At the borderland of ASD

[BookGoddess]

Interesting article. Check out the chart.

http://www.psychologytoday.com/blog/...borderland-asd

[LynnS6]

Very interesting. I've often thought of ds' issues as at the borderland of autism. He's got SPD, and probably anxiety. But when his sensory issues flare, he looks a lot more like he's got autism. He's spending so much energy on sensory stuff, he just can't do social stuff. When his sensory needs are under control, he looks like most other 9 year olds I know, if a little quieter and more observant. (But the latter are probably just his personality.)

[sbgrace]

So are they postulating that children on the extremely mild end of the spectrum may end up as adults who appear as the broad autism phenotype?

I saw a study once that found that male siblings (and fathers I think though I'm not certain of that) of boys on the spectrum almost always met the criteria for the broad autism phenotype. That was siblings who were kids at the time meeting the BAP criteria if I remember correctly.

I've never quite understood the difference between, particularly, NVLD and similar and PDD-NOS exactly. I see them as under the "atypical autism" umbrella. They benefit from the same interventions and accommodations. So I hate that a child might miss those because he doesn't have an "autism" diagnosis but rather NVLD.

Honestly, I not at all sure it matters much what you call it!

[Kristine233]

Interesting article. I'm with Rachelle, not sure that it matters. But more explanation:

Some people really want that specification, we typically avoid getting too specific because I think there are many things that complicate this idea. Some are obviously Autistic in some settings and only mildly in others. The specifications only capture one setting/point in time and don't take into consideration the whole picture. For example, my child has the official dx of mild-moderate autism. In many activities he thrives and people would not know that he is anywhere on the spectrum. (I should clarify and say that this is NOW, not 5+ years ago before he started social groups and speech therapy - back then everywhere would have been moderate-severe) He has learned to adapt and "appear" more normal in many situations. Anyone who knows him really well would pick up on the Autistic traits and see the struggle, but otherwise what you see is a "normal" child. Stick him in a school setting (and there are others, its just consistent there) and he can lapse into what we call "obviously Autistic" modes. Verbal and physical stimming, little to no eye contact, hard to follow conversations and attention to things that are not his interest can be brief. Someone seeing him in this setting may be able to say "Aha, he has Autism" with little questioning needed.

There have been times people find out he has Autism and they haven't seen him in a "obviously Autistic" setting and they say .. "He must have HFA then" and I reply "Sometimes." That usually leaves people scratching their heads. lmao

So when we start to overly specify my fear is that we'll pigeon hole kids and adults into one strict dx and they may not always be the most accurate dx for that individual. I can see insurance companies taking advantage of that and specifying what services a person can get depending on the specification within the dx. That scares me a bit.

So if they want to make a broad Autism label to include a range, then that would probably be something that could help avoid the pigeon hole effect and allow people to get services they need. If they use it to come up with some theory that all Autistic kids will eventually fit into this broader spectrum I think it could be harder for them to retain services because someone will decide its not necessary. It's complicated, lol, I don't know if my reasoning even makes sense to anyone else but me.

[sbgrace]

Originally Posted by Kristine233

So if they want to make a broad Autism label to include a range, then that would probably be something that could help avoid the pigeon hole effect and allow people to get services they need. If they use it to come up with some theory that all Autistic kids will eventually fit into this broader spectrum I think it could be harder for them to retain services because someone will decide its not necessary. It's complicated, lol, I don't know if my reasoning even makes sense to anyone else but me.

It makes sense to me and I share your concerns. I think it already happens. In Indiana PDD-NOS or an Aspie dx. mean insurance must provide therapy by law. A NLD/NLVD diagnosis gets you nothing and I believe that kid needs as much help in many cases.

And a child with a particular label (whatever it might be) might look far different than another child with the exact same label. One might be more affected than the other or they might have specific areas of strength/weakness.

Then there is the whole yucky to me issue of certain labels having (usually inaccurate) connotations compared to other spectrum labels.

I think I favor an umbrella autism spectrum diagnosis category for those reasons.

[kme]

I think it's interesting SPD wasn't listed in the "borderlands" conditions. My son is one of those who is in the "NQA" category. He has been classified as having SPD and a language disorder. The speech therapist at his school described him as being like an egg - when his sensory needs are met, he is "intact" and seems pretty typical. When they are not, the cracks start to show and he starts to look somewhat autistic. SPD definitely is in the borderlands and unfortunately does not qualify for any type of services.

[Kristine233]

Originally Posted by kme

I think it's interesting SPD wasn't listed in the "borderlands" conditions. My son is one of those who is in the "NQA" category. He has been classified as having SPD and a language disorder. The speech therapist at his school described him as being like an egg - when his sensory needs are met, he is "intact" and seems pretty typical. When they are not, the cracks start to show and he starts to look somewhat autistic. SPD definitely is in the borderlands and unfortunately does not qualify for any type of services.

Probably because SPD isn't in the DSM as a recognized diagnosis. Most Autistic kids have SPD, but not all SPD kids have Autism or fall on the spectrum. That's how it was explained to me anyways. Its confusing though because when you look online for resources the 2 are almost always cross referenced and they do share a lot of the same therapies and techniques for care. My son was originally identified as having SID/SPD (when he was age 2 and 3) so I understand the frustration with the lack of info and support in the form of services.