This morning, we spent two hours at the children’s psychiatric department. On checking in, they had me fill out a lengthy questionnaire which I could tell was geared towards conduct disorder, ADHD, anxiety etc. Then the psychiatrist called us in and talked about half the time to DS, half the time to me (mostly with DS outside playing with grandma and DD), with a bit of switching back and forth. About halfway through our consultation, however, she had the assistant bring in a “social communication”questionnaire which I could tell was geared towards ASD. One half was social communication skills in a narrower sense, where DS appears to score rather highly in the problem department, the second half was more “hardcore ASD” behavioral traits as it were (showing, pointing, sharing, imitating) where I could confidently put “nos” almost everywhere except one item about wanting to join in and imitate another group of kids on his own (DS has no problems participating in stuff like circle time and games as long as they are adult-directed).
We both agreed that there appears to be a massive spread between his socio-emotional and cognitive skills, that he has major trouble with understanding boundaries and other people’s needs and does not appear to understand his body in space. We did agree that he had some Aspergerish traits (he lectured quite a bit about planets and positively and negatively charges in clouds generating lightning, etc) and did have trouble sometimes relating to her questions.
She also asked how much of ourselves we recognized in him. I explained about periods of social isolation we’d both gone through as kids and when and how we had learned how to fit in (more or less!) as adolescents. And that I hoped DS might be spared those periods and develop better social skills now!
She does feel he might benefit from behavioural intervention and wants both his IQ tested and have him evaluated for Asperger’s to “understand where he is at cognitively and developmentally and to understand where his limits are, so we know what to target”. She’ll cunsult the psychologists on site and call us back for further testing.
I asked whether he’d be tested by the Gifted unit but she said they woudn’t refer him at this point and that Gifted was part of the adult psychiatric department, not children and youth, they’d use their own psychologists. Doesn’t really make sense to me, but whatever, we can always insist on being referred later if we aren’t satisfied with the results.
Oh, and AD/HD appears to be totally off the table. The compulsive-seeming teasing/poking/hitting other kids in trying to reach out to them sounds much more like Asperger’s than AD/HD, the shrink feels. I suggested sensory issues playing a part and she said she’ll tallk to the OTs on site whether they can do evaluations but thinks we may have to go elsewhere for that. I did have a hunch this wasn’t going to figure largely, I will have to keep on eye on not having this overlooked and if necessary, follow up on that one myself.
I am fairly confident that we will end up with a resounding “inconclusive” on the Aperger’s eval. Some traits, but not a full diagnosis. I do think it may be helpful to decide what kind of intervention, if any, will help him with social communication. But I am a bit worried about the “disorder” label (they want his preschool teachers to fill in a questionnaire, too) and whether this might hurt him educationally (our state has actually been cited by the UN for denying special ed children inclusive schooling where possible). So while I don’t mind the testing, I don’t want a diagnosis – we can get services on private insurance, but probably will get nothing but grief from schools...however, if they end up confident it’s Aspergers – so be it, I guess. I won’t stop the process now.
I am so glad I read the book “When the labels don’t fit” that Joensally recommended before going there today to hear this. DS is and will be his lovable quirky little self no matter what we end up with!
Edited to move the link to my 'Bermuda triangle' thread to the bottom...http://www.mothering.com/community/forum/thread/1282753/update-we-appear-to-be-about-to-enter-the-bermuda-triangle-of-giftedness-spd-and-ad-h-d