Re: Expressive vs receptive language - Autism

December 27, 2006

I'm seeing a lot of posts suggesting to people that their children

might have autism, and I feel compelled to play devil's advocate.

This hits home to me because I have spent much of the past year and

a half worrying if my 2 and a half yr old son might have autism or

PDD. I've read through all the checklists (CHAT, M-CHAT, DSM IV),

read books, visited forums, talked to the EI therapists we work

with, talked to a developmental psychologist, a neurologist, a

couple of pediatricians and so on. What I have learned is that

while early intervention is very important for children who have

issues (apraxia, pdd, asd, etc), it can be difficult to diagnose and

tease out the cause of their symptoms at a young age. Lots of

symptoms overlap. Since it is now a spectrum disorder, there is a

big gray area within the autism spectrum and many, many experts feel

that it is being over-diagnosed. Part of the reason why is that

instead of performing thorough evaluations of children, people are

relying on screening checklists like the M-CHAT, and these screening

checklists are intended for just that, screening. They let you know

if you need further evaluation. They are not meant to replace the

evaluation. They are not diagnostic tools.

Think about it this way, a symptom can have a variety of causes. If

you go to the doctor because you are walking with a limp, it might

be for any number of reasons. You might have a sprained ankle, a

hairline fracture or a pulled muscle. A good doctor will start with

the symptom (limp) and work backward to find a cause. A good doctor

or psychologist will do the same thing when presented with a child

who is exhibiting these red flag behaviors. S/he won't simply

diagnose based on the symptom itself.

Some of the symptoms I'm reading about (e.g., mouth stuffing, not

pointing) were a problem for my son too until we got him a good SI-

based OT. He wasn't pointing because he had trouble coordinating

deliberate movements with his hand and fingers (possibly because

of " limb apraxia " and/or poor body awareness). After a short while

of therapy he was pointing and signing, which led to a burst in

language, which led to greater connectedness with others and

stronger eye contact. After oral-motor work and exercises, he

stopped stuffing his mouth with food. For my son these problems

were sensory based and maybe also rooted in motor planning

problems. We are still working on getting to the bottom of his

issues, but with each successful therapy (or supplement) we use, he

gets better, and everyone is amazed at how far he's come.

The most important thing--in my opinion--is to seek out the

therapies and treatments that will benefit your child, and I think

you have to cast a wide net because even therapies that we associate

with autism (e.g., ABA, Floortime) have been reported to work well

with children who have different types of issues. Every child is

different and there is no one perfect therapy that will work for

every child regardless of the diagnosis. Good therapists (and

therapists who are a good fit for your child) are crucial too.

If you feel in your gut your child has autism or if you feel he will

get better services with an autism diagnosis, then by all means, do

what you feel is right. I just don't want people to read these

posts and go into a panic thinking their children have autism

because no one here is qualified to make that call (and if anyone is

qualified, they surely wouldn't make a diagnosis for a child they've

never even seen before).

Okay, that's way more than my two cents!

Kristi

PS sorry if this gets sent twice. I'm having some trouble with

tonight.

>

> I am curious as to what age did you find out that your son is

autistic because he is extremely young now. Was it a developmental

pediatrician, or who diagnosed him?

> My son was diagnosed a year and a half ago with a severe

receptive/expressive language disorder, and I often questioned

whether he could be mildly autistic,but it has been r/o by a

neurologist and a couple of speech pathologist. What type of

behaviors does your son have to prove that he is mildly autistic?

Does he say anything? My son probably had 4-6 words that were not

always understood. He is 4yrs2mos and he can say a little over 100,

maybe more, I really don't keep an accurate count. His probably is

forming sentences. He's trying to string 3-4 words together,but very

often not clear. There are a lot of words that you can definitely

understand. He can spell his name,which is Pierce. He can also spell

his sister's name,which is Jada. He has made alot of progress from a

year ago, and from even 6mos ago. He has a long way to go, but I am

here and God willing will continue to still be here and will hold

his hand all the way through this.

>

> Benetta

>

> Hi

> My son's receptive language is progressing very well but he has not

> added up to the 4 words he was able to say. He is 2.5 and mildly

> autistic.

> Could anybody give some piece of advice to what to do to help him

to

> talk. I am doing some works based on the book " More than words "

with

> him, but he seems has not taken off in his speaking yet. Any other

> suggestion?

> Thanks

>

> __________________________________________________

>

December 28, 2006