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UPDATED: ASD/Aspergers Diagnosis

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Update: Pediatrician confirmed my suspicions and referred me to a behavioral psych clinic in town for official diagnosis.  She said he is high functioning and very intelligent.  Thanks for the help everyone!


Recently (I even commented on a post yesterday over on the Chat forum) I've been coming to grips with the idea that my younger son (age 4) is showing signs of being on the spectrum.  I can't believe I didn't recognize it earlier, since my older son was diagnosed with mild ASD a couple of years ago.  However, my 9 y.o.'s issues are dominated by his severe ADHD and dyslexia, while it seems to me that my younger son presents more as classically Aspergers (I know that isn't technically it's own thing anymore, but it's still a good descriptor of what's going on with him).  Both boys are adopted and not biologically related.  I think I had it in my head that he was just one of those really really intelligent quirky kids, but now he seems so frustrated and unhappy that I think something else is going on.

My main 2 questions...

Does a pediatrician diagnose ASD, or will it always be referred to an evaluator?  My 9 y.o. was unexpectedly diagnosed during an evaluation for ADHD and dyslexia, not by his ped.

Do these concerns raise ASD red flags for y'all like they do for me?  Intense frustration/meltdowns, infant finger sucking (bloody callouses!) leading to toddler shirt biting, leading to present day repetitive whimpering (about every 2 seconds when he is not occupied by something else), precocious vocab and precise way of speaking, nitpicky of others' speech when it is imprecise, some toe walking, intense, detailed questioning, random aggression, doesn't want to make friends because, as he told me, you never know if they're going to be your friends forever or not, so why bother.  He was a very calm, almost lethargic baby that didn't babble much.  When he turned 2, he started talking normally almost all at once.  He verbalizes emotions well, but in a clinical, detached kind of way.  He pitches huge fits about haircuts, nail trims, and the vacuum.  When these things are not dominating, he's a sweet, smart little boy.

Thanks for any input y'all can give!

Edited by IvyInFlorida
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Yes, I'd say a lot of those are red flags. He sounds very much like my DS20 (who I always knew was on the spectrum but was only formally diagnosed when he was 16/17) was as a toddler/preschooler. I'm out of the loop with younger kids and will defer to those who have more current knowledge. But I can tell you that DS's psychiatrist (who he sees for GAD) told me she could diagnose him medically, but for school accommodations a psycho-educational evaluation is necessary. So the short answer there is yes, I think a ped can diagnose. But if you want to delve deeper into strengths and weaknesses and pick apart any co-occurring problems or conditions (which I'd highly recommend) you're going to need a full evaluation. And my guess is most peds wouldn't diagnose themselves, but would refer for a full evaluation.

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4 hours ago, IvyInFlorida said:

now he seems so frustrated and unhappy

Sounds like your thought to make a move on evals is timely. Whatever is going on, whatever combination, it would be good to get it sorted out.

It sounds like he'd be a really good candidate for Kelly Mahler's new Interoception curriculum https://www.kelly-mahler.com/product/the-interoception-curriculum-bundle/ If you join the FB group, you might be able to find an OT who is going to do it. He sounds like he has enough sensory issues to warrant OT anyway, and this would address the deeper oddities you're noticing about how he understands emotions, etc.

Also consider connecting him with a counselor (psychologist) who understands autism and very bright kids who can begin working with him. It won't be so much about what you're accomplishing now as planting seeds and getting him talking. The psych I have working with my ds tries to shift things from moping to self-advocacy and taking responsibility. 

I'm sure he's wonderful, and he's very lucky to have someone who's going to work so hard for him! Remember, evals are not about declaring someone defective or even trying to fix them. It's about opening doors, gaining tools, letting someone achieve their full potential. If someone has all this ability but is hampered by (pick your thing), they can be unemployable or not get to enjoy life as fully. We have such wonderful interventions and tools now, things that really speak to these super bright kids right where they are. 

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Thanks everyone! It's good to know what direction I should be going in.  I'm still sort of boggled that both boys, adopted from birth, both (probably) end up being on the spectrum.  Crazy.  But at least I already know some things I can start doing now to help relieve some of his frustration.

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