tone is due to a brain injury at or before her birth (she was a 29 weeker but I did have preterm labor for about 6-9 weeks prior to her birth.

 

For my son we didn't know he had low tone so we have no idea of the cause BUT he did have a head injury at birth and I did have preterm labor with him as well so it could have been an unknown brain injury I guess. I am very curious about the metabolic stuff though so if a neurologist wouldn't look into that how would we look into it? Keeping in mind I haven't read your other post yet :)

[sbgrace]

Thanks for the info. I will have to go read your post that you linked.

 

Is this something a neurologist would look into? For my daughter they do believe the low tone is due to a brain injury at or before her birth (she was a 29 weeker but I did have preterm labor for about 6-9 weeks prior to her birth.

 

For my son we didn't know he had low tone so we have no idea of the cause BUT he did have a head injury at birth and I did have preterm labor with him as well so it could have been an unknown brain injury I guess. I am very curious about the metabolic stuff though so if a neurologist wouldn't look into that how would we look into it? Keeping in mind I haven't read your other post yet :)

Take a look at the post of course. If you see signs of metabolics then you'd want to see someone who does them (metabolic neurologist or some geneticists for example) but if you suspected mitochondrial issues you'd have a very small pool of doctors to use who know mito. But I'm skipping ahead as this may not be the underlying issue for your kids at all. Please feel free to contact me (either place) if you've got questions. I'll try to help.

Edited April 23, 2010 by sbgrace

[courtney.byrum]

Take a look at the post of course. If you see signs of metabolics then you'd want to see someone who does them (metabolic neurologist or some geneticists for example) but if you suspected mitochondrial issues you'd have a very small pool of doctors to use who know mito. But I'm skipping ahead.

It's sort of curious that you have two kids with low tone. Does your daughter have a known brain injury, then?

 

Known injury - no, suspected injury yes. She never had any brain bleeds during our time in the NICU - they checked quite a few times. We and our neurologist agreed on waiting on an MRI since nothing would have really changed so it wasn't urgent. Now that she's 4 maybe we should consider having it done I guess. Her low tone was one sided -torso and leg -so that added to their suspecting it was a brain injury. It was her PT who told us about it and our ped referred us to a neurologist.

[sbgrace]

Known injury - no, suspected injury yes. She never had any brain bleeds during our time in the NICU - they checked quite a few times. We and our neurologist agreed on waiting on an MRI since nothing would have really changed so it wasn't urgent. Now that she's 4 maybe we should consider having it done I guess. Her low tone was one sided -torso and leg -so that added to their suspecting it was a brain injury. It was her PT who told us about it and our ped referred us to a neurologist.

Ah, one sided does sound brain related. Seems reasonable. And I see she has risk factors for that/potential causes. That said, metabolics can cause brain injuries as well. But the tone issues I usually see are low tone throughout. My son's is relatively mild though he had gross motor delays.

Did your son have the same risk factors for brain injury?