Re: ASD Diiferential Diagnosis-HOT BUTTON

[Guest guest]

karenpeikert wrote :

" It is my very uninformed and overly-strong opinion that many of

our children with apraxia who have been diagnosed PDD-NOS will have

that label removed if they are receiving the right speech therapy

and the apraxia begines to resolve. "

I am informed, and I agree with your strong, and correct opinion.

I am a firm believer that MANY children with speech and language disabilities

are being dx'd as ASD, and truly ARE NOT on the spectrum. You're right....if

you're missing one of the CRUCIAL diagnostic criteria, how can you then lump a

child into a category like that, when they truly don't fit the bill?

When my ped saw Jordan at 3, he said " He's definitely not autistic, but he's got

something " ...nothing like the medical community to guide us. At 4, he said

" It's developmental delay " .....after 6 months of speech and OT, when he saw him

at his 5 year check up, he said " This is NOT the same child that was here a year

ago....you've got a healthy little boy who's right on target, minus some speech

issues. " Did his " autism " disappear? You bet it didn't. He never had it. He

is classicly dyspraxic, which lead to articulation disorders, and his sensory

issues still remain, although surely not to the degree that they were. He is

NOT, nor was he ever on the spectrum. But it sure would have been simple enough

to place him there.

It's disturbing to me, both as a mother, and as a clinician, to see how this dx

is thrown around. A colleague, in an off the record conversation, once said to

me " we could put every kid on the spectrum if we looked hard enough. " That

petrified me.

Again, my PLEA to every parent on this list and every other. YOU know your

child. YOU know everything about him, more than an hour visit with a doctor

could ever uncover. If you're uncomfortable with a dx, or a treatment plan,

work until you feel comfortable with who is treating your child, and what they

are doing. It's the biggest favor you can do for your child, and for yourself.

~karyn

[ ] ASD Diiferential Diagnosis-HOT BUTTON

Hi-

I have been on a personal soapbox about the ever-widening definition

of ASDs for some time now. Anyone who will listen - pediatricians,

SLPs, neurologists, etc - get to hear me ask about this unbrella

diagnosis and practically SHOUT about it's inappropriateness for

apraxic kids.

I feel very strongly that my apraxic son, who has some SI issues and

gross and fine motor delays, is NOT autistic. He has NO repetitive

or compulsive behaviors, loves people, and has in my opinion, a

desire to socialize beyond what his language impairment allows him

to.

My son's neurologist said to us one time, " you know, he has many

autistic features, but is certainly missing the social ones. Well,

DUH!! If you are missing what many describe to be the 'lynch pin'

of ASD, the social withdrawl and inability to pick up social cues,

how can you even include ASD in the differntial diagnosis?? I hear

many on this list and others talking about how social their PDD-NOS

children are...I don't understand. Either you meet the diagnostic

criteria, which I believe is three-pronged, or you don't! Can you

remove one or even two of the criteria, and still be diagnosed with

ASD? It is my very uninformed and overly-strong opinion that many of

our children with apraxia who have been diagnosed PDD-NOS will have

that label removed if they are receiving the right speech therapy

and the apraxia begines to resolve. There is a statistic about how

many children with ASD have the label removed after a time ( 25%?) -

many believing they are cured. My suggestion is that some of these

children were misdiagnosed in the first place by an overzealous

practitioner of some kind. Or a school district who is looking for

a label under which to provide services.

Would ABA hurt my son? I don't know. I do know that a therapist

that operated under the assumption that my son simply does not have

the internal desire to socialize, engage and cooperate would be

completely missing what drives his delays. If this were combined

with the " right " speech, OT and PT that addressed his motor planning

deficiencies, would he still " turn out " OK? I have no idea. But

there don't appear to be enough hours in the day or money in the

world to give ALL of that to our apraxic kids and find out.

I know that this will become an issue in my family in the next year,

as my son will turn six and no longer qualify for IEP services under

a label of " significant developmental delays " . I will vigorously

argue that he be entitled to full IEP services under the " speech and

language impairment " category, as the law states that you can

receive complete services no matter which " label " gets you in. Just

because you come in under a speech label, doesn't mean you only

qualify for speech!

I'm sorry if I have offended some with the PDD-NOS label. I just

think especially parents of younger kids need to have their eyes

wide open when discussing these issues with their doctors and

teachers.

> Hi, my name is Gilda,, and I´m a mom of 2 beatiful girls who are 6

> and 3, my 3 year old is receiving Behavior therapy since January

this

> year due to reccomendations of a Development Pschicologist in San

> Diego, she receives therapy 5 times a week 2 hours a day, and also

> she gets speech therapy twice a week for 45 minutes each session.

She

> is not diagnosed yet, but the Behavior therapist suspects apraxia.

I

> read the post and the reply by

[Guest guest]

You know I have to totally agree with you. I see more and more kids getting the

ASD label and whether they actually are or not is questionable at best. When

the docs at the developmental unit gave me that bombshell with Hope back in May,

I was floored. There was no way my little girl is autistic. But then I started

looking at a lot of what they were saying, got a second opinion, and my whole

family was already expecting the ASD diagnosis so that helped get a grip on it.

Hope is fairly social and interacts well with other people, as a lot of kids on

the spectrum do. But with Hope the key that pointed straight to ASD was it has

to be on her terms. If she comes to you, that's fine. But if you go to her,

forget it. You get the sterotype autistic kid reaction when she pulls away from

you, wont look at you, and if the person is persistant (usually at family

functions with relatives that just dont get it) she'll have a complete fit. Of

course does have the obcessions and the stimming along with the " on her terms "

social behaviors that really point to ASD.

It took me reading all the information on autisim I was given when she was

diagnosed, reading on my own and standing back taking a good look at Hope, not

looking at her as her mother who said that's just the way she's always been, but

just looking at her to really get a grip on the ASD.

On the plus side as soon as that ASD diagnosis was given the fight with the

insurance company for more speech therapy came to a grinding hault. With verbal

apraxia they wanted another opinion and a boat load of documentation before they

would approve speech therapy beyond what she was getting through the IU. Now

that she's autistic her psychologist wrote that she needed speech therapy (6

sessions of 30 minutes each). It was approved without question.

Toni Wells

http://designs.merlins-avalon.com

[Guest guest]

I have a 6 y/o son never dx w/autism nor PDD however is being treated

with same medical interventions as a ASD child and above and beyond

any therapies, speech, ot, pt nothing removed his SI issues,

gross/fine motor delays, and speech issues better than the medical

interventions he has recieved. Something to think about.

[Guest guest]

In a message dated 07/19/2004 10:56:07 AM Eastern Daylight Time,

jkpeik@... writes:

> I have been on a personal soapbox about the ever-widening definition

> of ASDs for some time now. Anyone who will listen - pediatricians,

> SLPs, neurologists, etc - get to hear me ask about this unbrella

> diagnosis and practically SHOUT about it's inappropriateness for

> apraxic kids.

>

>

Amen. I couldn't agree more. We have been fortunate that our Dev Ped has

never dx our daughter with ASD. We just went today and she reemphasized that our

daughter has a language disorder and not ASD. However there have been many

" less experienced " professionals who would readily put the ASD label on her

forehead. Making incorrect assumptions is very damaging in my opinion. It

saddens me

how hard our children have to work to prove themselves and be understood. How

frustrated I would be.

[Guest guest]

My daughter is definitely not autistic. She has brain

damage. No doctor or therapist has ever suggested that she is

autistic.

However, she does the same thing in social situations. Everything is

still on her terms, but she is better now that she is older.

is almost worse than when it comes to social situations.

will actually scowl at people that approach her. does

not have brain damage, and isn't on the autistic spectrum.

Both girls have had speech problems: severe and mild

(and almost totally resolved).

I think that having speech problems causes social interactions to

change for these kids.

As both girls have gotten to be better speaker, the social issues

are starting to resolve. For example, a few years ago (when they

were 3 & 4) I had a difficult time leaving my daughters for a

Vacation Bible School at our church. They knew kids there. They

knew the church. They had a fit if I didn't stay. They didn't talk

to any kids, even if the kids talked to them.

This year (the girls are 7), I signed them up for another Vacation

Bible School. They couldn't wait to go. wore her clothes to

bed so she would be ready on time. They loved it. I only had to

stay until their friends showed up. Now, didn't participate

in the singing and hand motions. did somewhat. She was doing

very small hand motions and trying to sing the songs. Their friends

were totally into the music. After the session today, they were all

talkative with their friends. They even initiated the

conversations.

I think it's hard to judge social skills on a child with severe

speech and language problems.

> You know I have to totally agree with you. I see more and more

kids getting the ASD label and whether they actually are or not is

questionable at best. When the docs at the developmental unit gave

me that bombshell with Hope back in May, I was floored. There was

no way my little girl is autistic. But then I started looking at a

lot of what they were saying, got a second opinion, and my whole

family was already expecting the ASD diagnosis so that helped get a

grip on it.

>

> Hope is fairly social and interacts well with other people, as a

lot of kids on the spectrum do. But with Hope the key that pointed

straight to ASD was it has to be on her terms. If she comes to you,

that's fine. But if you go to her, forget it. You get the

sterotype autistic kid reaction when she pulls away from you, wont

look at you, and if the person is persistant (usually at family

functions with relatives that just dont get it) she'll have a

complete fit. Of course does have the obcessions and the stimming

along with the " on her terms " social behaviors that really point to

ASD.

>

> It took me reading all the information on autisim I was given when

she was diagnosed, reading on my own and standing back taking a good

look at Hope, not looking at her as her mother who said that's just

the way she's always been, but just looking at her to really get a

grip on the ASD.

>

> On the plus side as soon as that ASD diagnosis was given the fight

with the insurance company for more speech therapy came to a

grinding hault. With verbal apraxia they wanted another opinion and

a boat load of documentation before they would approve speech

therapy beyond what she was getting through the IU. Now that she's

autistic her psychologist wrote that she needed speech therapy (6

sessions of 30 minutes each). It was approved without question.

>

> Toni Wells

> http://designs.merlins-avalon.com

>

>