Asperger's Syndrome or not?

My son is turning 4 in July and has been attending a Pre-K program for kids who've received early intervention treatment.  At around 18 months, my wife & I noticed that he wasn't really speaking much.  My wife is a stay at home mom, so we attributed it to us catering to his every need.  He understood what we said to him, he learned shapes, colors, letters, numbers, all before actually speaking words.  It was mostly jargon.

We had him evaluated for speech therapy via early intervention and we began to see improvement in his speech.  The therapist then suggested that he may be on the autism spectrum, particularly because he would spell the words he wanted to communicate to us if we could not understand him verbally.  She also mentioned that he tended to "stim?!?" by spinning in circles if overstimulated.

At her suggestion, we enrolled him in a pre-k class with other such children and he has shown vast improvement in speech.  He talks constantly, he was reading, writing, counting and spelling before joining the class, it was his speech we were concerned about, not realizing that in other areas he was advanced for his age group.  We were mainly focused on the milestones he didn't meet which was social interaction and speech.  Again, we assumed that this was because he was home with my wife and that's pretty much all he knew.

While at his pre-school, I do notice that he will "hover" around the other kids. He would watch and observe, but appear to be too shy or not know just how to invite himself into the group.  Once he is accepted into the group, he does quite well, no tantrums or violent episodes that we've noticed or the teachers have notified us about.  Just being in the school has opened him up to being more receptive around large groups of people, which prior to that would cause him great anxiety initially.  He hasn't been formally diagnosed, in your opinion, what does his behavior indicate?

[Jessica L Thomason Sassi, Ph.D., BCBA-D]

Autism is diagnosed based on narrow or repetitive patterns of behavior or interests, severe and sustained impairment in social interactions, and delays in language acquisition.  Asperger’s is diagnosed when language acquisition is normal, but child behavior is characterized by repetitive behavior and social impairments.   Based on your description, it does sound as though he exhibits some language delays.  However, it’s tough to say whether he has real impairments in social skills or whether he is just shy (which is a very real possibility if he has cared for at home and has only recently joined pre-K).  Further, it is tough to say whether he exhibits the type of narrow and restricted patterns of behavior typical of autism – lots of typically-developing toddlers and young children engage in some stereotypy (or “stimming”), and it doesn’t sound like you are seeing a lot of stereotypy (hand flapping, body rocking, non-functional vocalizations are just a few common types) at home.

The only way to really determine whether he meets criteria for an autism spectrum disorder is to have him evaluated in person by a qualified professional.  I would recommend that you describe your concerns to your pediatrician (who will be able to incorporate their own observations of your child with your descriptions and concerns) and ask whether further evaluation is a good idea.

Best of luck

[ReSpAwNeD]

I would formerly have him diagnosed.  It sounds like the suggestion has been made and the signs and symptoms are compelling.  My son is 11 and has PDD-NOS (also part of the autism spectrum).  He was diagnosed when he was 8.  I have been doing a lot of research recently and am now advocating for autism and my son.  Based upon the delay in speech, spinning to ground himself, his solitary classroom involvement, and his above average intelligence I think there are enough signs for a possible diagnosis.  

Go with your instinct.  Stop second guessing yourselves.  I did that too which is why my son didn't get diagnosed until he was 8 and becoming harmful to himself and others.  It's because I was being told that I just needed to be more consistent and it was because he had the run of the house as a toddler and he was the boss of my husband and I, which really wasn't so.  

There are no two children alike on the spectrum.  It's very hard to get an accurate diagnosis.  For more information and a great resource check out www.autismspeaks.org

Good luck to you and your family.