3yo son - PDD-NOS? Asp? something else?

[Quill71]

Hi, I am in the process of finding out what is wrong with my son, who just turned 3. His behaviors are Aspergers-like in many ways, but he does not meet a lot of the social criteria for Aspergers.  He has tantrums every day over the same things  - change his clothes, change his diaper, take a bath/get out of the bath tub, put his shoes on, transitions of all kinds.  If something happens once, he "needs" that thing to happen again, even if it no longer has a purpose.  Non-acceptance is *THE* major worry for me.  I cannot understand why he doesn't come to realize that certain things simply have to be.

He doesn't sleep well or eat well, although it isn't a matter of household routine.

He does most of the things you would expect socially - eye-to-eye gaze, points, interprets facial expressions correctly, imitates a face if prompted.  His vocabulary is superior; he is very bright. He doesn't bring things to me, but he will say, "Look! I made a 'T'!" and things like that.  He doesn't play "nicely" with my other children for long.   He will for a while, but he crashes, smashes, runs around.  My other son tolerates this better than my daughter; I suppose he just views it as "rough-housing".  

I feel very mixed about him being evaluated for ASD.  If they say he does not fit on the AS, then WHAT is the matter with him??? If they say he does meet ASD criteria, then how will it help me with his problems?

[Jason C Bourret, Ph.D., BCBA-D]

Without impairments in communication or social interaction, it is unlikely that your son meets the criteria for an autism-spectrum diagnosis.  That being said, a diagnosis of autism or of any other sort is just a diagnosis.  It is a label that is used to identify individuals that tend to share certain deficits but it, in and of itself, will not change how your son behaves.  Problems with tantrums and noncompliance are not necessarily atypical.  I would recommend that you have your son seen by specialists who have experience diagnosing autism spectrum disorders to either rule it out or to find out if they believe that a diagnosis is appropriate.  However, regardless of whether or not he is given a diagnosis, the behavior problems sound to be of sufficient concern to warrant intervention.  There are behavior analysts and psychologists who have extensive experience dealing with the types of problems that you are describing.  I recommend treating the behavior problem as the problem and seeking professional help in managing it.

[SueNYC]

It can be hard to diagnose - especially at 3.  My son is 9 and he has a little bit of this and a little bit of that - and even his doctor just says he has a touch of asperger's.  He definitely has ADHD - but none of the meds do anything for him so now we are on Tenex after 2 years of trial and error.  ADHD children are not always hyper - my son can read for hours on end.  He also pointed and can read faces - but he rarely makes eye contact.  He was very emotional - which the Tenex helped.  But a 3 year old is far harder to diagnose than a 9 year old.  

I You should never be afraid to have your child diagnosed.  I took him to three autism experts - and they stuill haven't figured it out - but they will point you in the right direction to get the help you need.  It is unusal to have such a highly verbal kid - can you talk to him - ours was also highly verbal which was a great help in keeping him calm.

At 6 he would have 45 minute temper tantrums when we turned off the tv (even though he knew by 4 how to read and program the TIVO).  Now he will rant and tell us he hates us for about a minute.  Better than 45 - we aren't looking for perfection - only improvement.

And cheer up. the two neurotypical kids were just as good at throwing temper tantrums - some of this is normal childhood development.  You should see the temper tantrum my 7 year old throws if I forget to book her horseback riding lesson - it is other things that are more telling.  Cheer up.  

Susan

[dlb4boys]

I know exactly what you are going through. I have 4 boys. My oldest who is 7 has adhd and is on medication. It works great for him. My next one is 5 and he is ok in school for the most part. Then there is my 3 year old. He is aggressive and rage's if he doesn't get his way. I have the same issues with school with him. He doesn't play with the other kids in his class unless it involves running around. I have the public school system doing an iep on him but he speaks well and understands what people are saying. The women doing the speech evalution said that she doesn't think it s asp because he was interacting with her. He doesn't have a problem with adults it's other children that he has a problem with. We see a clinician who is thinking it is asp. I understand how frustrating it gets because like yours he does not seems to understand that that there are things that he can not do, but he keeps on doing them and he has no fear. He constantly hurts his brothers. If you get any answers please post so i can keep informed and i will do the same. thanks.

[MJIthewriter]

Being evaluated for autism would be a good idea.  Chances are if he is autistic meds designed for treating ADHD won't be that effective.  At one time they thought I was something of the sort and perscribed ritlin...(however it is spelled)  Well that worked as a stimulant and only made things worse.

The way you describe your son playing sounds similar to how I played with people as a kid.  I'd play with my toys alongside them, but snot really engaging conversation or playing with them.  If I got bored of the game, I just up and left them to play by themselves.  Around age 10 I do remember playing with a few people I considered friends. At the time it seemed I played better with children younger than me.  Perhaps it has to do with the PDD NOS...  On the upside (and off topic) I found I could sometimes get others involved with an activity and "assign" them tasks.  I remember making a huge fort made out of boxes that way by recruiting neighborhood boys and telling them what supplies to get.

[Quill71]

He plays near other children, but inter-plays with them very little.  I was watching him closely today when another little boy came over to play with his cars.  He didn't talk to the other boy, though he would look at him. The other boy tried to interplay with my son, but my son rarely reciprocated his actions.  For ex., the other boy bumped the cars into my son's car, like they were crashing, but M just moved the cars away.  Then, M did move his cars towards the other boy, like he would play, but he didn't talk and it died off in a minute. After a short while, M started to avoid the boy.  I walked a short ways off and M ran over to me and motioned for pick me up (although he can talk).

There are some boys he considers his "friends" at our homeschool co-op, but we haven't seen them since November.  I wasn't paying attention then, but I will look next time we see them at how much he plays with them as a friend.

I have thought about ADHD before, because he can be very hyper at times, but he isn't hyper when he's doing what he likes.  He can play very focused and still when he's playing with trains or toy cars or his father's tools (with father watching, of course).  

Also, re: time-outs and rewards, they seem to have little effect on M, that is why it is so puzzling.  He doesn't seem to "get it" that he can't behave badly or can't throw a fit about everything.  I have been tightening up some things and he does respond better to it, but it's sad to me.  I'm finding that I can't give him little perks because then he wants that all the time, KWIM?  So, IOW, if I match his rigidity by being a more rigid mother than I am, things go better. I use the timer constantly to help with transitions.  It might help, but it doesn't eliminate transitional problems.

Also, I am particular about food and rarely give food/drink with artificial junk in it, and I limit sugar anyway. We eat homemade food and a lot of fruits and vegitables.

Thanks, everyone, for your responses.

[portuguese mom]

Does he have friends? Does he like to play with other children? If so, maybe he is not AS.  Have you considered ADD or ADHD? Ask the doctor that will evaluate him for AS to check him for ADD/ADHD. He sounds to me like ADHD. Children that have ADHD have a hard time with transitions, staying focused on playing with others and controlling their impulses.  They need a structured daily routine, they need to be told ahead of time what is going to happen and clear behavior limit setting by the parents and teachers (manage behavior with rewards and time-outs). You also need to minimize sugar in their diet as well as artificial coloring and preservatives. This is just the beginning of my suggesttions. Please do some research on ADHD/ADD. Good luck.

[brandy777]

I am no doctor but my son has AS and that sounds like him!

[marjsmith03]

My son is very similar.  He tends to do things he knows he isn't supposed to as well.  He has a dangerous side lately and is climbing and jumping off of things.  He does things just to get a rise out of other kids...such as knocking down blocks, turning off lights, taking toys away.  He has great social skills, but with a little speech problem.  He has problems saying many words...especially those with 2 consonants together such as spoon...he says poon.  He is really loud and hyper.  He has missed a lot of his milestones until now.  He seems to have caught up for the most part.  I have had him to developmental pediatricians, neurologists, and genetics doctors.  Nobody seems to agree with the other.  
I guess what I'm saying is that I understand your frustration and confusion.  You are definitely not alone with this.  I really don't have any suggestions or help to offer, just an understanding attitude.  However if you do find anything out, please post and let me know.  Good Luck.

[jgb21]

There are alot of questions and always answers we are waiting for,  I myself was in your situation to.  One thing I can say is getting diagnosed isn't always the answer to the problem, but is helps us to the road of getting the right help.  When my five year old was diagnosed with ppd it was like a new beginning.  I am still always searching but I get help for the problems he faces each day.