The short story is that I am worried about ASD in my 3 1/2 year old but DH disagrees, says all of what DS does is "just being a little kid" and thinks I'm a hypochondriac (I agree, I'm a worrier, especially about the kids). Too much Google has me analyzing every little thing he does, every noise he makes and I think DH is about to kick me out of the house.
I try to observe other kids his age to compare, but unfortunately he's somehow always around girls and they are SO different at this age. For whatever reason, every time we join a class or playgroup, it's him plus tons of girls and maybe 1 or 2 other boys.
So, do these things sound normal or abnormal for a 3 1/2 year old boy? (Note: He is the oldest of two and has spent the past year adjusting to a new baby sister. He stays home with me, but started 2 days per week (2.5 hours/day) of pre-school this past September. He also goes one day a week to an outdoor program at a farm. We don't have other kids in the neighborhood and has never been in daycare, so maybe he's not around other kids as much as he should be.) For that matter, maybe I'm not around other kids enough to know what's normal.
He speaks very well, talked on the early side of normal, and picked up words and sentence structure a bit early. He's just like me...observant, excellent memory, and a bit hypersensitive to things around him, but more in a "hey, I notice that" way and not really bothered my them. He has not liked loud or harsh noises since he was much younger, but lately he's been OK with a wider range of noises and seems to be outgrowing that.
He can "read" some of his favorite books from memory, but is not like those gifted kids that are actually reading at age 3. He is "all boy" and likes trucks and trains, but also plays with a wide variety of other toys, including his play kitchen.
Once in a while, he will line up all of his cars or trucks, but not in any order (just in the order they come out of the bin). He maybe does this once per week, if that. Otherwise, he plays with things and makes up little stories. The stories are a mix of things he's seen on Thomas or other shows or books and his own ideas. Its not word-for-word Thomas, for example.
Like most kids, he has favorite videos and books and things he likes to do, but he doesn't watch or play or read the same thing over and over. He knows certain routines and will point out if something is different, but goes along with it without a problem.
If another child starts crying, he will look at them with concern and even stop what he's doing, but that's it.
I don't notice many things like toe-walking or hand-flapping but he seems to be always making some kind of noise with his mouth. He's either singing, humming or saying things he thinks are funny or that will get our attention.
DH says I'm being to hard on him and he's "just 3" (he'll be 4 in May) and I'm expecting him to act like a much older child.
So, if you were me, would you relax or pursue an eval? Oh, and the main reason I'm being cautious is that I feel matching a kid his age up with the really vague diagnostic criteria of ASD and the fact that we live in a time where they have a very narrow definition of "normal" will mean he'll get diagnosed with something and I don't want to do that if these are just normal things that 3 1/2 year old boys do and that he just needs a chance to grow out of.
Any help is appreciated. Sorry this is long!
I'm not a professional, but I don't see any red flags for ASD in your post. And almost all kids will show one or two "symptoms" of some disorder or another throughout their development. The symptoms themselves, if they aren't causing any distress, aren't really worrisome. From your post (and I realize there may be things you left out or whatever) he sounds like a happy, flexible, fun, smart kid. It's OK if once in a while he wants to line things up, or if he covers his ears occasionally when the vacuum comes on... that's just part of childhood, of being human. If he was compulsively lining things up all day long and/or wasn't able to engage in other kinds of play, that might be concerning... or if he covers his ears when the vacuum comes on and then has a 2-hour-long meltdown afterward, or avoids many places out of fear of loud noise.
My DS has had a couple of evaluations for his various issues. It doesn't hurt to have an eval, aside from costs if it's not covered by insurance, and DS really enjoyed his actually. However, you usually need a referral (again, depends on your insurance and who does the eval) and from your list above I don't know that you'd be likely to get a referral. So if you do think you need/want an eval, you might want to make a list of what things are difficult, what parts of his/your daily life are struggles, etc. so the doctor can get a clearer picture of what you are actually concerned about. An evaluation may be necessary if he is developmentally behind in one or more areas; if he is always miserable/hard to soothe/generally unhappy; if he is struggling socially, academically, or physically; if he is unusually violent or destructive; if he has a hard time communicating or loses language skills; if he's not smiling, showing you things, interacting, etc... Does that make sense?
I think crunchy is right on. When our son was younger we spent a LOT of time trying to decide if he was on the spectrum or not. Turns out our little one has a language disorder, but I learned a lot about what it means to be ASD or not. To me it doesn't sound like your son really has any of the three central criteria. 1) severe communication difficulties (this can be language but also includes gesture like waving and pointing and social communication like emotions) 2) severely restricted interests and 3) repetative/ritualized body motions that interfere with daily life.
That's totally my paraphrasing the criteria, but your little one really doesn't seem to have issue with any of those. You mention that he only pauses when another child is crying - that is 100% normal for a 3 year old. True empathy requires a more developed theory of mind and prefrontal cortex than a 3 year has. 3 year old children can act empathetic, and it is an emerging skill, but most children don't fully develop empathy until closer to 5 or 6.
Also, all kids line up toys, spin, etc. It is when it becomes obsessive and interferes with their functioning that I would worry.
All that said, you are his mom and you know him better than anyone else. My rules of thumb are 1) if there is something going on that is in any way interfering with a child's functioning (social, academic, or communication for example) then I would definitely get an evaluation or 2) If parenting a child seems significantly more difficult than other children, then I would definitely get an evaluation. Barring that I think you need to trust your instincts. If you are this worried, and can afford it, then go for it I'd say. The only potential risk is a mis-label and I think you can avoid that by going to a highly regarded developmental pediatrician that looks at a broad range of disorders (i.e. isn't a specialist in one thing like ASD since my experience has shown that those specialists are much more likely to dx a child in their area of specialization).
Do you have a ped you trust that you could just mention your concerns to?
Thank you for the replies. He is definitely happy and does all of the things a boy his age should. We see improvement with potty training, sharing, etc. week by week (meaning he is "growing up" as opposed to not developing or going backwards). The main parenting difficulty we have is not doing what we ask, being aggressive to the baby and whining/crying when he doesn't get his way. But I'm sure all of that is normal for a 3 year old, especially one who is dealing with a new sibling. We definitely notice he is a completely different boy when he gets Mommy and Daddy all to himself, and then does a 180 behavior-wise when the baby wakes up again.
He plays normally 95% of the time, so the lining up thing is not interfering. I see his play developing and he uses new things and integrates new toys into his play. He concentrates and participates in things for decent periods of time. If he's not interested in something, no one can "make" him do it. But again, probably all normal 3 year old stuff.
I want to trust my mommy instincts, but since I know I'm a worrier, I can't. The chain of events probably went something like this: I was worried about "the big A" from day one, like any other parent nowadays. 2) I randomly read or heard someone say something about ASD and lining up toys and thought, "OMG, DS does that!" 3) I probably then did tons of Googling about symptoms and saw other things like having a good memory and early talking and convinced myself something was wrong.
I guess the thing that worries me now is how he can't seem to ever be quiet, but isn't "talking" per se. It's a mix of "doo da doo" type humming, misc thoughts related to what we are doing, etc. I have friends who complain about their kids making constant noise, but their kids seem to actually talk, like say what's on their mind.
I mentioned the toy thing to the Pedi a while ago and she reacted kind of like she would never believe a child as verbal and social as DS could have ASD. But she did acknowledge that Aspergers is tricky.
So I guess the real question is: Is the constant babbling/humming and noise-making normal? Or a phase? It seems to happen when he is not doing an activity, so it could be boredom.
As a teacher, I have worked with a lot of kids with Autism Spectrum Disorders. My own son is slightly younger than yours, but he has a lot of the same traits: not exposed to a lot of other kids, observant, good memory, etc. Based on what you've said, though, it doesn't sound like your child has autism.
Most of the kids with autism I've worked with do NOT speak well, in fact its more common for them to start talking really late--if anything, they're usually relatively non-verbal, and when they do talk, it's often in a very different way.
Most of the kids with autism I've worked with have a pronounced aversion (or sometimes an interest in) loud noises, but they usually don't outgrow it--usually it's a lifelong issue.
Most of the kids with autism I've worked with don't play with toys in a typical way (when they do play with toys at all, they almost always do it in a way that looks very different than what kids normally do during play), and usually are preoccupied with a rather narrow range of toys/interests.
Lining up is a feature of autism, but lots of normal kids do that too.
Most kids like routines and are aware of them to a certain extent. Kids with autism usually NEED their routines, and usually fall to pieces if something changes.
Most of the kids with autism I've worked with are pretty oblivious to the behavior of other children unless the other children are making a noise that bothers them, or is doing something the child with autism perceives to be logically wrong...it's usually things we consider minor.
You see toe-walking or hand-flapping with severe autism, but not all kids with autism do that...but they usually do SOMETHING that seems a bit obsessive.
Kids generally making weird noises, loud noises, singing, or saying words they find amusing.
In other words, based on what you've said, it's pretty unlikely that he has autism. He's probably just a three-year-old. They're pretty strange even when they're "normal", whatever that is!
Yes, normal. I don't know many quiet 3yo's... they are usually talking to someone/themselves, or babbling nonsense, or singing/reciting songs and stories... right now DS is going "Aaaaachoooooowwaachooowachooowwwwwaaaaammmmmmaamamamammaaaaaa" lol.
OK, thank you so much ladies, I will relax. I really appreciate the responses. I guess we are just in an extreme noise-making phase. I think his social interaction is right-on with his peers, but I do want to get him around other boys the same age for a playgroup. He needs to start seeing how other kids react if he knocks down a tower they built, etc.
Oh, and I was helping him move some toys and dropped a wooden box on my foot and he really reacted to my "Ouch!" and went to get me a Band-Aid. I'll take that as a good sign and stop my Googling.
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