Aspergers or Autism???

[reggie0925]

I have two sons, ages 3 and 5.  They are two years and one day apart and will be turning 4 and 6 the fist part of August.  My 5 year old was WELL beyond the normal range of when things should be happening with your baby.  By this I mean when he was 12 months old, he was doing and saying things that children 18-22 months should be doing.  He is now at a more average level.  Then along came our second little guy and naturally, I just assumed that he would follow the same path.  Not true!  Although they both walked and crawled at the same time, the maturity level that my little one now has at age 4 is comparable to that of a 2 year old.  Of course I have heard everything; he may be autistic, he may have Aspergers syndrome, and it is all so very frightening and frustrating as well.    We are in the process of an evaluation to see where he is at, but when doing my own detective work on both topics, there is no way he could be lumped FOR SURE into one category.  His main issues are delayed speech and lack of emotional maturity for a 4 year old.  Example, throwing tantrums when told no, acting out and hitting his brother when his brother won't give in or play.  He is a very energetic child that is working on his speech skills, plays well with others and has actually done some things his brother never did at age 3.  Help!!! I am going crazy here with everyones arm chair diagnosis and they think I am not paying enough attention to it.

[Rebecca MacDonald, Ph.D., BCBA]

I'm not sure who is evaluating your older son, but I would suggest that you try to identify a hospital in an urban near you area where they specialize in diagnosis of children who present developmental delays, as well as, autism and aspergers syndrome. A comprehensive evaluation by a team of specialists will result in diagnostic information as well as treatment recommendations. You can then take these recommendations to your local early intervention program and public school. There is a lot of mis information out there so I would rely on the professionals who have see and evaluated your children for advice.

[blissfullyyours]

I know how you feel !!!  My little boy now eight has  had different dx's from all doctors seen., The problem seems to be at least educationally there's a different criteria in order to meet a dx (alot less) so my boy while educationally he classifies as autistic clinically he does not.  I've heard everything from ASD, to Ausbergers, to PDD. In the end, we treat his symptoms and try to come to grips that whatever you want to call it, he has some idiocycrises that we deal with on a day to day hour to hour basis.  For us, some medication has helped with symptoms but I worry alot about his future and other people and how he is treated.

[reggie0925]

Thanks for the reply!!! It is just so confusing and sometimes doing a bit of self education, just seems to confuse me more.  The little guy is so very smart, but not in that "rain man" sort of way.  I would like to credit this to his older brother and him seeing what he does, how he goes to school and so on, also, he got a Leapster and is doing so well with it.  I am so proud of his skills, then relay them to the director of the pre-school he will go to and she dashes my pride and reduces it to fear!   She says that he should be talking soooo much more by now, nut in reality, the only thing missing from what you would term "normal" is the speech.  He makes eye contact, socializes, sometimes to the point that he throws a fit when we need to leave, and does communicate, although not as well as his bro did at this age.  Then to have someone tell you that becasue he is writing his ABC's, that this is a sign of Apsergers!!!  I sometimes feel that people are so quick to label and just move on!!! ARGGGGGGGG!

[Sally44]

Have a look at the diagnostic criteria under DSM IV for both autism and aspergers (you can google it).  That will give you the list of behaviours they (professionals) are looking for and you have to tick a number of boxes in each category to get a diagnosis.
If it is autism, there is such a 'spectrum' of how it affects each individual.  It ranges from severe to very milld (or not enough traits to even get a diagnosis).
Usually, if there are no speech delays, (but there is other 'autistic behaviour), that points more to Aspergers, although they still do have communication and social interaction problems.  Again this can range from not wanting to initiate social interaction, or doing it in an 'odd' way or to the extreme of not understanding when another person has had enough and wants you to go away!  Children with Aspergers also tend to do better academically at school.
Children on the autistic spectrum tend to have speech delays and language processing problems.  For example they may be able to request things eg. a drink or something to eat.  But when you ask them a question you may get no response, or something totally unrelated to what you asked.  So their expressive language is better than their understanding of receptive language.
Then there will be social communication difficulties.  This may involve not understanding the social rules or the rules of a game.  Not understanding your role within a game.  Wanting to re-enact things they have read/seen on TV/DVDs and wanting others around them to also re-enact these things.  This shows a lack of imagination, but you have to look quite hard to see it because it looks like imaginary play until you see how they are rigidly sticking to the dialogue or the sequence of events that they have seen.
There are usually tantrums around change eg. change of routine, change of sequence of doing things, moving from one task to another, having to stop or start things.
For those children less severely affected with autism I believe (from my experience and that of other parents) that they can/do show eye contact/ empathy/sense of humour/ theory of mind etc.  Maybe not to the same level as their peers, but it is there.
There are usually some sensory issues eg. appearing deaf/covering ears at noises.  Tactile problems of having to remove tags on clothes or not feeling any pain at all.  They may be oversensitive to smell and taste and refuse food or only eat certain types of food etc.  But these sensory problems fluctuate and can be different day to day or even throughout the day.  This can confuse parents because they don't see the same response from their child.  Some children can only use one sense at a time eg. when they are making a lego model they appear deaf (ie. their ears are effectively turned off).
So I would suggest looking at the criteria.  Professionals usually look for the 'triad of impairments'.  This includes problems with speech, social interaction and lack of imagination.  From what you have posted you have already said he has difficulties with speech and emotional maturity (read appropriate social interaction), so there may be difficulties in two of the three areas and professionals will want to observe your son to see if he can demonstrate imagination.  Some children can show some imagination, but it is whether it is to a level consistent with peers.  
Even if it does turn out that your son is on the spectrum it really is not the end of the world (although it feels like it is at the time).  He sounds like he is doing really well.  So, although the diagnosis is devastating, it means he will get the support he needs within school.  Or it may turn out to be some delays, or even some traits of autism, but not enough to meet the criteria.  Speech and Language usually do a good job in recognising the speech/communication difficulties associated with autism and maybe able to tell you from their report whether they suspect autism.  But it will probably take alot of further observations for other professionals to confirm that.

[reggie0925]

Thanks so much for the advice.  We are in the process of waiting for a referral from our pediatrician so that's where we will start.  My mother in law did take him to her friends house.  Her friend has a grandson, same age with autism.  Her friends husband has really done his homework on the subject so he can be able to handle his grandson when they watch him.  She asked him to watch Reese and give her his opinion.  of course this is after relaying all the stuff we have been going through.  I understand that he is no means an expert or a professional but he did observe him for over an hour.  He said aside from his speech, in his opinion, there was nothing wrong with him.  He also interacted with him, asked him questions and so on.  I guess I feel a bit better since they have the experience first hand with an autistic child.  Anyhow, until we hear from our pediatrician, we can't really do anyhting.