socially engaging but still autistic???

[Guest guest]

You know...I live in NC where TEACCH, UNC Chapel Hill (one of the most

highly respected centers for autism evaluation and treatment in the nation)

is located. Anyway, TEACCH does free valuations for NC residents and they

are *very* thorough from what I have heard. There was a child in my son's

old class that TEACCH diagnosed with Aspergers who was definitely socially

engaging (he greets kids as they walk up to him, seeks friendships, loves to

please others, has good eye contact, etc, etc, etc) but he doesn't have

respect for social rules whatsoever and is good at manipulating situations

to what he wants.

I know that back when my son was non-verbal, all the professionals that

worked with him said that on paper (from all the written description of my

son's traits) he looked autistic but when you met him you would see that he

wasn't autistic because he had great joint attention, followed directions,

exhibited imaginary play, very socially engaging, etc

Anyway, I thought I would throw this in there. TEACCH diagnoses a lot of

kids that are borderline as having autism. I think they err on the side of

caution in order to get the children services and get the kids into their

program. I could be wrong. Maybe other professionals think of autism in

the more classic sense and don't diagnose the higher functioning kids.

Incidentally, we have started the process of having my son evaluated by

TEACCH. I initiated the request for the assessment when the school was being

a pain in the & *$#@. I wanted TEACCH on the " team " to help me advocate.

Now that my son has switched classes and is doing great, I almost felt like

I should cancel the evaluation. However it is an all day thing and I have

heard the report they give you is incredibly thorough. Are they going to

diagnose my son with mild autism? I don't know. In the educational

setting, there are some traits that come out (obsessing over stuff so that

he can't concentrate on the task at hand, having his own agenda,

distractible at times. However he is very socially engaging, great eye

contact, very socially aware, obeys social rules. So we will see.

I just wanted to stress that there are some organizations very well-versed

in autism (like TEACCH) who still diagnose children as autistic even when

they are socially engaging.

Tricia Morin

North Carolina

[Guest guest]

Everything I've learned through early childhood education and the

pediatric mental health system states that a social deficit is needed

to meet the criteria for 'autism', otherwise there may just be

a 'communication disorder' or something more like PDD NOS....???

This is interesting to me....I'll be watching this discussion.

As someone who is an Early Childhood Behavior Consultant I do get

called in to observe a lot of children who I end up referring for

autism evals. The ones I have met, who seem social, but yet end up

with the diagnosis usually have a rote communication quality about

them (more commonly seen with Asperger's); where if you watch them

for awhile or change the context of their social situation they may

be confused or seem more robotic. They are very capable of picking

up on the 'give and take' of the social world around them but don't

seem as emotionally invested or as capable of sustaining

relationships

as other children.

Obviously I am not an 'expert' in this very confusing field and am

always interested in learning more about autism and what criteria

others are using for diagnosis. I do believe that those kids with

autistic like behaviors (but not diagnosed with autism) can be

greatly assisted through the educational opportunities only reserved

for those diagnosed 'autistic' through their school districts. It

seems to vary so from place to place.

Thanks for your information and keep us informed about how the

evaluation goes for your child!

~Tracey

> You know...I live in NC where TEACCH, UNC Chapel Hill (one of the

most

> highly respected centers for autism evaluation and treatment in the

nation)

> is located. Anyway, TEACCH does free valuations for NC residents

and they

> are *very* thorough from what I have heard. There was a child in

my son's

> old class that TEACCH diagnosed with Aspergers who was definitely

socially

> engaging (he greets kids as they walk up to him, seeks friendships,

loves to

> please others, has good eye contact, etc, etc, etc) but he doesn't

have

> respect for social rules whatsoever and is good at manipulating

situations

> to what he wants.

>

> I know that back when my son was non-verbal, all the professionals

that

> worked with him said that on paper (from all the written

description of my

> son's traits) he looked autistic but when you met him you would see

that he

> wasn't autistic because he had great joint attention, followed

directions,

> exhibited imaginary play, very socially engaging, etc

>

> Anyway, I thought I would throw this in there. TEACCH diagnoses a

lot of

> kids that are borderline as having autism. I think they err on the

side of

> caution in order to get the children services and get the kids into

their

> program. I could be wrong. Maybe other professionals think of

autism in

> the more classic sense and don't diagnose the higher functioning

kids.

>

> Incidentally, we have started the process of having my son

evaluated by

> TEACCH. I initiated the request for the assessment when the school

was being

> a pain in the & *$#@. I wanted TEACCH on the " team " to help me

advocate.

> Now that my son has switched classes and is doing great, I almost

felt like

> I should cancel the evaluation. However it is an all day thing and

I have

> heard the report they give you is incredibly thorough. Are they

going to

> diagnose my son with mild autism? I don't know. In the educational

> setting, there are some traits that come out (obsessing over stuff

so that

> he can't concentrate on the task at hand, having his own agenda,

> distractible at times. However he is very socially engaging, great

eye

> contact, very socially aware, obeys social rules. So we will see.

>

> I just wanted to stress that there are some organizations very well-

versed

> in autism (like TEACCH) who still diagnose children as autistic

even when

> they are socially engaging.

>

> Tricia Morin

> North Carolina

[Guest guest]

Hi Tracey!

I agree with you. As my co author of The Late Talker Dr.

Marilyn Agin stated " Autism has it's own set of criteria including

the " triad " of an impairment in social interactions and play skills,

a communication disorder with deficits in communicative intent, and

stereotypical mannerisms. There is strict criteria for the number of

signs needed to make the diagnosis which is found in the DSM IV. If

you don't fulfill all the criteria, but just a few, you can be

classified as PDD-NOS. You need a trained professional to make the

diagnosis. "

I want to add to what Dr. Agin stated: when you want an

accurate diagnosis for whether it is 'just' a speech and language

impairment (even a multifaceted one such as apraxia) or autism -you

should seek evaluations from professionals who are experienced and

knowledgeable about diagnosing and working with both apraxic/speech

impaired as well as autistic/PDD children as well as children who

have both apraxia and autism.

There are a variety of therapies and as I've stated many times

prior, therapy for apraxia won't hurt a child even if the child

is " just " a late talker. (may hurt your pocketbook) On the other

hand therapy for autism such as ABA is not only inappropriate, but

as reported here can be detrimental to a child who is not autistic.

(and also may hurt your pocketbook) So don't jump when someone

yells " autism " -and if you do, keep a close eye.

Tricia, since you already know they will " err on the side of

caution " if autism is in the least bit suspected, when is

most likely diagnosed as autistic/PDD/PDD NOS... what does everyone

believe the " mild autism " diagnosis will change in therapy or

placement (or expectations) for , if anything?

(expectations?)

" Approximately 70-75 percent of individuals with autism also have mental

retardation. "

http://www.cdc.gov/nip/vacsafe/concerns/autism/autism-facts.htm

" But autism does not necessarily correspond with mental impairment. More than 10

percent of people with autism have an average or above average IQ. A few show

exceptional intelligence. "

http://www.autisticsociety.org/modules.php?name=Encyclopedia & op=list_content & eid\

=20

How does his teacher and

therapist view now? Have they shared concerns with you that

is displaying signs of autism, or ADHD or CAPD? Did you

share with them that you are taking for the TEACCH eval?

Not sure if the following MDs are who you are going to see, but

since the University of North Carolina sponsored the Apraxia

Conference that CHERAB booked all the speakers for (pro bono)

http://www.cherab.org/news/nc2003-conference.html , I just received

the following email that may interest you and others in your area

who suspect their child of having autism and are seeking a

developmental pediatrician.

" -

I'm a developmental-behavioral pediatrician at the University of

North Carolina (at the Center for Development & Learning) and would

be happy to have the family contact our program to set up DB ped

follow-up here. They can download our 2-page " contact form " at

http://www.cdl.unc.edu , click on " print contact form " and then complete the

form and mail or fax it in as mentioned on the form. It would

probably help for the parents to mention my name and that they are

seeking dbpeds follow-up services (as opposed to a new team

evaluation, etc.). If questions, they can call our client

coordinator, (919-966-4895).

Other dev-behav. pediatricians in this area who see young children

with autism include: Dan Moran (head of DBPeds at Duke Med. Ctr, 919-

684-0293), Ave Lachiewicz (Duke Med. Center, 919-684-5513), and Lynn

Wegner (Learning & Dev Associates, 919-380-0028).

Stuart Teplin, M.D. "

=====

[Guest guest]

Tricia,

I don't usually have time to post, but read your post since you are from

NC and mentioned TEACCH. My son, is 2.5 and was evaluated by TEACCH in

Feb. of this year. We haven't gotten the written report yet, but we

were told he has autism. How long have you been on the waiting list?

They do have a short list (cancellation list) so we were able to be seen

in less than 2 months. Although the evaluation is a day long process

10-3:30pm (2- hr eval. in the morning) a 2 hr. break for lunch and then

conferencing in the afternoon, it is not a multidisciplinary evaluation.

I was a little surprised that there were no O.T. or S.T. participating

in the eval. Process. I do believe that my son exhibits traits on the

autistic spectrum so the results from this evaluation weren't a shock.

Like you, I wasn't sure that this evalation was necessary, but I do

think that any piece of the puzzle helps and that it would be helpful

should anyone want to get more services from them. I will tell you that

my impression was that they do not like to differentiate between the

varying degrees of autism. We were told our son has autism, even though

my impression is that he may end up being Aspergers or mild autism.

However, I do understand at my son's young age it is hard to say where

he is going to end up. I will let you know when we get our report (in

fact I may need to make a call to see where it is)what I think. I am

thankful that there are people out there like TEACCH that do err on the

side of caution, because I have a friend that couldn't get anyone in the

medical field to say that her child needed services (he is now 10 and

recently diagnosed with Aspergers).

Even though I don't usually post and I can't read all of the emails that

come through. I really appreciate having access to this group of people

as a resource. It helps to know that I'm not alone.

Bracy

North Carolina