We got the results from the SIUC Center for Autism yesterday, and they weren't very helpful on the diagnosis front. They gave him a diagnosis of autism (not Asperger's. not PDD-NOS. Autism).
BUT... (and it's a really big "BUT") he did not register as having autism on the ADI-R (which is the parent interview.) He failed because he did not show social impairment with peers.
He had all kinds of autism symptoms on the ADOS, and scored well above the cut-off.
He does not have autism by the DSM-IV criteria because he misses the age of onset of symptoms, which is before age 3. (I don't think they believed me when I say he had no symptoms before age 3, but he didn't have symptoms before age 3. He was a normal toddler and used whole sentences by 18 months.)
He does not have autism by the DSM-V criteria because he has appropriate peer relationships. He has friends.
They're giving him an autism diagnosis, anyway. My impression is that they're dxing him as positive for autism because he scored pretty high on the ADOS, which just counts symptoms, and the two criteria he failed to meet (age of onset and presence of peer relationships) are based on parent report (which can't be trusted.)
I'm not convinced. He doesn't meet either DSM criteria, and some of those symptoms are muddled by the fact he's gifted. I'm really sure that my recollection of age of onset is correct. I know that he was a normal toddler. I'm really sure that this kid has friends and has an appropriate relationship with his little brother. We've seen a private practice psychologist and I think her diagnosis is probably more correct -- language disorder and gifted. (Our pediatrician agrees.) Autism is a disorder that has a triad of impairments -- impaired social interaction, impaired language, and restricted and repetitive behavior. He has good social interaction and gifted kids often show very focused interests in topics.
DH has stated the entire time that it's not an ASD. DH has an MS in clinical psychology (as well as a BSN) so he's qualified to make the DX.
We've been reading what we could find on dxing an ASD in a gifted kid, and everything we've read says to be very careful when dxing an ASD when the kid is also gifted, because some gifted behaviors can look like ASD behaviors.
We're back to where we started: treating the identified deficiencies and unsure about the label. We'll continue with speech therapy, and with karate and gymnastics, and using applied behavioral techniques.
BUT... (and it's a really big "BUT") he did not register as having autism on the ADI-R (which is the parent interview.) He failed because he did not show social impairment with peers.
He had all kinds of autism symptoms on the ADOS, and scored well above the cut-off.
He does not have autism by the DSM-IV criteria because he misses the age of onset of symptoms, which is before age 3. (I don't think they believed me when I say he had no symptoms before age 3, but he didn't have symptoms before age 3. He was a normal toddler and used whole sentences by 18 months.)
He does not have autism by the DSM-V criteria because he has appropriate peer relationships. He has friends.
They're giving him an autism diagnosis, anyway. My impression is that they're dxing him as positive for autism because he scored pretty high on the ADOS, which just counts symptoms, and the two criteria he failed to meet (age of onset and presence of peer relationships) are based on parent report (which can't be trusted.)
I'm not convinced. He doesn't meet either DSM criteria, and some of those symptoms are muddled by the fact he's gifted. I'm really sure that my recollection of age of onset is correct. I know that he was a normal toddler. I'm really sure that this kid has friends and has an appropriate relationship with his little brother. We've seen a private practice psychologist and I think her diagnosis is probably more correct -- language disorder and gifted. (Our pediatrician agrees.) Autism is a disorder that has a triad of impairments -- impaired social interaction, impaired language, and restricted and repetitive behavior. He has good social interaction and gifted kids often show very focused interests in topics.
DH has stated the entire time that it's not an ASD. DH has an MS in clinical psychology (as well as a BSN) so he's qualified to make the DX.
We've been reading what we could find on dxing an ASD in a gifted kid, and everything we've read says to be very careful when dxing an ASD when the kid is also gifted, because some gifted behaviors can look like ASD behaviors.
We're back to where we started: treating the identified deficiencies and unsure about the label. We'll continue with speech therapy, and with karate and gymnastics, and using applied behavioral techniques.