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First off... My son's PT commented yesterday that since he has started making good eye contact we can "rule out autism". Isn't that old thinking? Sorry if that's not the right way to say it, I don't know a better way to put it.


A few months back ds had tons of autistic like behavior and I don't know if anyone remembers but our doctor told us she thought he had autism. It turned out he was having seizures and the eye rolling wasn't a stim & as soon as he was put on seizure meds most of those behaviors went away. However, there are still a few things that have caught our OT's attention. Mostly sensory issues & she's going to be screening him for SID. I don't need the label but if it will get us more OT she can do whatever she wants!


Along with having some obvious sensory issues he is also fascinated by doors, cupboards, etc. Basically anything he can open and close. He typically won't even remove anything from the cupboard, he'll just open and close it. If we walk into a room with cupboards and I get close to them he gets really excited and leans out of my arms to reach them.

Another thing he's doing recently is spinning. He'll sit on the kitchen floor and move himself in circles.

I filled out a checklist type screening that sbgrace posted for PDD and he scored as possible mild pdd.

I know he's still young(13 months) and truthfully autism is the least of my concerns right now with him but I wanted to see what other opinions were. Right now he's receiving OT only 2x a month & PT just moved up to 1x a week. He could definitely use more OT so would "sensory issues" or "autistic like behavior" qualify him to receive more therapy or do you need an official diagnosis?
 

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Yes, thinking in stereotypes for sure. Kids with good eye contact can be on the spectrum.
My son has never been eye contact aversive. I did hear a lot when he was young that he couldn't possibly be on the spectrum because he had great eye contact. As he's gotten older I see that his eye contact actually isn't 100% typical but it sure seemed that way when he was young. Now I think he does a lot of looking at mouths/eyes/parts of faces rather than the whole. He also tends to have great eye contact when he is talking/initiating conversation but as he's gotten older (not when he was young) he is more likely to break eye contact when he needs to listen. I suspect maybe that he's learned that he concentrates/hears better without the visual input of the face. And he started sometimes looking out of the sides of his eyes after I think age 3.
Anyway, the fascination with opening and closing (if it persists and depending of course on frequency/duration/etc.) is I think likely a stim. My son didn't have the typical stims you read about but he had and has a fascination with edges and he stims in that way. It's subtle; the ding dong who first evaluated him didn't even pick up on it. Course that person also told me he couldn't have autism because he "gave 5"
:
My son scores mild pdd.
Anyway, I'm not sure how your system works. In our early intervention system we couldn't get OT for sensory issues alone. But they always found ways to qualify him for OT somehow anyway. Perhaps talk with the OT to find out if he/she agrees you need more frequent visits and if so how to approach it.
 

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My daughter has fantastic eye contact - it's so good she'll stare you down. So while she makes eye contact it was the quality of the eye contact that caused the clinical psychologist who dx'd her to question it. At first it was kind of like "oh she makes eye contact, that's a good start" then later it was "her eye contact is weird, it's like it lacks substance, she just stares at you" so she received 'points' on some sort of diagnostic tool for it.

I agree that if the SPD/SID label gets more OT for you then sounds good to me. For my daughter OT has done more than anything else to help her - it even helped her language skills. My daughter was a door opener/closer - she'd stand and do it repeatedly. She's still a spinner although not as pervasively as before - thankfully. OT has helped with those two things.
 

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Well, on the one hand, I will just say that when anyone says the words "rule out autism" it's usually not something you can do, especially in a young child. So many times I've heard people suggest having an evaluation to "rule out X" when "X" can't really be entirely ruled out based on whatever is being proposed (usually a few hours with an expert who will see entirely different behavior based on what kind of toys they have).

OTOH, I don't think that anything you've listed necessarily points to autism. In a child his age, opening and closing doors and cabinets is a very developmentally appropriate task--it's different in a 4 y.o., especially if the child seems to be shutting out all other aspects of the world while opening and closing. Frequent seizures can have unpredictable developmental effects, so I also think it's too soon to tell.

At the same time, I think that OT may be very beneficial to a child who may be playing developmental catch-up on some level. Lot's of preemies get OT for sensory issues during toddlerhood, for example, and it might help him to have some varied experiences. Has he had an OT eval recently? Kids on the spectrum tend to get more OT covered, but delays and sometimes sensory issues can be used as the reason for OT--it depends who you are seeking approval from. It would be helpful to find out what is available and what you would need to get it.

Sherri
 

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I didn't get a chance to read the other responses. But personally I don't think you need a dx if that is not what you want. You can still get therapies without a dx. They can still tell you what his "symptoms" are and treat that without a dx. We didn't get a dx until after 3 (our choice to wait) but my son still got st and ot for his speech and sensory issues. Since he got his dx of autism his therapies have not changed.

I meant to add. When my son was in EI they just did an OT eval and found out he had "sensory issues" so he qualified for OT in addition to the other services he was getting. So he didn't need an official "you son has SID" dx. Just an eval that showed he needed services.
Good luck with your decision!!
 
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