ASD or normal?

[NobbyNobbs]

i was wondering if some of the parents who know more about ASDs in children could tell me if i need to push for testing or not.

 

M is 8 years old, and is a very difficult child. she is in care and has had a very traumatic childhood which is why i'm not entirely sure whether her behaviours are linked to a possible ASD or just her life experiences. the main issues are -

 

- she has a fixed unusual talking pattern. if you speak to her on the phone she always say 'hello' in exactly the same way; too loud, in a rush and with a big breath on the helbit. she is immensely pedantic when telling stories of events. to tell a story about her journey to school she will list every junction, every person and every car she has seen and doesn't discriminate between important things like 'we saw an escaped cow' and 'we saw a red car, a blue car, a red car...'

 

- she is entirely obsessed by food and gets very anxious and worked up about for no obvious reason. this one is complicated because she was malnourished when younger, so naturally has a strange relationship with food from that but it seems to me to go further than that. she will not eat red foods at all, wont eat anything with a sauce on it, but will eat meat with the sauce scraped off (so its not the flavour she doesn't like). she has days where she just refuses food for no reason that we can see. it will be something she ate earlier in the week, but she absolutely will not eat it. she also doesn't remember foods. she'll ask 'have i had that before? did i like it?' and even if the answer to both is yes, if she doesn't like the look of it that day she wont eat it. she will also eat certain foods cut a particular way, but not any other; carrots must be raw and cut into sticks or left whole no chunks allowed!

 

- she has no understanding of other peoples feelings (again this is a potential cross over from previous experiences). she doesn't understand why she should say sorry as it is just a word. she has no understanding of how her actions affect other people. she doesn't make friends with children, only adults. she doesn't seem to have any social embarassment - she'll throw a tantrum right outside school where all her classmates can see her.

- she has no imaginative play (yet another crossover from poor early years stimulation), she will cut up sheets of paper, and glue them to another sheet of paper and write the same word over and over to fill a page.

 

- she has massive meltdowns for unknown reasons. she will just break down into a screaming sulk for the tiniest things, usually involving doing things (she thinks other people should do them and not her). she shreds her clothes from stress in situations where peoples attention is on her. she makes the same repetitive noise and seems to be unable to control it which gets her in a lot of trouble!

 

- she doesn't seem to understand the need to wipe after going to the toilet (but had regressed during the neglect to not using the toilet anyway). even if she sees the result of not wiping, she refuses to admit it was her who did it. i dont think that can be just embarassment because for over a year she would wet herself repeatedly through the day and would eventually admit she had.

 

there are lots more things like this, but i can't go into detail because confidentiality is obviously an issue for this one. am i looking for things where they aren't there or are these ASD behaviours? i wasn't diagnosed until adult and my parents thought i was just an 'annoying, strange child' so they can't remember if i did these things, although my mother is constantly telling me 'M is just like looking after you as a child'

Edited May 28, 2008 by NobbyNobbs

[warrenpenalver]

To be quite frank, you will need professional opinion on this. Early childhood trauma can sometimes cause similar problems to ASD's. MAny of the symptoms/behaviours found in ASD children are common in all children at some stage of growing up, the problems arise due to timing, intensity, appropriateness etc of these symptoms.

 

Other things to bear in mind is that many children whove had traumatic childhoods can be withdrawn and very bad tempered or throw tantrums for no reason, not out of nastyness but out of maintaining control. Control for them can be a method to aid keeping themselves safe.

 

The food issues are complex as likely related to her past as you say and i guess only a steady routine with eating will slowly help change her behaviours.

 

Toilet troubles can be a sign of distress or illness in a child. It can also be part of control again, for example not getting her way leads to "accidents", and sometimes with certain types of trauma toilet problems can be the result of fear and panick and also as a way of getting people to leave the child alone by being smelly etc.

 

The hard thing here is determining if a symptom/behaviour is learned (or lack of learning) or much deeper and potentially ASD related. Communication will be an issue with an 8 year old when trying to determine the reasons for her behaviour.

 

Sounds like you would benefit from the opinion of a child psychologist or experienced child mental health professional. Ultimately there is only so much you can do yourself and sometimes love and a safe environment alone wont repair the damage caused by the trauma without the right mental health or other specialist interventions.

[Bard]

Warren is absolutely right, you need a number of professional opinions on her, abused and traumatised children are very complex characters, and their ability or inability to handle life manifests itself in so many different ways.

I would be seeking advice and help from specialists in childhood trauma and abuse.

I have over 20 years experience of teaching in primary schools, and sadly I have encountered many children who have already been damaged by their families and their life experiences, and the complex behaviour that such abuse creates.

As I am a non-specialist, I sometimes found and find it very hard to see the logical connection between behaviour and cause, and in many cases it takes years of counselling and support for the child to understand and rationalise what has happened. Sometimes that understanding doesn't happen. You don't say why you are involved in this case, so apologies if you know this sort of stuff already.

 

She is 8, even the professionals who specialise in this area will find it hard to untangle the mess that she is, before attempting to try and help her move on.

Soiling, rocking, controlling the situation and environment, swearing, aggression, lack of social awareness can all be symptoms of abuse in a child. At 8, you also need to consider that antenatal abuse, poor nutrition, violence, a neglectful or traumatic infancy may have affected her mental development and linguistic capabilities.

 

As warren said

" The hard thing here is determining if a symptom/behaviour is learned (or lack of learning) or much deeper and potentially ASD related. Communication will be an issue with an 8 year old when trying to determine the reasons for her behaviour.

 

Sounds like you would benefit from the opinion of a child psychologist or experienced child mental health professional. Ultimately there is only so much you can do yourself and sometimes love and a safe environment alone wont repair the damage caused by the trauma without the right mental health or other specialist interventions."

 

I hate to think why you know so much about this area, warren.

 

What you could try is using some ASD-friendly strategies with her, based on building a secure routine; visual and pictorial information and timetables, social stories, the manner in which you speak with and to her, accepting that something you don't understand is of huge significance to her, giving her a safe space to retreat to.

I have found that some other non-ASD children often benefit from having those sorts of approaches and strategies used with them, and they do no harm to try. Observe and learn, then you will begin to have a better idea of whether she is needing to move towards a dx.

You have an enormous task on your hands if you are going to be closely involved with her care, but someone needs to help her cope with what others have done to her. Good luck.

Edited May 28, 2008 by Bard

[Suze]

Some of the behaviours do seem to be connected to processing problems, I agree with what has already been posted and I would try to get a referral to camhs and get someone on board who can help and unravel her complex behaviour, best wishes suzex.

[pearl]

What everyone else said, with a little personal addition. One of my relatives adopted three little girls from a traumatic background. We noticed that their behaviour wasn't quite "right", but put it down to the trauma, adjustment etc. But five years down the line, one of them has indeed been dx'd with an ASD.

[Tally]

You have already been given really good advice. I do think it's worth looking into the possibility of ASD, but there are so many factors involved here.

 

It would be extremely difficult to work out which behaviours stem from her experiences, and which may be caused by ASD. For this reason, it's possible a diagnosis of ASD would be withheld. However, her history of abuse may be enough to access the right support for her.

 

Children starved of sensory stimulation at a young age often do not develop normal sensory processing. If she did not get much attention from other people, she may not have had the opportunity to learn how to communicate in normal ways. The developing brain does not form the usual connections, and forms the wrong ones instead. Do you remember hearing about the Romanian orphanages where the children were left unattended the whole time? A lot of British families adopted these children and they have an autistic-like condition as a result of the neglect, but it is not autism. There could be something similar going on with this child.

 

I think Bard is right, it would be useful to see if some strategies intended for autistic children help. In fact, many of those strategies would probably be very helpful for any child who needs to feel secure, but anyone caring for a child with a history like this is probably already aware of that.

[Frangipani]

M is 8 years old, and is a very difficult child. she is in care and has had a very traumatic childhood which is why i'm not entirely sure whether her behaviours are linked to a possible ASD or just her life experiences. the main issues are -

 

.

 

there are lots more things like this, but i can't go into detail because confidentiality is obviously an issue for this one. am i looking for things where they aren't there or are these ASD behaviours? i wasn't diagnosed until adult and my parents thought i was just an 'annoying, strange child' so they can't remember if i did these things, although my mother is constantly telling me 'M is just like looking after you as a child'

 

 

You will really need to see someone who Specialises in Child hood trauma to figure this out. I highly suggest you start with someone that specialises in trauma and then work your way back to ASD as it does present as the same.

 

Its impossible to get this information through the normal process for dx of Autism. My bet is 'trauma' from what you have described.

 

[warrenpenalver]

a neglectful or traumatic infancy may have affected her mental development and linguistic capabilities.

Also consider permanant effects of what the abuse/trauma may have caused. Unfortunately children who are beaten at an early age can have brain damage as a result limiting thier potential for development. Might be worth considering that and getting appropriate medical investigation.

 

I hate to think why you know so much about this area, warren.

Personal experience unfortunately, but i was lucky i had a safe and loving family wich helped lesson the damage.

 

It would be extremely difficult to work out which behaviours stem from her experiences, and which may be caused by ASD. For this reason, it's possible a diagnosis of ASD would be withheld. However, her history of abuse may be enough to access the right support for her.

 

I think Bard is right, it would be useful to see if some strategies intended for autistic children help. In fact, many of those strategies would probably be very helpful for any child who needs to feel secure, but anyone caring for a child with a history like this is probably already aware of that.

Id agree here that the strategies are useful as such children often come from chaotic and dysfunctional family backgrounds with even the most basic routines such as eating and sleep all messed up.

[NobbyNobbs]

M is already referred to CAMHS, fortunately she gets to jump the line due to her situation! i think her behaviours stand out more because she is an incredibly intelligent child. however her comprehensive language skills are pretty much non-existant. she'll read the words of any adult book you put in front of her, but can't understand basic childrens stories or instructions (admittedly sometimes i think that she just doesn't WANT to understand when we tell her to tidy up). she will parrot off entire pages of books that she read 4 months ago, giving you page number and chapter references, but hasn't got a clue what it is that its saying. obviously she's a very damaged little girl, but getting her the help she needs means knowing if there is anything more than her poor start in life behind the behaviour and i'm worried the obvious reason of her past will be used as a way to avoid looking any deeper.

 

thanks for all the advice, i think i'll really push for someone to at least consider it. then if they think its just normal for a kid with her experiences then at least i know i've tried my best to help her, whatever way it is.

Edited May 28, 2008 by NobbyNobbs

[warrenpenalver]

M is already referred to CAMHS, fortunately she gets to jump the line due to her situation!

Thats good!! She seeing child psychologist or educational psychologist?? Still reckon she needs the expert opinion to decipher the symptoms.

 

she will parrot off entire pages of books that she read 4 months ago, giving you page number and chapter references, but hasn't got a clue what it is that its saying.

sounds a bit like an autistic trait but could also be another form of control by filling her mind with useless information to block out memories of the past.

 

obviously she's a very damaged little girl,

arrrrrggggghhhhhhh No disrespect to you but i HATE that term "damaged"!!! traumatised is a better term in my eyes! Damaged to me implies unfixable. Maybe its because ive heard the term "damaged goods" too much and we all know damaged goods are disposed of!

 

but getting her the help she needs means knowing if there is anything more than her poor start in life behind the behaviour and i'm worried the obvious reason of her past will be used as a way to avoid looking any deeper.

yeah navy tried that with me until therapy bowled out things that havent changed despite therapy. Certain things will respond well to therapy and some things will not. A good therapist will be able to tell the difference as trauma tends to follow certain patterns or sequences as the person heals and ASD originated symptoms are unlikely to have the same results. conversely ASD specialist therapies have been proven to work with kids with similar symptoms or those with "ghosting" or ASD traits but work much quicker than with people more severely affected by an ASD.

 

thanks for all the advice, i think i'll really push for someone to at least consider it. then if they think its just normal for a kid with her experiences then at least i know i've tried my best to help her, whatever way it is.

you need to keep re-assessing over time. as long as she gets proper assessment for all conditions and illness and gets some treatment then at least she will improve. Then as she improves and heals any ASD type symptoms will become more visible as the trauma related issues subside and she catches up in those areas.

[Stephanie]

With regards to the reading part, sounds like hyperlexia. I would suggest you start there then look into autism taking on board all the other trauma issues.