Should I seek professional evaluation for ASD?

[Natasha01]

I was looking for some opinions on if I should seek evaluation/treatment for my son.  He was diagnosed with possible ASD at 18 months and then Aspergers at age 4 by the public school system.  His pediatritian was unconcerned and said that if he had autism it was very mild and he would grow up to be very high functioning.  The problem is that my son has violent uncontrollable temper tantrums.  He is now 5 and it takes several adults to restrain him during his tantrums.  He picked up a baseball bat and started swinging at his principal and teacher during the last one, to which the principal replied that he didn't think it had anything to do with being on the spectrum. (We switched public school districts and the new one kept his ASD certification but are not sure they agree with the diagnosis.  They say he seems to be highly gifted and has the behavioral problems that go along with that).

My son has never played with toys, only lined them up.  He has had an obsession with calendars and clocks since he could crawl and had not had much interest in anything else. He scored extremely high on an IQ test given at age 4.  His social skills are pretty bad although he is not completely isolated, just prefers to talk to adults and much older kids. These violent tantrums scare away the kids in his class, not that he notices, but I do. I am asking for advice because I am a single parent and his only caregiver. I want to get him as much help as possible but we don't have any insurance coverage for mental health. 

I would have to pay for any professional evaluations but would do so if it would help.  I just don't know if I should wait out these tantrums, he has started to use whatever he can find as a weapon against me and I'm afraid to do nothing.  Thanks for any help!

[SpottedFoxx]

Whether it's ASD or something entirely different, it sounds like something is going on and an evaluation is definitely warranted.  It's very unusual to find a pediatrician who "gets" delays.  My pediatrician told me that my son was just a boy when I expressed concerns about his not speaking.   My son has a severe articulation and expressive language disorder (among other things).  Even after the diagnosis - she blew it off as being no big deal.

Find a developmental pediatrician or autism center in your area and set up an appointment.  The sooner you understand what is going on with your son, the sooner you will be able to get him the help he needs.

[FarmerBeth]

Anytime it's hard to function, then that's a good reason for an evaluation.  Your son's tantrums are hard for school to deal with (if your son was an adult, we'd be saying he's having problems functioning on the job, and hard for you, and it must be very hard for your poor son to be feeling this way.  I'm sure it's worth it to find out what's wrong so that he can feel better and is easier to deal with.

[Linda on the move]

Originally Posted by Natasha01 
 I just don't know if I should wait out these tantrums, he has started to use whatever he can find as a weapon against me and I'm afraid to do nothing.

My advice would be to do everything you can rather than waiting them out. This is the behavior that gets kids taken out of regular school and put into school for behavior problems. This is huge. Once a child ends up on that diversion track, it's hard to get them back.

I'm pretty much always a fan of evals and getting more information so that we can better meet our kids needs, but the stakes are much, much higher for a child who becomes violent than for a child who shuts down.

I'd start by doing lots of research on what is available in your area, find an autism center, contact a close university, try to think outside the box with help with this financial. There may be a way for someone else to help pay for the eval.

I'd also look into sensory issues, if you haven't already. Some kids, esp. boys, with sensory issues, can become violent when they are overwhelmed because they don't have any other way to cope. Figuring out the sensory issues and how to get them the sensory input they do need while avoiding things that are triggers for them can have a massive impact on their behavior. School can provide sensory accommodations for kids on the spectrum, but not for those kids with sensory issues who don't have a dx of being on the spectrum.

You also might see if there is a social skills class for kids his age where you live. When my DD (who is high functioning) went to SS class, one of the kids was very similar to your son. He was in middle school and his mom was trying to get him back into regular school. He was a VERY sweet boy, and meeting him when he was calm and in a situation where he felt safe it was hard to believe that he had a history of hurting teachers and scaring other children. In addition to a solid DX with accommodations that worked for him, helping him learn to deal with social situations was part of the plan to re-integrate him.  Even if this isn't something that can happen now, you could keep it in the back of your head for down the line.

Good luck!!! 

[mamarhu]

Have you looked into eligibility for state medical insurance? In my state, it is far better than ANY private insurance for mental health. As a single mother, my job pays my insurance, but not my kids'. It would cost more than 1/2 my salary to add my kids, so they are eligible for state aid. I had to apply at the same office as for welfare and food stamps. Also, look into SSI (automatic medical benefits for a child who qualifies for financial assistance). Qualification through the Department of Developmental Disabilities (Autism Spectrum Disorder counts) opens many doors in my area. NAMI (National Alliance for Mental Illness) may also be a resource, depending on how active the branch is in your area.

From your OP, it sounds like you need more help than you are getting. School will probably not be the source of the best diagnosis or treatment.

[RiverTam]

OP, you list your location as "Midwest" and that covers a lot of area, but if you go to the Autism Speaks website, they have resources for most states.

The violence is a big red flag. I'd see someone about it. 

It may not be an ASD. It might be something else. 

Your child can be very gifted and still have something going on. Mine does.  

[Linda on the move]

Originally Posted by RiverTam 
Your child can be very gifted and still have something going on. Mine does.  

totally agree, My kiddo is gifted and on the spectrum. Understanding as much as possible about what is going on with her (which will never be everything!) means we can better meet her needs and she has a much better chances of having the kind of life she is capable of (whatever that ends up being).

[Emmeline II]

Though I agree that the school isn't the best place to get help from, you're going to have to jump through their hoops to get any useful cooperation from them. I didn't know what those hoops were when my ds was in K and he was suspended twice, along with full day ISS's and numerous lunch detentions--though he didn't have a diagnosis and the school had it's head in the sand that he was anything but a "behavior problem."

I'm a little confused as to what "ASD certification" is. Was he evaluated for special education services at 4yo and found that he qualified as OHI due to Autism under IDEA? If this is the case then the evaluation should have resulted in services and probably an IEP (IEP Goals for Special Needs Kids at the Preschool Level).

I recommend reading this book ASAP for advice on dealing with the school: Wrightslaw: From Emotions to Advocacy

They can't just decide that they "don't agree with the diagnosis"-- from what I've read the teacher would have to make a written request for a re-evaluation Autism Society - School Evaluation ~ otherwise they need to act on the eval already done.

If a child already receives special education services, the above standards apply for re-evaluation. A re-evaluation must take place at least every three years. It may, however, be conducted more often if the parent or teacher makes a written request. An evaluation may also be done in specific areas of concern. A re-evaluation of all areas of suspected need or one for particular areas may occur if parents feel their child is not meeting the short-term objectives of the current IEP. 81wds.

(Autism Society - School Evaluation).

The Midwest Center for Autism Spectrum Disorders- (Parents of children with ASD and anyone else who is interested in making a referral or learning more about the center is urged to call 660-543-4272) 

--this is just a brochure; they don't seem to have a website.

(For an initial evaluation I'd submit a written/dated letter requesting that the school do education/learning disability testing--you need to "start the (legal) clock" in your letter of request; the school has 60 days from the date they received parental consent for evaluation to do one; your written request should note that this letter is the consent for evaluation. [And, if you did not do it in writing, it never happened!]). 

Twice Exceptional Children (2e) - Wrightslaw

Twice-exceptional children are gifted children of above average abilities who have special educational needs - AD/HD, learning disabilities, Asperger Syndrome, etc. Because their giftedness can mask their special needs and their special needs can hide their giftedness, they are often labeled as "lazy" and "unmotivated".

This page includes articles, resources, book recommendations, free publications, and a short list of information and support groups about twice exceptional children. 73wds.

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Determining Eligibility: How Many Days is 60 Days? - Wrightslaw

The Art of Writing Letters by Pam and Pete Wright - Advocacy ...

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Assessments, Evaluations, and Testing - Wrightslaw ...

Special Education Rights - Independent Educational Evaluations ...

Independent Educational Evaluations: What? How? Why? Who Pays

When Parents & School Staff Disagree

When parents and the school district disagree about the need for an independent educational evaluation (IEE), there are certain conditions in which a school district may be forced to pay for the evaluation....

Additionally, if the parents disagree with a school district evaluation and request an IEE at public expense, the school district must obtain the IEE and pay for it unless the school district requests a due process hearing and the hearing officer rules that the IEE is not needed. 34 C.F.R. 300.503. 90wds

Under IDEA/IEP, if your child has a disability that adversely affects educational performance, your child is entitled to an education that is designed to meet the child's unique needs and from which your child receives educational benefit.

A 504 is helping your child get the same education that everyone else is getting--more for a student that needs accommodations to help them learn (like sitting next to the teacher) or for behavior, and that they are not punished for things that they cannot control due to the ADHD (like needing to work standing up or not sit inside a group).

[A IEP or 504 is not an escalation or punishment for the teacher/school. It's more about getting all appropriate parties involved and on the same page. The student, parent/legal guardian, teachers, principals, Pupil Services administrators, support staff (i.e. nurse, counselor, psychologist, language/speech pathologist) as well as the student's physician or therapist may be involved in the placement process including the 504 meeting.]

Eligibility under IDEA for Other Health Impaired Children

Key Differences Between Section 504, the ADA, and the IDEA.

(http://www.wrightslaw.com/info/sec504.summ.rights.htm)

Edited by Emmeline II - 12/23/11 at 1:22pm

[Natasha01]

Thanks to everyone who replied, it was very insightful.  My son's school has been very helpful, and has kept his autism certification although some don't agree with it.  For example, after one of his severe tantrums his principal said he didn't think his behavior has anything to do with being on the spectrum.  I wish he would have said what he did think it was(inborn personality, bad parenting?).  I am looking into getting a professional evaluation now because of the advice here.  Sensory issues have never been brought up through the school system it had never really crossed my mind. 

Anyway, thanks so much, my son is my only child, its just the two of us, and its all new to me.

[Emmeline II]

Originally Posted by Natasha01 

Thanks to everyone who replied, it was very insightful.  My son's school has been very helpful, and has kept his autism certification although some don't agree with it.  For example, after one of his severe tantrums his principal said he didn't think his behavior has anything to do with being on the spectrum.  I wish he would have said what he did think it was(inborn personality, bad parenting?). 

Though helpfulness makes things easier, it's not simply about "agreeing" or not with the previous school's evaluation; your school has legal obligations to meet based on that evaluation. I'd be concerned about what the principle said as it can affect his attitude toward your child and how your child is disciplined; a child covered by IDEA has procedural safeguards that a typical student does not, such as having a manifestation hearing prior to a school disciplinary hearing.