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#1 of 61 Old 03-04-2010, 07:00 PM - Thread Starter
 
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Hello. I had a not-so-good morning this morning. I have been pursuing accomodations at my daughter's school for her ADHD and possible learning disability and I had a follow on meeting with the school psychologist and speech pathologist this a.m. They told me that some of my daughter's behaviour is indicative of Asperger's Syndrome and they would like to implement some interventions targeted at those behaviours. I want to emphasize that they explicitly stated that they were NOT diagnosing her as such, and they said that she is a complex little character. They were saying that it might be something to consider. Regardless of the name of what's up with her, the interventions would likely be helpful. Needless to say, this took me by surprise. She does have a Dx for ADHD, and a prior psychologist had mentioned the possibility of NLD (which has similarities to Aspergers), and, in looking over a lot of the symptoms/characteristics, sometimes she does meet the criteria. But it isn't ALL the time, and at times she exhibits the exact opposite behaviour. I am also reading that giftedness can mimic some of those characteristics. I found a great resource as an excerpt from the book here: Misdiagnosis and Dual Diagnosis of Gifted Children and Adults http://www.sengifted.org/articles_co...Children.shtml. It's a start, and I have ordered a couple of books.

I guess besides just wanting to talk with someone about this, I was wondering if anyone else has had a school psychologist or other professional suggest this about their child.

Thanks for listening/reading. I don't want to go to family and friends because I know it will (1) label her, and she has enough of those already and/or (2) cause a flurry of their own opinions of the possibility of her having AS. Both of which I don't need that right now. DH is enough of a handful with all this. He rejects it outright, that her social development is just developing (he does have a PhD in biopsychology..but he is also a dad that doesn't want to see anything wrong with his little girl). I don't want to do that. I mean, she has some issues (social interactions) that need support and having a word to describe why and help direct ways to help her, then I think we need to at least evaluate the possibility. I just don't know where to start. An educational psychologist? Regular counselor/psychologist? I don't want her giftedness to be labeled as a pathology --- unless it is a true diagnosis, so I need someone who can differentiate. Anyone have any ideas? Should I post this in the special needs section as well?

I am quite sad about this, and truly hope that it is not the case. I don't want to see my child struggle, but I guess she is already.
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#2 of 61 Old 03-04-2010, 08:30 PM
 
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The thing that jumps out to me in your post is that your child is seeing a speech pathologist. One of the traits of Asperger's Syndrome is no speech delay, so this isn't making a lot of sense to me.

How old is your DD and what kind of speech help is she getting?

Asperger's is a spectum, and there is a really big difference between folks on one end and folks on the other. I'm pretty sure my DH is on the spectum, and other than some minor quirkiness, he's fine, so I wouldn't get too concerned about the label.

At the same time, what are they seeing that causes them to throw that label around?

but everything has pros and cons  shrug.gif

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#3 of 61 Old 03-04-2010, 08:32 PM
 
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This stuff is so hard. She is the same kid she was yesterday...and the same one she will be no matter what diagnosis is considered or decided upon.

I'm wondering what sort of physician gave her the ADHD diagnosis and if they mentioned Asperger's? Has she had a private evaluation and testing for giftedness?

I'm glad you are reading. It is true it is quite overdiagnosed. What is important at this point is that they are identifying things she needs help with and offering her help. Do you agree with the observations about what she's having trouble with and are you confortable with the sorts of services they suggested.
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#4 of 61 Old 03-04-2010, 10:27 PM
 
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<waves>

This is an ongoing thing circulating with professionals and teachers re DS. The jury is out as some think he is not on the spectrum, and others think he may have very mild PDD-NOS. I don't think he has PDD, but know that it can manifest more clearly when the child is older and their social world is more complicated, so I keep watching. We have not done the full PDD assessment process, but have completed a number of other assessments and he doesn't appear to have PDD through these processes.

PDD is a spectrum with a wide range and various manifestations. It's worth spending some time really thinking through the DSM criteria - it's clear that DS doesn't meet the criteria for asperger's, but is some of his thinking style due to spectrum or just his way of things? <shrugs>

I am really ambivalent about all of it. On the one hand, I don't want this for my child - I don't want him to have a special need and the possible associated challenges. On the other, if it's a label that applies to who and how he is, then what's the issue? I'm not looking to change him (he's delightful!), but I do want him to not have too hard a time of it. And the label does bring funding and services. If I had a third hand, I'd note that he already has a bunch of labels, so what's one more? Did I mention I'm ambivalent?

DS also has the ADHD label, but I think he doesn't have it. First, he does not present as ADHD at home, with his current teacher, or most environments - only at school with other teachers or in very, very high sensory environments. He looked more ADHD before we resolved his vision issues, and there's a high correlation between convergence insufficiency/strabismus and ADHD diagnosis. Reading about giftedness and overexcitabilities, I think this is a better explanation, along with the SPD. I don't generally like the tools used to diagnose ADHD, and I find it very interesting how often it's diagnosed as co-occuring with other "disorders" - is there no ADHD but ADHD-like behaviours caused by the primary diagnosis? In DS's case, I think it's SPD and gifted OEs.

A number of resources I've found very helpful, many of which have free previews on google books:

http://books.google.com/books?id=DmU...age&q=&f=false

http://books.google.com/books?id=kPt...age&q=&f=false

http://books.google.com/books?id=J5M...age&q=&f=false

The Eides' The Mislabeled Child has chapters on giftedness and other brain differences.

The Misdiagnosis book is very good.

A book with good descriptions of Asperger's is The Oasis Guide to Asperger's Syndrome.

Hugs to you. This is tough stuff.

Mom to a teenager and a middle schooler.

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#5 of 61 Old 03-04-2010, 10:28 PM
 
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Originally Posted by Linda on the move View Post
The thing that jumps out to me in your post is that your child is seeing a speech pathologist. One of the traits of Asperger's Syndrome is no speech delay, so this isn't making a lot of sense to me.

But couldn't it be Asperger's AND a speech delay?

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#6 of 61 Old 03-04-2010, 10:32 PM
 
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This stuff is so hard. She is the same kid she was yesterday...and the same one she will be no matter what diagnosis is considered or decided upon.

I'm wondering what sort of physician gave her the ADHD diagnosis and if they mentioned Asperger's? Has she had a private evaluation and testing for giftedness?

I'm glad you are reading. It is true it is quite overdiagnosed. What is important at this point is that they are identifying things she needs help with and offering her help. Do you agree with the observations about what she's having trouble with and are you confortable with the sorts of services they suggested.
Absolutely yes to the first paragraph!

I also want to concur with the last paragraph - I believe that it is very overdiagnosed. A huge driver of that overdiagnosis is that a spectrum diagnosis comes with additional funding, in some jurisdictions an exceptionally greater level of funding over the funding for other SNs. So quirky kids, SPD kids etc etc end up "on the spectrum" as a way to access resources. I also think that the rate of quirky and SPD kids is on the rise, but that many of these kids do not actually meet the criteria for PDD.

Mom to a teenager and a middle schooler.

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#7 of 61 Old 03-04-2010, 10:54 PM
 
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So quirky kids, SPD kids etc etc end up "on the spectrum" as a way to access resources. I also think that the rate of quirky and SPD kids is on the rise, but that many of these kids do not actually meet the criteria for PDD.
I see another part that many professionals don't really understand aspects of giftedness like asynchronous development, emotional intensity, sensory sensitivities, and overexcitabilities. They correctly spot "hey something is different here and it needs attention" but then draw the wrong conclusions. Also, the inflexibility of school situations are often a problem for asynchronous gifted students. Easier to single the out the kid instead of the system.

As many of you probably know the new DSM has proposed getting rid of Asperger's and PDD-NOS as separate diagnoses and putting them all under the autism umbrella. For good or bad that may mean some of the kids who are mostly quirky but get Asperger's diagnoses may not now.
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#8 of 61 Old 03-05-2010, 02:05 AM
 
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But couldn't it be Asperger's AND a speech delay?
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Reasonably normal language development is a distinguishing feature of Asperger's compared to childred with true autism or even high-functioning autism.
Quirky Kids by Klass pg 60

It is possible for a child with Aspergers to have a speech delay, if they know exactly what caused the speech delay (such as a problem with the ears) and are very sure that nothing developmental is making the speech problem worse.

However, generally speaking, kids with Aspergers have normal speech development. It's one of the things that makes Aspergers different from closely related disorders.

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#9 of 61 Old 03-05-2010, 02:54 AM
 
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Quirky Kids by Klass pg 60

It is possible for a child with Aspergers to have a speech delay, if they know exactly what caused the speech delay (such as a problem with the ears) and are very sure that nothing developmental is making the speech problem worse.

However, generally speaking, kids with Aspergers have normal speech development. It's one of the things that makes Aspergers different from closely related disorders.
No, I get that re the DSM criteria, but the OP didn't say what the child was in speech for .

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#10 of 61 Old 03-05-2010, 03:01 AM
 
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I see another part that many professionals don't really understand aspects of giftedness like asynchronous development, emotional intensity, sensory sensitivities, and overexcitabilities. They correctly spot "hey something is different here and it needs attention" but then draw the wrong conclusions. Also, the inflexibility of school situations are often a problem for asynchronous gifted students. Easier to single the out the kid instead of the system.
Absolutely.

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As many of you probably know the new DSM has proposed getting rid of Asperger's and PDD-NOS as separate diagnoses and putting them all under the autism umbrella. For good or bad that may mean some of the kids who are mostly quirky but get Asperger's diagnoses may not now.
I don't know where that's going, as the DSM V website seems to present it as a consultation document. I understand they're trying to create a scaling of severity like other diagnostic areas in the DSM and there are collateral documents that include more potential details than what's in the current proposed definition. If they keep it with the bare bones, must meet all 3 areas for diagnosis in the proposed structure, then a lot of kids who currently meet various PDD diagnosis criteria are not going to gain (or maintain?) an autism (old PDD) diagnosis. I don't know what that will do to funding. I wonder if they're looking at a whole other category for the range of folks who fit more with asperger's and PDD-NOS; nothing I've seen indicates that.

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#11 of 61 Old 03-05-2010, 10:33 AM
 
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However, generally speaking, kids with Aspergers have normal speech development. It's one of the things that makes Aspergers different from closely related disorders.
My understanding is that many kids with Aspergers have problems with Pragmatics (the social use of language) and are often work with an SLP for that. After all, what is usually refered to as "speech therapy" is actually speech and language therapy.

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#12 of 61 Old 03-05-2010, 03:10 PM
 
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But couldn't it be Asperger's AND a speech delay?
If there is a general speech-delay, Asperger's is ruled out.

From DSM-IV diagnostic criteria:
"(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)"


That doesn't mean there is no language impairment. Aspie kids frequently have a delay in social/pragmatic language skills, with the rest of their language abilities remaining intact.
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#13 of 61 Old 03-05-2010, 03:14 PM - Thread Starter
 
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Thank you all for your replies. Lots of good information and helpful insight there .

Her traits are related to social interactions and sensitivities mostly such as apparent lack of empathy, difficulty in social situations and understanding social conventions, problems with transitions, doing what is expected of her when it is expected of her, sensitive to loud noises and chaos, her socks can annoy her at times (have to be on the right way). She was originally diagnosed as ADHD at age 6 as a result of on-going attention issues at school and when we were having her assessed for dyslexia because she was most defiant when having to write. She still doesn't like to write, but she does and a computer is helpful. I don't think she ever had dyslexia, even though she was intially both transversing and reversing three letter sequences when evaluated for that. Her verbal skills are very good. She spoke very early and was speaking complex sentences clearly at age 2. She reads (vocabulary & comprehension) at a college level. She does just fine in math, though not exceptional, and has difficulty explaining mathmatical concepts, which could indicate a deficiency in abstract thinking (another indicator of AS). The visit with the speech therapist and the psychologist was, as was mentioned, related to language use and social interactions.

Yes, she has had intelligence testing at age 6, the WISC IV, she had the COGat, and also the Ravens just recently, although through the Ravens she didn't meet the GATE criteria, which is fine, although because the school psychologist and the teacher are convinced she is gifted, they are trying to talk to the testing center and see what's up. No matter, she's still bored to tears at school even though she is in the GATE class. She is particularly verbally gifted, which were her highest scores.

She has been identified as "different" by schools since she was 5. How being able to classify her benefits the school and/or us...I don't know. I do think that the interventions can be helpful for her. At least they aren't seeing her as a definant, undisciplined child like the private Catholic school did. They see her as the whole child, which is much, much better - even if they are potentially classifying her in a way that I am not sure is accurate. If it helps identify some interventions under a 504 plan that will help her, all that much better.

I just made an appointment with someone who is a specialist in twice-exceptional children and am looking forward to it. She specializes in helping differentiate between gifted traits and aspergers, especially in these cases where it is subtle and you need someone who understands both to see where one ends and the other begins or if there is any real reason to be concerned at all.

It's a journey, being this wonderful, complicated girl's mama. She IS the same girl she was yesterday and will be tomorrow. No matter what, but it is good to know there is support and guidance and friendship to be had along the journey. Thanks for sharing that with me! Really, truly, thank you for your time and thoughts.
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#14 of 61 Old 03-05-2010, 03:28 PM
 
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I see another part that many professionals don't really understand aspects of giftedness like asynchronous development, emotional intensity, sensory sensitivities, and overexcitabilities. They correctly spot "hey something is different here and it needs attention" but then draw the wrong conclusions.
Yes, ITA with this. A few people mentioned or hinted at Asperger's for my DD when she was younger. She probably has SPD, and she used to spin a lot and sometimes do some stuff that seemed like verbal stimming. Now that she is 6, I can finally say that I think this suggestion was totally off. Her empathy is, if anything, now overdeveloped, and she has many characteristics that never did at all fit with Asperger's. But it's taken us this long to sort it...and having people hint at it really made us wonder.

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#15 of 61 Old 03-05-2010, 06:24 PM
 
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This is a difficult thing, also because the school may need something like Asperger's in order to pay for/ qualify your daughter to receive support in the school. So a parent has a difficult situation of accepting a label that may not be true-- but they do because it gets their child some help in the areas where they are asynchronous.

I wish people could accept that gifted education IS special education, and get these kids the social/sensory and academic accommodations they need.

So, do you need the label to get her the help? Can you ask for a full neuropsych evaluation??? That is what I would/will do if our situation pans out like that. In our situation the school is working with our son, and we'll hoepfully get an OHI label. I know that all of this stuff is nauseatingly political, though.

I'm glad that you found someone who knows gifted kids. That made a world of difference to me, and when I spoke with the school psych and mentioned overexcitabilities and she nodded and wrote it down I could have hugged her.

People have mentioned Asperger's for my son as well--but he is *highly* coordinated, and socially sophisticated with adults...

James Webb's book is a really good resource.


 hh2.gif  ~~~~~~~~~~hh2.gif
 

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#16 of 61 Old 03-05-2010, 07:10 PM
 
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I just made an appointment with someone who is a specialist in twice-exceptional children and am looking forward to it.
That's great!

but everything has pros and cons  shrug.gif

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#17 of 61 Old 03-06-2010, 02:03 AM
 
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Giftedness and Asperger's are not mutually exclusive. Of course, your dd may not have Asperger's, but if she does it doesn't make her any lesser. She's still the same kid and she's still gifted.

Have you read anything by Temple Grandin? She's presenting here in Colorado next month about giftedness and ASD: http://www.bvgt.org/Grandin.pdf The thing that I found interesting in that link is that she is dx with Asperger's and she did have a significant speech delay, so I am not sure that having a speech delay rules out Asperger's. Of course, it doesn't sound like your dd had a speech delay.

I, too, had someone suggest that dd#1 had Asperger's when she was about 8 (at a Mensa AG none the less!). She does not. You know your dd better than others, but if you too are questioning there is no harm to doing a little more research to see what fits and what she needs from you to best support her.
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#18 of 61 Old 03-06-2010, 10:02 AM
 
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I'm late to this discussion, but just wanted to share that we are in the same situation.

DS1 is being assessed for Asperger's in 2 weeks because it was suggested by his teacher last year and there is an almost 18 month waiting list for an appointment with the recommended pyschologist who is experienced with differentiating gifted kids who present with Asperger-like symptoms and gifted kids who actually have Aspergers. I want to know. I don't think he has Asperger's, but I do think that some of the behavioural interventions that sometimes are good for kids with Asperger's are useful tools for working with him. If he is dx'd with Asperger's, he will be eligible for some services through the school that wouldn't otherwise be available. I would rather know and understand him and help him be the best he can be than avoid a diagnosis.

Personally, I think that DS1's behaviour that looks like a lack of empathy is that he seriously can not believe that other children do not think as completely and complexly about the world as he does.

We are also having a complete psycho-educational assessment done at our own expense in a couple of weeks because I want to be able to advocate for him most effectively in the school setting.

My husband has reluctantly followed my lead on this one. He is moderately gifted and was only slightly stunted by his experiences at school. I am more extremely gifted and was badly damaged by my school experience. It is clear to me that DS1 is more my son than DH's on this issue and I want to see if I can help him thrive instead of be damaged by school.

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#19 of 61 Old 03-06-2010, 12:44 PM
 
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They told me that some of my daughter's behaviour is indicative of Asperger's Syndrome and they would like to implement some interventions targeted at those behaviours. I want to emphasize that they explicitly stated that they were NOT diagnosing her as such, and they said that she is a complex little character.

My daughter is similar. Complex defines her. They have not stated she is Asperger's, but I have talked with the SLP, and we have both stated there are a few 'quirky' items that are a bit 'autistic' in nature. She isn't diagnosed, and I think she recognizes my concerns with getting her diagnosed via the school district.
If I had someone, though, offering me services without diagnoses, then


That sounds like potentially a good solution.

The only item to consider is whether your daughter really does need a label or not. I think that can be very complex to figure out.

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#20 of 61 Old 03-06-2010, 12:53 PM
 
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Have you read anything by Temple Grandin? She's presenting here in Colorado next month about giftedness and ASD: http://www.bvgt.org/Grandin.pdf The thing that I found interesting in that link is that she is dx with Asperger's and she did have a significant speech delay, so I am not sure that having a speech delay rules out Asperger's. Of course, it doesn't sound like your dd had a speech delay.
Temple Grandin was also dx'd with autism. If she had a generalized speech delay, then a diagnosis of Asperger's was not correct. Sometimes people prefer to label high-functioning autistics as "Asperger's" because it provides a better idea of the scope of their abilities and prognosis, but it is not correct. The DSM-IV diagnostic category specifically states that a generalized speech delay is a rule-out for Asperger's disorder.

It's these discussions which are the reason that the APA committee on childhood developmental disorder has recommended combining all of the ASD categories into one. They describe the current diagnostic categories as attempts to "cleave meatloaf at the joint."
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#21 of 61 Old 03-06-2010, 01:04 PM
 
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For "complex children" in school settings, I think that formal assessments are valuable if they are done by competent people. So much of what a school can do is guided by what the mandates on special education are and many of the schools can do very little without a diagnosis, and what they can do may be determined by the diagnosis. Looking for people who have experience with 2E kids is important, so the diagnoses are correct.

DS1 has a lovely relationship with the vice-principal at his school because he spends a lot of time in the office due to his challenges. Early on in the year, it was because he was getting in trouble. Now, it is a regular part of his schedule because it helps him cope with some of those challenges. And, she has come to know him very well. In a conversation we had yesterday about options for next year, we discussed the possibility of transferring him to a different school. Her biggest fear about moving him to another school is that he is likely to be misunderstood. Part of the reason we are having so much assessment done is so that we can have documentation of what professionals have seen in an attempt to decrease the likelihood that he is misunderstood.

We have waited a long time to be so close to having the assessments done because the waiting lists of the people in our area with the right expertise are very long.

Kate
mother of Patrick (7/31/03), and Michael, William, and Jocelyn (4/27/07)
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#22 of 61 Old 03-06-2010, 03:06 PM - Thread Starter
 
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<waves>


DS also has the ADHD label, but I think he doesn't have it. First, he does not present as ADHD at home, with his current teacher, or most environments - only at school with other teachers or in very, very high sensory environments. He looked more ADHD before we resolved his vision issues, and there's a high correlation between convergence insufficiency/strabismus and ADHD diagnosis. Reading about giftedness and overexcitabilities, I think this is a better explanation, along with the SPD. I don't generally like the tools used to diagnose ADHD, and I find it very interesting how often it's diagnosed as co-occuring with other "disorders" - is there no ADHD but ADHD-like behaviours caused by the primary diagnosis? In DS's case, I think it's SPD and gifted OEs.

Hugs to you. This is tough stuff.
Interesting that you mentioned convergence insufficiency. Vision issues have been mentioned to be before as a potential factor in ADHD. I didn't reallize what that really meant. I have had dds vision tested, but they did not do anything other than the normal tests. DD has complained before of double vision, but never of headaches or any trouble reading. AND I am also diagnosed as ADHD and have definite CI - I was a premie and had a crossed eye at birth and had two cosmetic surgeries. So, that is something I am going to look into for both of us. Fortunately I am going to meet with Katoshka (from this board) today and I think she knows of a vision doctor for this. Thanks for sharing your story. And I appreciate you giving me your perspective very much. And the hugs, too.
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#23 of 61 Old 03-06-2010, 03:37 PM - Thread Starter
 
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Okay, wow...thanks for all the "yea, that was suggested for my child too" notes. I also don't really think she has aspergers. There are so many conflicting events. Just yesterday she was so engaging and polite to the kids who waved to her (sometimes just just doesn't notice them), to the principal, offered to give up her place in line for the ice cream bus to a woman and her kids behind her ... saying "would you like to go first?" I am just confused. She sometimes plays with kids, but sometimes they are too chaotic for her. She sometimes reacts inappropriately to things...well, she does that a lot actually. But nothing is consistent. And her meds really do affect her at school - she is far more subdued. I HATE that. HATE it. But, I love my meds because they help me sooooooooo much. And she has improved in her behavour and in her academic skills. I have seen her succeed like she didn't before. Sigh. Perhaps an adjustment is in order. I do want to know, conclusively, that she doesn't fall on the PDD-NOS spectrum. But they are offering her some services even without it - because she DOES already have the ADHD dx. But I need to know. And I need to see a gifted specialist because her characteristics are so typical of highly-gifted kids. I really need to know exactly where she falls so that we can best support her. I know she is gifted, but we couldn't get an accurate WISC-IV due to her attention issues. Sometimes, especially with this little complex girl of of mine, it is so valuable to have accurate measures. The specialist we are seeing has her own 2E daughter, which is what her impetus was for getting into the field. She is also a nurse. She said she has "cured" kids misdiagnosed with ADHD before. And while she does support a diagnosis of AS, PDD-NOS, or autism where warranted, she is conservative in that judgement. She seems like what we are looking for. Our appointment is this upcoming friday for the first parents-only interview, then we'll schedule the tests for sometime during dd's spring break.

Those of you going through this journey right now too...please keep sharing your experiences. I can't recall your names right now, but hopefully I'll get to know them soon.

Blessings, SkySunSea (sorry, I have a thing about posting my name on-line...)
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#24 of 61 Old 03-06-2010, 04:10 PM
 
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Have you read anything by Temple Grandin? She's presenting here in Colorado next month about giftedness and ASD: http://www.bvgt.org/Grandin.pdf The thing that I found interesting in that link is that she is dx with Asperger's and she did have a significant speech delay, so I am not sure that having a speech delay rules out Asperger's. Of course, it doesn't sound like your dd had a speech delay.
My understanding is that she was diagnosed in the early 50s, when the diagnostic criteria was different, as well as the understanding of spectrum. It's also clear that many individuals end up with different spectrum diagnoses through their lifetime as they change. A huge part of the complexity is that there is such variation within the spectrum, in width, depth and area (ie social, language, intensity).

There is a new movie on the movie channels about Temple, starring Claire Danes. It's very good. Temple was very involved with it, and she promotes it on her website:
http://www.templegrandin.com/

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Temple Grandin was also dx'd with autism. If she had a generalized speech delay, then a diagnosis of Asperger's was not correct. Sometimes people prefer to label high-functioning autistics as "Asperger's" because it provides a better idea of the scope of their abilities and prognosis, but it is not correct. The DSM-IV diagnostic category specifically states that a generalized speech delay is a rule-out for Asperger's disorder.

It's these discussions which are the reason that the APA committee on childhood developmental disorder has recommended combining all of the ASD categories into one. They describe the current diagnostic categories as attempts to "cleave meatloaf at the joint."
s

The thing is, look at the difference in the description of speech between autism and asperger's in the DSM-IV:

autism:
Quote:
(a)
delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime)
(b)
in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c)
stereotyped and repetitive use of language or idiosyncratic language
asperger's
Quote:
There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)
Temple Grandin does not, IMO, meet the autism criteria re speech, but did not start speaking until between 3.5-4. I personally think that the asperger's criteria includes an e.g., therefore allowing for a range and professional judgement. I don't think speech alone should put an individual in one category or another with an e.g., particularly once they're older and other criteria can be assessed more definitively.

The other thing I've learned in this journey with my son and working in the child services field is that many people are "co-occuring" - there's not one diagnosis, but a differential diagnosis. So, I think someone can meet the criteria for asperger's AND have speech delay from another source (and isn't speech delay a vague, catch-all term). I'm speaking beyond DSM, as it's a point-in-time document - after all, the current DSM does not allow for ADHD and PDD diagnoses, even though it's often seen co-occuring. I understand that a lot of things are under consideration for DSM-V, including the gut issues, anxiety, OCD and ADHD that are also frequently experienced by individuals on the spectrum.

Mom to a teenager and a middle schooler.

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#25 of 61 Old 03-06-2010, 04:14 PM
 
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DS1 has a lovely relationship with the vice-principal at his school because he spends a lot of time in the office due to his challenges. Early on in the year, it was because he was getting in trouble. Now, it is a regular part of his schedule because it helps him cope with some of those challenges. And, she has come to know him very well. In a conversation we had yesterday about options for next year, we discussed the possibility of transferring him to a different school. Her biggest fear about moving him to another school is that he is likely to be misunderstood. Part of the reason we are having so much assessment done is so that we can have documentation of what professionals have seen in an attempt to decrease the likelihood that he is misunderstood.
This makes me LOL. DS had a close relationship with a principal one year, and loved going to her office. After all, her office was quiet and she was pretty (his observation). He started making a soap and water mess in the bathroom semi-regularly because that was a fun route to his favourite spot at school .

Mom to a teenager and a middle schooler.

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#26 of 61 Old 03-06-2010, 04:18 PM
 
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The only item to consider is whether your daughter really does need a label or not. I think that can be very complex to figure out.
This is a very important consideration. The psychologist we saw pointed out that a spectrum diagnosis could end up with people lowering the bar for DS at school, and what would the outcome of that be for DS? In our jurisdiction, a spectrum diagnosis leads to a large amount of additional funding, so school folks are motivated to pursue that avenue. This is the tension - some of the people who are uniquely positioned to observe and report on DS in the school context are not unbiased.

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#27 of 61 Old 03-06-2010, 04:21 PM
 
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. The specialist we are seeing has her own 2E daughter, which is what her impetus was for getting into the field. She is also a nurse. She said she has "cured" kids misdiagnosed with ADHD before. And while she does support a diagnosis of AS, PDD-NOS, or autism where warranted, she is conservative in that judgement. She seems like what we are looking for. Our appointment is this upcoming friday for the first parents-only interview, then we'll schedule the tests for sometime during dd's spring break.
Who is doing the tests, and what tests? A nurse cannot perform the accepted tests for gifted, spectrum, ADHD.

That said, some of the best advice we've received has been from people other than those who did the testing.

Mom to a teenager and a middle schooler.

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#28 of 61 Old 03-06-2010, 04:28 PM
 
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Interesting conversation about the variations btwn diagnoses. I am not an ASD expert by any means so I don't claim to know the specifics. My oldest, the one who had someone suggest she had Asperger's at the Mensa AG a few years back, does have an acquaintance who is gifted and also dx with Asperger's. There are some distinct differences in what I've seen btwn the two girls.

Dd eats lunch in the math teacher's classroom with a couple of the other girls from that class b/c it is quieter and she likes the teacher. Dd does have sensory overresponsiveness and the event at the AG that precipitated someone telling me that she had Asperger's was being in a very noisy "kids trek" where some rather overbearing boys were grabbing dinosaur bones out of her hands when they were doing a "dig." She tried to make herself a small, quiet little spot with one piece to dig and they started snatching things from her, throwing sand and yelling. She completely melted down & was crying, was yelling at the other kids and totally refused to return to kids trek after that. She was a bit shy of 8 y/o at the time.

Her friend, too, is noise overresponsive and also has tactile and food aversions. None of these would automatically say "Asperger's" to me, though.

Dd has a good vocab and sounds like a little adult, but she also uses words in proper context, doesn't repeat phrases over and over and understands & uses nuances in meaning.

Her friend, on the other hand, will repeat things over and over at times -- [dd] "is not home right now; I realize that. She will call me back; I realize that," for instance in a phone call. Dd says that it sounds like she has a foreign accent b/c she has an unusual intonation to her speech. Dd also told me about a month ago the friend didn't understand the term "point of view" in relation to literature. She said that the friend was unable to separate from seeing this phrase as the literal "point" at which someone was standing and looking. Reading things in totally literal terms does sound like something that would make me wonder about Asperger's.

eta: Both girls also have distinct styles and my dd dresses more plainly than the typical middleschooler, but she knows what makes her look weird and wears appropriate attire. Her friend dresses in a manner that makes her stand out as quite different and has been teased quite a bit behind her back from what dd has heard. Dd and another friend went and spoke with the counselor about it. Her friend doesn't seem to realize that she is making herself look odd by wearing Laura Ashley dresses.

I don't know if this helps at all in distinguishing btwn gifted and gifted w/ Asperger's, but there is a distinct difference to me in seeing the two girls.
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#29 of 61 Old 03-06-2010, 04:44 PM
 
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. Dd also told me about a month ago the friend didn't understand the term "point of view" in relation to literature. She said that the friend was unable to separate from seeing this phrase as the literal "point" at which someone was standing and looking. Reading things in totally literal terms does sound like something that would make me wonder about Asperger's.
Your post really does illustrate the subtle, and not so subtle, differences between slight quirkiness and asperger's as manifested in these two girls.

As to the above, I think this may be the whole Theory of Mind.

Quote:
Theory of mind is the ability to attribute mental states—beliefs, intents, desires, pretending, knowledge, etc.—to oneself and others and to understand that others have beliefs, desires and intentions that are different from one's own
- wiki

DS can be literal at times, but absolutely possesses theory of mind. So when he's being literal (which usually happens when he's being denied something, as in "but you said...", and lessens as he ages, one of his teachers points this out as a spectrum behaviour.

Mom to a teenager and a middle schooler.

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#30 of 61 Old 03-06-2010, 06:54 PM - Thread Starter
 
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Who is doing the tests, and what tests? A nurse cannot perform the accepted tests for gifted, spectrum, ADHD.

That said, some of the best advice we've received has been from people other than those who did the testing.
I should have specified - the Dr. doing the tests WAS a nurse. She returned to school and received her doctorate in psychology and her dissertation focus was 2E kids.

Interesting comments about the differences between G/AS and G kids. Yes. The more I am reading and understanding the more I am sure that even if she does meet some critieria on the spectrum, she really doesn't fall within that category. They brought up "theory of mind" in the meeting. I haven't seen anything that would indicate to me that she doesn't undertstand that others have their own point of view. And she doesn't take things quite literally, although there have been some events where her over-reaction to something would give that impression. Hum. Lots to think about.
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