Friday, November 14, 2014

HB and Aspy?

So last evening we had a meeting with the pediatrician.  Basically he said that he believes (based on discussions with the teachers and his own brief observation) that HB is on the autism spectrum.  The dr's not entirely sure because HB's behaviors "are all over the map."  So it's also likely but less so that he has ADHD.  There's a lot of over-lap between the two in terms of behavior. 

It's important to understand that the pedi's a trained surgeon and biologist.  And he hasn't referred us to an autism specialist for further evaluation either. 

He is wanting to use resources through the school district so that some behavioral help can be made available to HB.  As the dr's pointed out if he's wrong about the autism then the behavioral stuff won't actually do HB any harm.  The teachers are chiefly concerned that if he has another fit he'll attempt to dash out the school again.  So the pedi is trying to get something in place for their benefit.

In other words the dr's using a label in order to have something happen sooner.  A label he's not entirely sure about.

HB does seem to have similar symptoms to Asperger's but it's really difficult for even me to say that's true because then again he doesn't.

Usually one of the key symptoms is speech related.  Unlike others on the spectrum, Asperger's children don't have language delays or regressions.  It's how the speak socially that you notice something is up.  They tend to interrupt and can't seem to stop talking.  Sometimes they talk mono-tone or in a sing-song way.  They also tend to prefer certain topics of discussion.  But this is indicative of other children too.  So sometimes Asperger's isn't obvious until the child is a bit older.  HB has no noticeable speech issues.

They also tend not to look at people or read social cues very well.  But it isn't always the case that they won't look at people.  They prefer to play by themselves, which is one of the things that are bothering the teachers.  By this age they expect to see HB interacting more with his peers, but he doesn't want to.  They also get stuck on certain activities or things.  They tend to look at parts of things instead of the whole (or vise versa).  So rather than building with legos (for example) they like to manipulate a single lego.  This describes HB.

And at times of stress for them, they tend to withdraw or self-harm.  HB doesn't really do either.  He lashes out.

Another important factor is the lack of empathy.  Very young children struggle to empathize, but as HB gets closer to 5 he should have no trouble being empathetic.  Yesterday HB pointed out when another child was crying.  I asked him to go inquire if she was okay.  Offer empathy.  He told me no and said Knee should do it.  Naturally Knee went over, talked to her, and hugged her.  HB rarely does that.

So basically it's the lack of empathy, lack of desire to interact with peers (according to his teachers), his parts-interest, his intense interests, and his fits that make me thing Asperger's. 

But then again I'm not happy about his teacher's exaggerations (they said he has odd speech which I disagree with and physical issues which he's not clumsy).  And the lack of an evaluation other than this pedi.  These all send up red flags for me as a parent.  If it's true that he's on the spectrum.  He's on the higher end (something the pedi didn't like using even though high functioning autism is a technical term).  And he also needs to evaluated for things he needs and things he does not need like physical therapy since Asperger's doesn't have the same gross/fine motor issues that some autistic kids have to deal with.

At any rate, my husband has a colleague who is HFA.  He received early intervention and as a result unless he disclosed you'd never know he was autistic.  I told Hubby to corner him and ask him his thoughts.  He plans on buying him lunch.  The simplest way for a parent to learn what they face up the road ahead is to ask someone else who been there-done that.  And I know of other children who are HFA because they blend so well once therapy has started.  It's as I said far easier to diagnose autism in children who have more severe issues.

Which then leads to the next set of issues.  Labeling and disclosure.  How much do you tell people?  A lot of people thing autistic people are stupid.  And trust me HB is not.  But that's a future post.

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