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ADHD, Asberger's, or Anxiety?
Kari
Posts: 1,765
I had Justin's fine motor skills evaluated and while he was kind of low and had a mild tremor in his hands, the evaluator thought it would be fine if he just works at it. Behaviorally she noted a few things from her observation that I also corroborated on the phone with her: low frustration tolerance, difficulty completing a task when he wants to start another (like finish pulling on his pants if he sees a toy he wants), aggressive behavior when excited, and babbling in baby talk when stimulated. But she thought he was fine and I should give them a call if, over time, I notice any sensory issues.
Fast-forward about eight hours. We're home on Halloween and Justin is sitting quietly at the table eating dinner. My dad shows up and Justin loses all interest in eating and is running around the house. He starts to calm down about 10 minutes later when his buddy from daycare shows up to trick-or-treat with his dad and grandma. Justin goes into a tailspin and spends the next ten minutes running around the room, yelling, talking in his made-up baby babble, tossing a ball repeatedly in this boy's face, squawking, etc. The grandma and I talk frequently and she knew I'd had him evaluated recently. I looked at her and said, exasperated, he passed with flying colors.
This morning she waited for me at the daycare and said I absolutely should have him tested by someone else because his behavior was very similar to her son, who has anxiety and difficulty in social situations. I talked to the school nurse, and her son also has anxiety and the behaviors seemed awfully similar. My sister thinks he has ADHD, but she only sees the hyper side of him because he gets really spastic when we visit them, but he's calm and can sit down and work at a puzzle or game quietly and with concentration for 10-20 minutes frequently throughout the day. At the end of daycare the grandma also suggested the possibility of Asberger's.
I was kind of glad my dad witnessed the whole thing because he's been saying to me that Justin is spoiled or manipulative, but after last night he started asking questions like how frequently and to this intensity has this happened in the past, and is this what I've seen when I've made vague comments about having a difficult time at library hour or the supermarket, and why I turn down invitations to go out to dinner.
Any thoughts on the way to tell the difference between the three? Does a checklist of behavior comparison points exist? If anyone else went through a diagnosis process with their kids, was there an "a-ha" moment when you knew you were on the right path?
Fast-forward about eight hours. We're home on Halloween and Justin is sitting quietly at the table eating dinner. My dad shows up and Justin loses all interest in eating and is running around the house. He starts to calm down about 10 minutes later when his buddy from daycare shows up to trick-or-treat with his dad and grandma. Justin goes into a tailspin and spends the next ten minutes running around the room, yelling, talking in his made-up baby babble, tossing a ball repeatedly in this boy's face, squawking, etc. The grandma and I talk frequently and she knew I'd had him evaluated recently. I looked at her and said, exasperated, he passed with flying colors.
This morning she waited for me at the daycare and said I absolutely should have him tested by someone else because his behavior was very similar to her son, who has anxiety and difficulty in social situations. I talked to the school nurse, and her son also has anxiety and the behaviors seemed awfully similar. My sister thinks he has ADHD, but she only sees the hyper side of him because he gets really spastic when we visit them, but he's calm and can sit down and work at a puzzle or game quietly and with concentration for 10-20 minutes frequently throughout the day. At the end of daycare the grandma also suggested the possibility of Asberger's.
I was kind of glad my dad witnessed the whole thing because he's been saying to me that Justin is spoiled or manipulative, but after last night he started asking questions like how frequently and to this intensity has this happened in the past, and is this what I've seen when I've made vague comments about having a difficult time at library hour or the supermarket, and why I turn down invitations to go out to dinner.
Any thoughts on the way to tell the difference between the three? Does a checklist of behavior comparison points exist? If anyone else went through a diagnosis process with their kids, was there an "a-ha" moment when you knew you were on the right path?
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It's hard to be at the beginning of trying to figure this out, it seems there are so many potential difficult scenarios. But, no matter what, he is still Justin.
I don't know anything about aspergers.
I just turned 50 and fabulous!!! Enjoying life with my amazing family!!
Mom to Rachel 33, Bethany 30, Rebekah 30, Zachrey 20 and several angel babies
Grandma to Larissa 11, Brittney 11, Trevor 11, Destiny 7, Jayvin 6, Jackxon 3, Kaleb Joshua Rian 1. Grandbaby #8, Sariah Grace born 11-17-16
When we have company over Aiden shows off and competes for my attention. He suddenly begins climbing on the couch, jumping off the couch, jumping off the coffee table, etc. Could he have ADHD? Yes, he certainly has more of a risk based on family history, but he can be calm and focused and is most of the time.
That is exactly how my child behaved at that age. By age five, he could silently read for 2 hours. He could watch a Disney movie from start to finish at 3. Certain things captured his attention, but often times he was wildly out of control. He hardly spoke at all until about 3.5 to 4, except to me, and even then, it was like he was being tortured. However, he did have an advanced vocabulary - it was just difficult for him to "converse". He was an aggressive child, as well, and had an extremely low frustration tolerance. Although there are marked similairities between ADHD, Aspergers (and even giftedness), it is the intensity of the individuals issues that often differentiate between them - but the lines are blurry even to experts.
Having an evaluation helps - it helps moms keep a disability perspective when dealing with their children. For instance, a child with diabetes would not be disciplined for their failure to adequately control their blood sugar, neither should a child with ADHD or Aspergers be disciplined for behaviors outside of their control. Talked to after a calming period has passed? Yes. Given help and tools to help them deal with frustration in the future? Yes.
Anyway, I digress. Yes, please respect your gut feelings and have him fully evaluated. The earlier that interventions are started, the more effective they will be.
Good luck!
The Autism spectrum is HUGE, and each child who is diagnosed is very different. I am a kindergarten teacher, and I have taught many autistic students. Aspberger's is a high functioning form of autism. Even children who have Aspberger's are not all alike. Some have communication issues, some do not. Some have academic issues, some do not. Some have social anxiety, some do not. It depends on the individual child. As a teacher, I also see TONS of kids come in, at 5, already labeled as ADHD. As a previous poster noted, Autism is often falsely diagnosed as ADHD early on. For me, I would want the evaluation as early as possible because I know how difficult it is to get services once children are enrolled in kindergarten. Even with a diagnosis from a doctor, it can take months, if not an entire school year, to get through the process of aquiring services. Not that you will necessarily need them, but that is something that I would consider. The same goes for Occupational Therapy (for fine motor issues) and even Speech. If they don't come to kindergarten already receiving these services, they have to go through the entire referral process to get them, at least in my county. This means at least 6 months of classroom level interventions and testing before they ever see a school psychologist.
When I pick him up from daycare, he's out on the playground. If I go into the classroom to get Juliet first, he starts sobbing outside to the point that they bring him in to me. I'm cautious to not take him into the baby room because he gets all worked up at the toys he doesn't usually see and can be too rough with the babies and not want to leave when I've got Juliet packed up. I asked him why he gets so upset, and it's because he fears that I'll get her and forget him. So I worked out a deal with him that I'll stop by the playground to check in with him, give him a hug and kiss, remind him that I'll get him in a few minutes, and then I go inside and get Juliet. Most of the time he's fine with this. About once a week he either begs to come with me or threatens to hurt another child if he doesn't get his way. (When he does this, I put him in the car and leave him in his car seat while I get Juliet, because he has followed through on his threat and pushed other kids.)
I was also asked to no longer come through the toddler room to drop off Juliet in the baby room because it sets Justin off. That's the usual route all the babies' parents take because the only other way to the room is through the staff kitchen/break room and we're not supposed to go that way. But Justin gets too upset when I take her in or pick her up and have to leave him in the toddler room. So now I drop him off at the door, then go through the kitchen to drop Juliet off. His daycare provider chalks his behavior up to jealousy, but again, I don't know.
I called the kids' pediatrician today and asked for a referral to a homeopathic P.A. who treats kids with autism spectrum disorders, allergies, ADHD/ADD, sensory processing issues, developmental delays, anxiety and depression, etc. A former co-worker's almost 4-year old is being treated by her for sensory issues and separation anxiety and is doing so much better right now. Plus, I like the idea of seeing a homeopathic doctor vs. someone who might recommend taking medication after medication until something clicks.
Have you contacted anyone to assess him? The school district should be able to help with screening him - it is simple and when they are doing it they are playing and chatting - I am amazed how much information they get through their assessments. It is likely that the first screening they will dois the ASQ Ages and Stages Questionnaire - it you google Oregon ASQ you can do the screening at home with him and see if there are any areas that he is having trouble with. Answer it honestly and try to remove your Mommy goggles - hard because we all want our children to be absolutely perfect but if you answer the questions honestly you might have a preview of what the assessors will do with him and the data they will collect. Assessment through the school district is free.
I am a big proponent of Head Start and if Justin is diagnosed with one of these or many other challenges he could very well qualify for services.
I would get him tested then go the route that makes the most sense.
Progesterone therapy and baby aspirin daily
Two miscarriages in between (August 2012 - same donor as Maggie, and December 2014 with husband)
Maggie
Maine (I think Kari is from Maine) begins evaluating at 3.
Child Development Services
The Child Development Services (CDS) system is an Intermediate Educational Unit that provides both Early Intervention (birth - two years) and Free Appropriate Public Education (FAPE for ages three - five years) under the supervision of the Maine Department of Education. The CDS system ensures the provisions of Special Education Rules - Federal and State Regulations statewide through a contractual or grant relationship between the Department of Education and each regional site.
Provides case management and direct instruction for children birth through age five and their families.
Conducts ChildFind (the process of identifying children with disabilities) screenings and evaluations for children birth through age five.
Identifies eligible children through Part C or Part B and secure local service access for services.
Provides Early Intervention and Special Education programming in the following areas:
Physical Gross/Fine motor skills
Cognitive
Communication (Speech and Language)
Social/Emotional
Adaptive
CDS consists of nine regional sites, a State Office and a State Level Advisory Committee, comprised of one member from each regional site. Each CDS site is an Intermediate Educational Unit (IEU) with a Board of Directors, separate from the local public school. The State CDS Office maintains a central data management system, system-wide policies and procedures, and provides centralized fiscal services for the local sites.
Early Intervention Public Data
MUSER Statutory Changes and Revised Procedural Safeguards
**Under IDEA - it should be covered.**
Progesterone therapy and baby aspirin daily
Two miscarriages in between (August 2012 - same donor as Maggie, and December 2014 with husband)
Maggie
Orally gives first, last, middle names and age (he got his first name right)
Points to red, blue, green, yellow, and orange
Names pictures of boat, kite, wagon, ladder, scissors, leaf
Knows use of book, scissors, refrigerator
Copies horizontal and vertical lines, circle, and cross (he got credit for the first three, but the circle looked like a U)
Balances on each foot for five seconds, walks forward heel-and-toe four steps
Demonstrates number concepts by giving 2, 3, and 5 objects to tester
Builds tower with 6-10 blocks (higher score if you use all 10 blocks)
Identifies chest, back, knees, chin, fingernails, heels (got chest and heels wrong)
Repeats sentences with 4 syllables, 6 syllables, and 8 syllables
Uses prepositions and irregular plural nouns (he got half right on the second part)
That gets tallied into a possible 100 points.
Then they observe right/left/uncertain handedness (he got uncertain, but he's definitely right-handed)
Grasps pencil with fist or fingers (fist)
Hearing appears normal (no test given)
Vision appears normal (no test given)
Record other observations (tremor in hand noted when doing fine motor activities)
They provide a checklist summary:
this child scored lower/average/higher
this child's age is lower/average/higher
the teacher rates this child lower/average/higher
the examiner rates this child lower/average/higher
They do a write-up of what they observe behaviorally, but there's no way of quantifying it. For example, it says they noticed frustration, whining, redirection, inability to focus on the activity at hand (focusing on upcoming activity instead), anxiousness, impulsive behaviors, pushing, etc. The evaluator said to me on the phone that she thought some of the behaviors are because he's in a classroom of four kids and he's the oldest by 6 months (by more than a year for another) and he might be bored. Like today one activity was practicing getting in and out of snowpants, which he's been doing for a year now. So he didn't have to participate, but he also wasn't included in the activity. He'll be able to move up to the preschool room when he's potty trained. Today is day #3 in underpants with dry days (at daycare at least; he had one accident at home during the Halloween trick-or-treating fiasco).
Today I purposefully gave him several different foods with food coloring for lunch, and skipped his favorite breakfast of chocolate chip pancakes. He had a good 10-15 minute meltdown over getting dressed and brushing his teeth. Then we had an AWESOME evening. My dad did not come over (sometimes this sets Justin off, even though he comes over 3-4 times a week). I'm going to start journaling to see if there's a correlation with either foods or visits that makes him spiral. Tomorrow is my birthday, a party, lunch at my sister's, MSG-loaded Chinese food, cake . . . wish us luck!!
It is entirely possible that moving to preschool will help tremendously. If he has already conquered all the goals in the toddler room he probably does need the challenge of new goals. Is your daycare willing to move him up soon - or does he have to be potty trained for a certain amount of time before the transition?
Progesterone therapy and baby aspirin daily
Two miscarriages in between (August 2012 - same donor as Maggie, and December 2014 with husband)
Maggie
Once you've compiled a good amount of data take it to your preferred health care provider. Don't stop documenting just because the evaluation process is underway.
Good luck to your family during this challenging time.
if we hadn't already had the IEP we'd have been starting from scratch and as i'm sure you know it's easy for children to get lost in the mix if the teacher thinks they are just troublemakers.
to all the parents on here - advocating for your child is hard, hard work. we've had several meetings with ds1's teacher/school special ed/psychologist as we discuss what's best for him. his teacher FINALLY realized he was playing her and since then his behaviour has improved markedly...we've been telling her since the first meeting that he's exceptionally smart but because he acts like he's not in class she just thought we were another set of those parents who think their child is gifted.
kari, good luck.
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I don't think it's unusual these days to ask for evaluations, especially with a first-born boy. I'm looking at the questions you got in your eval, and our DS would have aced that test. He wasn't developmentally behind at all. It was a hundred little things that added up to "something's off."
Earlier is best. Early intervention, intensive ABA, speech therapy, etc. are key to getting a kid on the spectrum ready for mainstream education, which is where I, at least, think high-functioning autistic kids belong. If it's a food allergy or some other trigger that you can identify and modify, earlier is still better!
Oh, and I should probably add--because we had an Aspergers child already, we watched our last DS like psychotic hawks. We worried a lot, especially because his emotional reactions tended to be out of proportion and he flapped as a stimming behavior. He outgrew his meltdowns when he was 4 years old. Is he possibly on the high end of the spectrum? Possibly we all are.