What are the chances we will get an autism diagnosis?

[muzomamma]

I took my son in to see his regular pediatrician about going to see a developmental pediatrician. Fortunately the practice has a developmental pediatrician on staff, so I won't have to wait as long as I would if I had to go to a big hospital. So anyway, my son has some hand flapping (going away I think), no imaginative play, doesn't seek interaction with his peers, and has language delays. Actually, he has lots of words, but he doesn't use them spontaneously in a meaningful way. He uses them to label, get a drink, or tell us what he sees or hears. At 20 months, he had no pointing and no eye contact. Through therapy he has greatly improved with both. He interacts well with his immediate family and is an affectionate boy to those he is familiar with. His OT feels strongly that he will fall in the autism spectrum, probably PDD-NOS. I know she can't diagnose, but she is around autistic kids. I would think that she knows what she is looking at. With what I've read and seen in videos, it fits my son. I've felt that there is something "wrong" with him, but I could never put a finger on it. I never would have suspected autism. The pediatrician does see some red flags for autism, but is unsure because of the interaction he had with his sister in the exam room. So I have to wait and see for now. I was just wondering what some of you on the forum though. Oh, and my son is almost 2 1/2 years old. He doesn't know it though. He doesn't know his name or age, but he knows numbers 1-10 and the letters of the alphabet by sight. ??? Don't get that one. Thanks for your replies!

[awrightsd]

My son, who is now 16, has high functioning autism.  He too recognized his letters early.  His situation turned out different...he has hyperlexia, which is a 'syndrome' where kids read and identify with the written work at a very early age.  In 1st grade, he could read and understand a 5th or 6th grade book.  He still reads and comprehends materials way above his grade level.  He is a voracious and very fast reader.  He is also a very good speller.  

This has been a blessing for us because the good reading/spelling translates into good writing and other subjects such as history, science, etc.

Andie

[Sally44]

I suppose the phrase must be a UK one.  But that was just an example of how literal interpretation of language can lead to children being assumed to be rude or silly when they are not at all.

[888mom]

It is very good that you are staying on top of the doctors.  Your son sounds a lot like my daughter.  She'll be 3 in October.  She was diagnosed PDD, though the developmental pediatrician would not diagnose her as autistic or as PDD-NOS because he said she was too young at this point.  And she may not have autism, but regardless of whether or not she has autism or PDD or not, he said that her brain is different, and she will always be different the rest of her life.  Diagnosing autism is hard.  He said with a spectrum, some people may have autistic/asperger like traits and not be autistic or almost autistic.  He cited my husband and myself and said we may or may not be, but having a label does not change who we are and what idiocyncricies we have and what type of coping mechanisms we've developed over the years to deal with them.  The doctor also pointed out that he had some autistic tendencies but was not autistic.  So, how do you diagnose autism?  Is there a cut off line?  Like if you did one more thing you'd have autism?  The brain is so very complex.  Well, if my daughter does not have PDD-NOS or autism, then she will have ADHD, OCD, social anxiety disorder, sensory integration disorder, and verbal apraxia.  Actually the verbal apraxia is a diagnosis in addition to the PDD, but the other things roll into PDD.  So a diagnosis of PDD rules out a separate diagnosis of other things that are common with ASD.  My mind feels like it's going to blow up sometimes when I think about all those technical categories.

Having said all that... living in the U.S., children will qualify for public developmental preschool or speech or OT therapy through the public school system when they turn 3 even without a diagnosis.  What matters is that their speech and other development are significantly below age level, then they will qualify.  Having a diagnosis can help the school system place your child in a classroom, or if you trust the doctor better than school system.  If you are in a Birth to 3 program, they will help you transition and contact the school system and set up those meetings for you.  Oh, and the other thing I am so thankful for is that your child does not need to be potty trained either.  My daughter is just starting to potty train but I think it will take a few months since she does not have bladder control yet (thank God for pull ups!).  

Sally,  is the phrase "pull your socks up" a British expression?  I'd never heard of it before, other than meaning that your socks are falling down if you had knee highs or something like that.  

[Sally44]

I'm glad the Help Page helped!  Autism is a very 'difficult' thing to see, until you've spent some time reading about it and observing kids, then it becomes much more obvious.  When the SALT first mentioned a probable diagnosis of an autistic spectrum disorder I wrote her a long letter about the things that he could do very well and those that he couldn't do or struggled with.  At the time I thought I was proving he wasn't autistic.  Now when I read back over it it is classic autistic behaviours.  It isn't a black and white diagnosis and every single child will be different because we are all individuals anyway with our own personalities and differences and likes and dislikes.  There are many children who are social and loving with family members but maybe struggle with the concept that they should behave differently with strangers or may have other social interaction or communication problems with other people in different environments.  They can find it very hard to isolate what the relevant information is in any situation and know what the relevant learnt information they already know can be manipulated to fit the new/similar/different situation.  This aspect of their difficulties is known as 'generalisation'.  Once we learnt something we can quite quickly see how we can use that learnt information in different situations.  For them each situation is almost a brand new experience and nothing they have experienced before is relevant because it was different.  That is why some children can be taught numeracy or literacy using colours and they associate the colours with the number of letter.  But change the colours and they won't recognise previously learnt numbers and letters.  If you imagine that same difficulty in social settings and language etc you can see how they struggle.  Interpretation of language tends to be 'literal'.  If I told my son to 'pull your socks up', that is what he would do.  He wouldn't understand that I mean 'try harder' or 'get a move on'.

[muzomamma]

Thanks for the response! Sometimes I feel crazy for thinking the way I do, so I'm glad to see that I'm not. I know that there is hope for kids with autism. We still have a long road though. I just had my son at a baseball game, and all he wanted to do was walk around. And he had to stomp on every drainhole cover. I think he actually sought them out. He just loves to run off! We ended up leaving the game early, because it was getting late. I knew that he was tired, and that he wasn't going to cooperate.
Anyway, thanks for the encouragement. It is a struggle, but we can get through it!

[muzomamma]

Thanks for the response! I did look at the diagnostic criteria. The real life descriptions were very helpful. At this point, I'm not sure what the waiting list would be to get a multi-disciplinary team evaluation done There is a hospital near me that specifically does autism assessments. It's exactly as you described. I'll see what the doc says in October when he sees the developmental ped.
I understand what you mean about not making the connection with the numbers being a set amount of things. I think he is that way with his colors. He has been exposed to colors, but I don't think he can understand that an item can be the label and a color at the same time.
The more I read on this and other message boards about autistic children, the more I see that it takes on many faces. A kid can be somewhat social and on the spectrum. Even if he turns out to not be autistic, I still have this awareness and understanding that not a lot of people have.

[lovemy2boys]

Great job MOM recognizing that something isnt "quite right" and pursuing an appointment with a Developmental Ped!  Your post reads EXACTLY as I would have posted 2 years ago.  Our son was diagnosed with PDD-NOS and because of our early diagnosis and intervention he is going into an intergrated pre-k this fall!  Our son is considered "advanced" for his age in terms of accademics, but still have a lot of struggles with him running away and getting over stimulated in new environments.  All of which we will overcome with persistance and the help of a great team of professionals.  Your key to succes, if you get a diagnosis, is early intervention and persistance from you.  Don't let him "off the hook" when he is acting out - it takes A LOT out of you as a parent, but he'll catch on:)  Keep us posted and best of luck to you and your family!!

[Sally44]

As you have concerns you should ask for a multi disciplinary team assessment, which will usually involve a Speech and Language Therapist, an Educational or Clinical  Psychologist and maybe a Paediatrician or an Occupational Therapist depending on other characteristics or behaviours.  You should also ask that the professionals who observe/assess your son have experience in diagnosing autistic spectrum disorders.  For example, a good SALT should be able to tell you if an autistic spectrum disorder diagnosis is on the cards simply by the speech/language difficulties your child has.
You can also look up Semantic Pragmatic Disorder to see if that is relevant.  You say he has delays.  Has he/does he repeat either phrases he hears from people/TV or repeat questions back to you, or does he give totally unrelated answers to questions you ask him?
He is just at that age when his social side should be starting to become more noticeable as it develops.  If you are noticing that that is not happening, along with the use of language only for asking for things etc, but not being used in a social chatting kind of way then these are things to mention.
You can also click on the Health Page icon on the top right hand corner of this page and have a look at the behavioural characteristics behind the DSM IV criteria for autistic spectrum disorders.  There are also a number of parents who have posted examples of their child's behaviour that meets the criteria, so that will give you an idea of what the professionals are looking for.
It can also be helplful to keep a daily diary of things that concern you and also things that he is very good at.  
Does your son appear to have any sensory issues?  Is he over or under sensitive to touch, sound, smell, taste, vision.  Does he appear clumsy?
Autism is a spectrum disorder which means it can be very mild to severe.  Even within those at the milder end they may appear much better in the home environment with familiar family members and may have learnt how to interact quite well.  However, when they are in a school setting, or at a childrens party their 'different' behaviour becomes more noticeable.  
My son also interacts well with his older sister and family members.  However in a group of children he struggles.  For example him and his sister were playing with two brothers today of a similar age.  The three children were playing a pretend game and my son wanted to join in, but he wanted to be a soldier and he wanted to make other soldiers appear to fight the other children.  This was not part of the game the other children were playing and when they wouldn't change their game to fit his 'story' he became very upset and left them to play on his own.  Also alot of his play is actually re-enacting things he has already seen on TV or on DVDs.
He also has alot of friends at school.  Although his concept of 'friendship' is not very developed.  However, he is moving to a new school in September and he has been very upset about not seeing all his friends again and has needed me to reassure him that his friends can come to his house to play with him.  However, when they come to the house he may only play for a few minutes before he tells me to play with them and wants to go and do his own thing.  So it might be the predictable environment and the children in it that he wants rather than the actual 'friends'.  But he does have some good close friends, he has a sense of humour, he can tease you and trick you.  He is capable of many things, and you too will find that your child will develop and learn and grow and achieve many things too.  But you may always find that he is very capable in some areas, may have trouble applying learnt knowledge to similar but new situations, and may struggle with some things you consider are quite simple.
It is very common with those on the autistic spectrum that they are very good at some things and very poor at others.  So knowing his numbers and letters of the alphabet by sight can be common.  However he may, or may not be able to use that information learnt in other situations.  For example, my son has known his numbers from 1-10 since he was 2.  He could put them in order etc.  However he is only now, at 7.5 years, beginning to understand that those numbers represent set amounts.  I think they call this one to one correspondence.  Because although they may recognise the numbers and what they are called, they have problems with the concept of what that 'represents'.  Because the number 5 can represent 5 children, or 5 animals, or 5 oranges, or 5 fingers, or could mean 5 more, or could mean 5 less etc etc.  My son also knows alot of the letter sounds of the alphabet, but he cannot sound out the letters in a word and then guess what the word is.  Maybe the easiest way to explain this is that they don't get 'the connections' between things or some information that we automatically seem to grasp.  These children can also be very good at puzzles, constructions games such as lego.  Some may be good at art, but many struggle with writing, drawing etc.
There are many high functioning adults with autism and aspergers who own their own businesses, give seminars, work, maybe specialists in certain areas, marry and have children etc.  
I too never suspected autism.  But if that is what it  is, then I would recommend you get in touch with the National Autistic Society in your country for advice regarding the kind of support your child should receive in nursery and school.  I would also advise joining a parent support group because you will get alot of information and support through them.
They also run seminars and Help programmes that are very useful to parents trying to figure out how autism affects their child, because it does affect each child differently.  For example some children find it hard to cope with going to new environments.  My son is quite good regarding that and we can go practically anywhere with him.  However if we have to change our plans because of the weather for example, he will get very upset about that.
Regarding his difficulty with his name etc.  Does he have problems with pronouns ie. me, you, I , he, she, etc.  This can be a common difficulty because pronouns change depending on who is speaking to whom.  So, as his mum, I can still be called I, you, she, her, me, etc.  An autistic person can struggle with this concept of many words for the same person in different situations.
Hope that gives you some ideas, if you want to ask something else please post again.