spd vs aspergers

[csb13]

Does anyone have any good info on how to determine whether a child has spd or aspergers? My DS is 6 and was diagnosed with spd at age 4. We were in OT for about a year and have just recently started at a new clinic. His sensory issues are obvious and severe. He has a really tough time socially and trying to make friends. He doesn't seem to get adult authority. He runs off in public and doesn't seem to understand when I tell him about the danger of parking lots or crowds. He's really bright, he's been reading well since age 2 and mathwise he's usually faster at calculations than me (and I teach math). He does get jokes and sarcasm (I thought this was something that aspergers kids don't understand?) He melts down a lot b/c of overstimulation. He's aggressive with his sister. He has trouble staying on task, completing projects, reading a book cover to cover (he skips around and I know that he has the ability to read well). He doesn't make a lot of eye contact with me. He does sometimes flap his arms when he gets excited.

I'd appreciate any ideas. Where is a good place to go for diagnosis-psychologist, psychiatrist, developmental ped? I think that I could easily get an aspergers diagnosis but I want an accurate diagnosis that takes in account all the layers of quirkiness of my DS.

Thank you for your help!

[RiverTam]

There's a chapter on Asperger's and a chapter on sensory processing disorder in "The Mislabeled Child." The authors include information on differentiating these problems from other problems.

[csb13]

perfect! thank you so much for the book info.

[joensally]

It depends on where you live. There are diagnostic tools practitioners can use (where I am, typically psychologists) to determine ASD. SPD is not in the DSM, and is typically diagnosed by an OT.

I found the Oasis Asperger's book very descriptive:
http://books.google.com/books?id=_O5...ed=0CC8Q6AEwAA

Also:
Kids in the Syndrome Mix
http://books.google.com/books?id=DmU...page&q&f=false

When the Labels Don't Fit
http://books.google.com/books?id=kPt...page&q&f=false

It wasn't clear until 7.5 that DS is not on the spectrum but does have SPD and some other issues. Kids development is so confusing when they're younger.

ETA:
this is also very good:
http://books.google.com/books?id=NQr...page&q&f=false

[Linda on the move]

Originally Posted by joensally

Kids development is so confusing when they're younger.

I agree, and I think that 6 is still really young. You can tell more at 6 than you can 4, but you may not get all your questions answered, not matter who you see.

I found the person who tested my DD last year by checking with a counselor who worked with children and teens and had been in the same area for a long time, and therefore knew everybody.

The doctor who did the testing is a PhD in psychology, but specializes in testing kids and has a good reputation with figuring out kids who are more complex.

Sometimes kids don't fit a dx exactly, but it's still the best fit. My DD is on the spectrum. Her label used to be PDD-NOS and now it's Aspergers, but she has a sense of humor. She loves watching The Office and totally gets it. She can make jokes in writing but not in conversation, which moves too fast for her. For the most part, she is what you would expect from a girl her age with Aspergers and her IQ pattern is text book for Aspergers, so the doctor was very comfortable dxing her with Aspergers.

[DaughterOfKali]

Originally Posted by Linda on the move

Her label used to be PDD-NOS and now it's Aspergers, but she has a sense of humor. She loves watching The Office and totally gets it. She can make jokes in writing but not in conversation, which moves too fast for her. For the most part, she is what you would expect from a girl her age with Aspergers and her IQ pattern is text book for Aspergers, so the doctor was very comfortable dxing her with Aspergers.

That's my son, too (except for watching The Office. heh heh)
There are some things with my son that falls more in the classic autism label but not enough (according to his most recent eval.)

OP- It does sound like your child may have more than spd going on.

[kme]

We are in the same boat. My son just turned 7 and he doesn't really have a definitive dx. He most definitely has SPD, but whether it goes beyond that is not as clear. I thought he might have Asperger's and so did a developmental pediatrician that we took him to when he was 4. As he got a little older we took him to another deveopmental ped, a neuropsych and a psychologist who specializes in ASD. All of them have told me he does not have Asperger's and is most likely not on the spectrum although he does display some ASD symptoms. His symptoms are due to sensory and slow processing problems. He has been given a myriad of different diagnoses but none of them Asperger's. Here are his dx: SPD, ADHD, expressive/receptive language disorder, and possible dyslexia. As mentioned, he also has a very slow processing speed which affects him in most areas of functioning.

The thing I made sure of when I took him to all the specialists was that he/she specialized in ASD. I wanted someone who sees ASD every day and knows it when they see it. I don't think someone who doesn't specialize in ASD would be able to tell the difference between my son's difficulties and Asperger's. There is a lot of overlap. I am like you - I wanted to know where the difficulties were stemming from (the CAUSE) so we would know how to best help him.

I also love The Mislabeled Child and I could see after reading it that my son most likely does not have Asperger's. It's very thorough but also easy to read for parents.

[tankgirl73]

When my son was little, I refused to believe he had ADHD, I just called him "hyper-kinetic".

When he was about 8, I think, I learned about SPD, and everything fell into place! He was a sensory-seeker and it explained everything.

Well, almost everything. By the time he was 10, I was starting to think he did have ADHD after all.

But even that didn't really explain everything. I never really considered Asperger's because I assumed it meant certain kinds of social problems -- withdrawal, shyness, etc. But when I did look into it, I realized I was wrong about that. Asperger's causes social problems, yes, but not NECESSARILY withdrawal and shyness.

My son is actually very social -- almost aggressively so. His social problems aren't that he withdraws from people. His problems are that he's unable to properly interpret social cues and interactions... so it is difficult for him to keep friends, sometimes, because he comes on so strong and doesn't interact with them the way "normal" kids do.

That was like the last piece of the puzzle, and when he was 11 and we just couldn't handle all his issues on our own anymore, we went and got a formal evaluation. The psychologist agreed, he met the criteria for ADHD and Asperger's! (she wasn't evaluating for SPD but gave me the name of an OT).

It took us a long time to get here precisely because there is so much overlap of symptoms and it can be sooo difficult to sort things out when there is "co-morbidity". Dual diagnosis and misdiagnoses are common.

So, basically... don't panic if you can't figure things out right away, or if the dx changes over time, as your child matures and things become more clear bit by bit. That's normal (though, admittedly, frustrating)

[LowFlyingAnimals]

As frustrating as it is, if you possibly can hold off on an official diagnosis. My dd is a lot like the other kids described here. She is 8 and still undiagnosed. She has seeking SPD, language delays, social quirks, etc., but she's not entirely fitting with any one diagnosis. She gets services, has an IEP, therapies, etc. But, they're tailored to her, and not some diagnosis that doesn't quite fit.

However, finding someone who is able to give an accurate assessment to get a full picture of deficiencies and potential treatments and rule out potentially underlying medical cause is really worthwhile.

[Linda on the move]

Originally Posted by LowFlyingAnimals

As frustrating as it is, if you possibly can hold off on an official diagnosis.

why?

She gets services, has an IEP, therapies, etc. But, they're tailored to her, and not some diagnosis that doesn't quite fit.

That's how it works -- an IEP for the student, not the dx. My DD's 504 Plan wasn't exactly like any other child's with the same dx. Having a dx doesn't stop the team from looking at the child to see what they need.

Right now, the OPers child only has the label of "SPD," which doesn't warrant any accommodations at all (it should, but it doesn't).

[LowFlyingAnimals]

Originally Posted by Linda on the move

why?



That's how it works -- an IEP for the student, not the dx. My DD's 504 Plan wasn't exactly like any other child's with the same dx. Having a dx doesn't stop the team from looking at the child to see what they need.

Right now, the OPers child only has the label of "SPD," which doesn't warrant any accommodations at all (it should, but it doesn't).

You don't want to diagnose at the age of 4 because:
A lot of 4 year old behaviors that are more or less typical overlap with behaviors used in diagnosing things, so kids can be misdiagnosed. Lots of kids outgrow certain behaviors and end up stuck with a diagnosis that doesn't fit. Plus, why?

You do NOT need a diagnosis of a specific thing to get services, especially at the age of 4. You ONLY need to demonstrate that there is a certain percentage of impact on learning in school. SPD won't get you services alone unless it impacts the child's learning, and often it doesn't. My dd, however, was given services with the SPD diagnosis alone because clearly there is other stuff going on. The percentage and qualifications can vary. When you do need a diagnosis, it only needs to be something very unspecific like developmental delays, neurological damage. (I'm rusty on the specific language).

Yeah, ideally, a child will have education plans tailored to the individual. But, it just doesn't work that way, even in the most well meaning school system. Special Ed advisors, teachers, and everyone else involved are almost always overworked and overbooked. If they see "autism" for example, they are likely to recommend the child go to, say, the school with the ABA program. In my dd's case, she could have qualified for the autism diagnosis. She would have floundered and done really poorly in an ABA program. As it is now, her IEP is very different than every other child's that I know. Perhaps it would have been the same, had I gone with a diagnosis, but at the same time, the autism diagnosis doesn't really fit any more at the ripe old age of 8, at least the way it is commonly understood. No one has treated her in a stereotypical way as I've seen other kids treated. Frankly, too, our experiences with special ed, EI, and all therapists and doctors have been absolutely peaches and cream compared to others, so I really cannot knock this method, even if it drove me completely mad when she was 4.

Kids at the age of 4 change sooo very much over the next few years. I'd hate to base how I treated a child on a diagnosis at that age. Some things that look like autism aren't even really testable until early elementary years, such as auditory processing disorder.

[Linda on the move]

Originally Posted by LowFlyingAnimals

You don't want to diagnose at the age of 4 because:...
You do NOT need a diagnosis of a specific thing to get services, especially at the age of 4.

The OPer's child is 6, and you do need a specific dx to get special services past preschool.

My DD is 13 and on the spectrum, and my advice to any parent is to get the best info about your child you can (evals!), and document everything with a solid paper trail, even if you are homeschooling.

[csb13]

Thank you again to everyone who has provided more information to me. It is great to have a place to go for support. I think part of my frustration was not being able to figure it all out and here I have learned that SPD, Aspergers, ADHD really do present so many similar symptoms. I think that I am going to hold off on a diagnosis for a while as we have just started at a new OT clinic and it really is an amazing place. I want to see what kind of progress my DS can make in the next 6 months as there isn't a clear diagnosis. We did do an audiology evaluation this fall, I thought maybe auditory processing disorder. The audiologist was surprised to find out the DS had the best hearing he had seen for a long time in 6 year old...and he is actually left ear hearing dominant! We are homeschooling for now, as school was a complete disaster for DS when we tried. I guess I will just hope that the answers become more clear as he gets older!

Again thank you so much for all that you shared. I have learned a lot and really appreciate your willingness to help me in my search for answers with my DS.

Cathy

[LowFlyingAnimals]

Originally Posted by Linda on the move

The OPer's child is 6, and you do need a specific dx to get special services past preschool.

My DD is 13 and on the spectrum, and my advice to any parent is to get the best info about your child you can (evals!), and document everything with a solid paper trail, even if you are homeschooling.

Not to derail the thread, but No, you do NOT need a specific diagnosis to get services past preschool. I have a dd who is living evidence of this. She's several grades past preschool, absolutely no diagnosis beyond language delay or neurological delay. Federally, you need to fit certain criteria: (I did a quick search to find this list. It's from 1993, and I think the language has changed some since then, but not the overall basic categories).

Hearing impaired;
Both hearing and visually impaired;
Speech or language impaired;
Visually impaired;
Severely orthopedically impaired;
Impaired in strength, vitality, or alertness due to chronic or acute health problems severely chronic or acute health problems (other health impaired);
Autistic-like behaviors;
Mentally retarded;
Seriously emotionally disturbed;
Learning disabled.
Autism
Traumatic brain injury

Most of these are not diagnosis, but descriptions. It may be easier to get services if you have a specific diagnosis in some areas, but I maintain that that is when you'll get the cookie cutter services that they always give to kids who have x with a few minor adjustments here and there.

A lot of parents don't know this. I think this makes for misdiagnosed kids who may not get to grow to their potential. It inflates numbers and makes it harder to research a specific disorder or condition because all the kids labeled with it are not the same (think autism).

As far as the professional evals, I recommended the same thing, as I stated in my previous post. There's just no need to push for a name or diagnosis specifically. Whether a child has just SPD with some quirks or aspergers makes no difference in treatment plans. It just doesn't matter what you call it. Therapies will be similar. Even at 6. (Sorry I got the age wrong. I mistake 4s and 6s all the time). At 8, my dd still has no diagnosis and is still considered too immature to be accurately assessed for things like auditory processing disorder. She still receives all the services she needs, and frankly, she has a very specific IEP.