My child dignosed as ASD, but I doubt about it

[FSG]

My daughter is 5 and diagnosed by her pediatrician as ASD. I never realize that she has any problem till 6 month after she went to preschool. She met the milestones from my view. From 2-3.5 she had very tough time at home. There had been excessive amount of fighting, crying and she was neglected all the time. She stayed at home that time.
She has very good self care skills—she can dress and undress her since she was about 3 years old, she can feed herself since she was one and half.... She has been such an easy kid at home even now. I have no problem to communicate with her or she expresses her needs to me. And she is so lovable, I believe I have all the kisses and hugs and ‘I love you’ as all the lucky moms in the world.
But she is speech delayed and social very behind (she is bilingual). She will not play with her classmate and not interested in pretend play at school. She is doing quite good turn taking play with family members and she seems to attach to her brother when they are in a social environment.
Her most difficulties are come from school. She sometimes seems doing bad thing for no reason. The episode won’t last long and she will back to normal when the moment is gone. And she understands she is wrong and she hurt other’s feelings. She still does not demonstrate age proper sympathy although she shows that to me and Dad.  All in all, she has marked problems in social skills and communication with people outside the family. I do notice all the time she become a different person compare to at home when she is put in a social situation.
She is very smart since she can write many words, count to 100, read simple books.... But she seems to have difficulty to answer the questions beyond the surface of the book.
She has been in speech therapy for a year and the progress is remarkable.
I am really wondering all the time if that the tough time she had sets her back too much or she is really has ASD?

[Rachel Thompson, Ph.D., BCBA]

Children are incredibly resilient. Difficult situations at home can certainly set children back, but I have seen many children “catch up” with the right kind of support. So, I would encourage you not to focus on the past, but to focus on what you and your child’s school can be doing right now to help her in any of the remaining areas of difficulty. It sounds like your child has some wonderful strengths. It is important to recognize and build on those, but also to make sure that you are challenging her to develop in other areas as well. Given the large discrepancy between school and home, I recommend that you try to work closely with your child’s school and any service providers to encourage appropriate social behavior. It certainly sounds to me that your child has some age appropriate play, language, and social skills. If you are questioning the diagnosis, I recommend seeking the input of a local professional who is experienced in diagnosing autism spectrum disorders.

[SueNYC]

Definitely go to an expert.  I have a team of the best psychiatrists, psychoneurologists, and psychologists looking at my son and they are a bit stumped whether he is ASD or not.  He is what they call very borderline.  He is very smart.  His IQ is in the 98% - but htat really doesn't matter when you lack social kills.  He reminds us of Sheldon on the big Bang Theory.  

Am I upset that ehre is no definitive answer - not really.  We know his executive functioning is in the toilet and he has a very rigid vieew of the world - but all the ABA therapy we have down with him has worked wonders in our ability to function as a familyy.  He is definitely improving.

And all of those big reports all those doctors wrote - got us into a school were the staff was professionally trained to dela with his persosnality both emotionally and academically.

Many of the children in his school are exceptionally bright - but many still have trouble functioning when they graduate.  In fact, his school has just set up an agreement with a college so tht the supports are still in place if they want to attend college (ASD hava high dropout rate).

After three years, no one can definitely dx my son.  Right now it is technically ADHD, ODD, tic disorder and an unspecified mood disorder.  Many of the autism doctors feel that he is a little bit autistic but not full blown criteria,.  NYU is starting to move into researching this whole borderline area of children -- she just may be one of them.

My son almost has pragmatic speech down (he is good 90% of the time), is getting better at controlling his emotions when things aren't going his way, and is learning to be more flexible - but it si a process.  Be happy that she seems relatively normal - the more normal she is the better chances at a good outcvome.  My son never qualified for any services until we sued the state - and he was struggling so bad that we were afraid he was turning suicidal.  He had a bad incidence on Prozac - leading his psychiatrist (who specializes in Asperger's but is also a pharmacologist) to start thinking along different lines (as certain conditions react badly to SRRIs).  THese are what experts can help you sort out.  He may be bipolar (too young to tell),  but these are things they can monitor.

Now he is in a place that celebrates him.  They work on his strengths and his weaknesses.  He is so happy now that his anxiety levels are way down and he has made friends.  We truly thank all the professionals at the NYU Child Development Center that built the roadmapp for us to follow.  I think that the scope of some children''s problems need a professional who sees more of it than your average pediatrician.  Our pediatricians are kept informed but they acknowledge that it is best to get expert advice.  

It truly disturbes me that so many people on these boards rely on quicly done psycho-eds at their school or a quick checklist at the doctor's office.  There are definirely waiting room diagnosis (in my son's school they abound) but I am finding the more we get into this that there are so many shades of behavioral issues or neurological disorders.  What one parent regards as autisitic my actually be the symptom of many other conditions - or it may be autism.  THe dx isn't always as important as getting the right therapies for your child.  ASD gets you alot more help than ADHD or ED - so take it as a gift.  You can always have the paper work shredded when your child ages out of the system.