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Recognizing The Signs of ASD In School Aged Children
When quirks are more than "just quirks..."


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#1 baddmammajamma

Posted 23 December 2011 - 11:32 AM

Hi Fellow Mums of Primary School Aged Kids:

(This note used to pinned atop the consolidated "School Aged Children" board, before the board was segmented into ages 5-8 and 8-18. It can still be found on the 8-18 year old board, but I hope it can also be pinned here. Early primary school is a very common time for the signs of ASD to really come to the forefront).

In the past, I have posted related notes on the other kids & toddlers boards and have shared the information below in various forms on EB. I am trying to raise awareness of the warning signs of autism spectrum disorders (ASD), which are now Australia's most common set of developmental disorders. Now that another school year heading toward a close, it's a good time to remind parents of what some of the potential flags are in school aged children.

If you click on the link in my signature, you can see why I am particularly passionate about raising awareness of ASD.

ASD can be tricky to detect sometimes because there is no set profile for what autism looks like. It's called a spectrum precisely because the blend of symptoms, and the degree to which they affect a person, can vary dramatically. What people with ASD share are (varying degrees of): (1) differences/difficulties in social interaction, (2) differences/difficulties with communication, (3) restricted/repetitive interests and behaviors. Almost always, they show some sensory sensitivities as well.

Signs of possible ASD in school-aged children

It is not uncommon for ASD to go undetected until school age, especially when kids have (for lack of a better term) higher functioning profiles (like people with Asperger's).

For instance, ASD can be masked by giftedness. Or parents might mistake ASD for mere "quirkiness" or social awkwardness, while not fully recognizing the degree to which their child is struggling. Here are some of the more common ways that ASD might present itself in a school aged child (this list is representative, not exhaustive, and it's important to remember that not every child with ASD will show every sign):

Communications



Your child may:

* have had unusual language development when they were younger (used language that is different to that used by other children their age);
* sound unusual when they speak;
* repeat words or phrases that they have heard rather than responding to them;
* refer to themselves as "you," "she" or "he" after the age of three;
* use unusual words for their age; or
* use only limited language or talk freely only about things that interest them.

Social


Your child may:

* not be interested in playing with other children;
* try inappropriately to join in with other children's play (for example, your child might seem aggressive);
* behave in a way that other people find difficult to understand (for example, they may not do as they are told);
* be easily overwhelmed by being around other people;
* not like people coming into their personal space or being hurried.

Interests and behaviors


Your child may:

* struggle to take part in pretend play with other children or play in which they need to cooperate or take turns;
* have difficulties in large open spaces (for example, they may stay round the edges of the playground);
* find it hard to cope with changes or situations that aren't routine, even ones that other children enjoy (for instance, school trips or the teacher being away).

Other factors:


You child may:

* have unusual skills (for example, have a very good memory or be gifted in math or music); or
might not like the sound, taste, smell, touch of certain things.



A Twist: ASD in Girls

Adding an extra wrinkle to the warning signs above is the tendency of girls with ASD to present differently than boys. Sue Larkey, an Australian expert in ASD, has written a terrific summary of the key ways in which ASD tends to "look" different in girls than in boys (again, bearing in mind that these are generalizations):

Ten Ways Girls with an ASD differ to Boys with an ASD

1. Their special interests are usually animals, music, art, literature.

2. They often have a very good imagination, which includes imaginary friends, games, being animals or taking on persona of other girls.

3. They often see speech therapists for their speech and may be diagnosed with specific language disorders however there is something different about this girl no one can quite put their finger on.

4. They often play with older children or much younger children. This play is sometimes unusual for example "Mums and Dads," but she will want to play the same role and game every time. She usually wants to be the pet or baby, whereas most girls want to be the Mum or Dad.

5. They often have hyperlexia -- the ability to read but comprehension does not always match their reading skills. They are often the class book worm or write stories but they write the same story over and over changing a few characters. Many have a special interest in literature.

6. They have unusual sensory processing, like the boys, however bigger fluctuations often going from one extreme to the other.

7. They get anxious like boys, however their anxiety is rarely physical or disruptive. In fact many have great copying mechanisms at school however the family see a very different child at home where the anxiety can explode.

8. Often their difficulties with social skills are called "shy," "quiet," "solitary."


9. They often like to organize and arrange objects. I watched one little girl spend hours seemingly playing "My Little Ponies," however on closer examination she was just arranging and re-arranging the horses over and over.

10. The main difference is there are MANY more undiagnosed girls/women than boys/men. Currently we only diagnose 1 girl to 7 boys. In the future it is thought by many psychologists the ratio could be more like 5 to 7 as we become more aware of this group.


Yet Another Twist: Gifted + ASD

Giftedness and ASD are not mutually exclusive — they can and do exist together in some individuals! In fact, giftedness can mask some symptoms of ASD, and ASD can hide some indicators of giftedness. The common term for someone who is gifted and has learning differences or learning disabilities is  “twice exceptional” (2e). It is important to remember that IQ/cognitive testing provides only one slice of a child’s developmental profile and by itself cannot rule in or rule out ASD.  A comprehensive assessment by a qualified specialist — ideally someone who has rich experience with twice exceptional profiles and will use gold standard assessment tools — is the best way to determine if a child has something “more than giftedness” in play.


What To Do If You Have Concerns
If you have concerns that your child might have ASD, the next step should be getting professional guidance. Talking to your GP can be a good place to start (and to get a referral to a specialist), but also be aware that not all GPs are up-to-speed on ASD. All the more reason for you to arm yourself with good information!  

In younger children, the diagnosis process almost always involves a medical doctor (paed, developmental paed, or psychiatrist) or a panel approach that includes a medical doctor. For school aged children, it is not uncommon for psychologists to drive the assessment/diagnosis process (but be aware that several states require a medical doctor to be involved in order to get an educational diagnosis that will be recognized by the schools).

For more detailed information on how to seek an ASD assessment in your state or territory, check out:
http://www.essential...smentdiagnosis/

There are also some terrific on-line resources to help guide parents. Two particularly valuable ones in Australia are:

http://raisingchildr...sm_landing.html

http://www.autismawareness.com.au/ (includes state-by-state directory of professionals who are well versed in ASD)

Additionally, the mums who are active on the Special Needs/Disabilities board are very supportive and happy to share recommendations of great "ASD-savvy" professionals (via PM, because we aren't allowed to make explicit recommendations on the board), provide information, or answer questions. Your child doesn't have to have a diagnosis of anything for you to voice your concerns or ask questions.

(I am in Sydney and am always happy to pass along my suggestions of ASD professionals in this area).

Thanks for reading this far! style_emoticons/default/original.gif

Edited by baddmammajamma, 25 August 2013 - 10:47 AM.


#2 hoohoobump

Posted 23 December 2011 - 11:48 AM

Great information as always. I think my six-year-old self may have ticked many of those girl criteria and may have benefitted from some intervention.

#3 Soontobegran

Posted 23 December 2011 - 12:01 PM

You're a good sort BMJ. That is terrific information you've taken the time to give there! original.gif

#4 reng

Posted 23 December 2011 - 12:02 PM

My mother fits most of these categories.  At 62 she often still behaves like a toddler, and really really struggles to 'see' other people's emotions.   Reading things like this is really helpful for me - to understand why she behaves like she does, and to help implement strategies so that we can all live with her in some sort of peace!

But regardless, she is a talented artist and pianist.  She finished a university degree in science.  She is still married after 30-something years (Dad is a rather vacant academic which might be why it works!).  She had 4 children and none of us have any major issues (unless you count the one that joined a religious cult).  (She didn't really cope well with having children, and only had that many to get a boy, a whole other story and one which didn't happen.  But we all turned out ok).

And she grew before autism/ASD was an openly discussed topic.  She no longer rocks herself in the corner of her bedroom (something she did as a kid), but she still struggles with eye contact and social interaction.

#5 baddmammajamma

Posted 23 December 2011 - 12:20 PM

Thanks for the kind words. I've lost count of the EBers who have been compelled to get their child assessed after reading a note by me or another "ASD parent." So grassroots outreach on EB does have value. original.gif

reng, I have some friends who have been diagnosed as adults after having an "a ha" moment when their own children (or grandchildren!) were being assessed!

I don't have much knowledge about adults with ASD, but there are some EBers (with ASD themselves, are with a  partner who has ASD, and/or have parents or siblings with ASD) who are really tuned in to resources, support groups, etc.

#6 Gumbette

Posted 23 December 2011 - 12:28 PM

It's the 23rd of Dec and you're still taking time out to help others when everyone is running around frantically. Merry Christmas to you BMJ. Some seriously good karma must on it's way to you. original.gif

#7 brazen

Posted 24 December 2011 - 11:28 AM

oh reng, it really breaks my heart to think of adults who grew up pre-aspergers days, they must have been so misunderstood in so many ways.

after ryan's diagnosis we were able to see ASD traits in virtually every adult member of the family on both sides wink.gif

#8 LambChop

Posted 01 January 2012 - 08:55 PM

Great post BMJ, I reckon 5-7 is when parents really start to notice the difference because development of self awareness in relation to peers starts to be expected, and this is an area that can be really bewildering for kids on the spectrum.  Hopefully if there are parents out there reflecting on their year they'll see this post and potentially go see someone.

Wish stuff like this had been around when we were going through diagnosis.

#9 2 Gorgeous Girls

Posted 02 January 2012 - 10:33 AM

These are genuine questions so I hope it doesn't come across the wrong way.

When you have a gifted child who is "quirky" how do you tell if it's something more? What's the difference between not being able to relate well to other children because they are not on the same intellectual level and it being because of ASD. Is it not possible that they seek out older children because they have more in common?

Any time I've mentioned that I'm worried about my 6 year old I'm always told it's just because she's smart and that I'm looking for problems. Yet she ticks everything in that girls' list except the speech therapy. But then is it a case of it being like star signs where it's so generic everyone will find something that relates?

Also if you have a child that is highly functioning but has ASD traits is there any benefit to a label? It seems like an exhaustive and cost prohibitive process. What happens if you can't afford all the intensive therapies when all is said and done?

If I was ever to go to my GP I doubt he would take me seriously. He only ever want to talk about how smart she is and if I ever have any behavioural concerns it's always because she has had "a harder childhood than most" (multiple hospital admissions)

#10 baddmammajamma

Posted 02 January 2012 - 10:55 AM

I don't take offense at your question at all -- I think it's a really good one.

For what it's worth, I have a daughter who has a massive IQ and has ASD. And yes, sometimes it's not crystal clear what the drivers of her quirks and challenging behaviors are. At the same time, there is something clearly different about a child with is Twice Exceptional (gifted with SNs or learning disabilities) and a child who is gifted.

For us, having the 2e "label" has meant several things: formal recognition by the school that she needs a tailored program that caters to both her intellectual abilities and takes into account her social/emotional challenges, support from other parents and educators/professionals in the 2e space (not feeling like I am the only parent in the world who is dealing with this combination of gifts & deficits), and most importantly, a better understanding of my daugther's unique wiring.

This might just be my own perception and also a vast generalization, but when your child receives a diagnosis of ASD, you sit up and take notice! You are almost forced to take action -- be it formal therapies (OT, social group, etc.) or more informal ways of skill building. In contrast, if you think you're child is simply "gifted quirky," you might not feel the same sense of urgency in pursuing various therapies or programs.

Because my daughter was dx'ed with ASD at a relatively young age, we've also been able to take advantage of some of the government funding (the bulk of which is available for kids who are dx'ed before the age of 6) and early intervention. Having said that, there still are various forms of funding and support (subsidized sessions with OTs, speech therapists, psychologists, for instance....the Carer's allowance, etc.) available for school aged kids who are diagnosed, and early intervention is not the only way for a child to hone their "tool kit."

If your child has quirks and behaviors that impact her daily living and/or happiness, then my strong advice for you to consider a comprehensive developmental assessment (ideally by a psychologist or developmental paed who has experience with gifted kids/kids with ASD -- and yes, they do exist!) Under a Mental Health Care Plan (that your GP would prepare), you would be able to claim some of the costs of a psychologist. Just google to see what it covers. Of course, that would require that you actually HAVE the support of your GP. You might want to consider seeing one who would take any concerns you have more seriously. I imagine it's very frustrating to be told that ALL of your daughter's behaviors are due to her IQ and past health issues.

Good luck. There are a fair number of 2e mums on EB. We tend to congregate on the Gifted & Talented thread. original.gif






#11 FeralZombieMum

Posted 02 January 2012 - 12:24 PM

QUOTE (2 Gorgeous Girls @ 02/01/2012, 11:33 AM) <{POST_SNAPBACK}>
When you have a gifted child who is "quirky" how do you tell if it's something more? What's the difference between not being able to relate well to other children because they are not on the same intellectual level and it being because of ASD. Is it not possible that they seek out older children because they have more in common?

Any time I've mentioned that I'm worried about my 6 year old I'm always told it's just because she's smart and that I'm looking for problems. Yet she ticks everything in that girls' list except the speech therapy. But then is it a case of it being like star signs where it's so generic everyone will find something that relates?

Also if you have a child that is highly functioning but has ASD traits is there any benefit to a label? It seems like an exhaustive and cost prohibitive process. What happens if you can't afford all the intensive therapies when all is said and done?

If I was ever to go to my GP I doubt he would take me seriously. He only ever want to talk about how smart she is and if I ever have any behavioural concerns it's always because she has had "a harder childhood than most" (multiple hospital admissions)


My DD1 was diagnosed as gifted at 6 years (also diagnosed as ADHD), and it wasn't until she was 9 when she received the Aspergers diagnosis - the paed we were seeing kept dismissing it as she 'played' with the toys in his office - but he didn't really note how she played with the toys.

We were told by a few people that our DD was acting the way she was, because she was gifted, and we did listen to them, and delayed getting a diagnosis, but I had suspected Aspergers since she was 5. Part of me didn't want my DD to have a label. Having a diagnosis meant that doors were opened up for her. She was able to get some funding for an integration aide - but I think this was more based on her behaviour issues rather than her having Aspergers.

ASD is a spectrum disorder - so each child is different.

In hindsight, some of the warning signs my DD1 had were:
* she toe walked

* she had a lot of sensory issues - buying her first pair of shoes was a nightmare. She hated socks - could feel the seam along the toes. She hated tags on clothes. She hates clothes that have static electricity - so refused to wear silky nighties to bed. (She also had a fear that the static electricity would cause a fire. laughing2.gif)
She had a heightened sense of smell - which caused issues with using other people's toilets - even if they were 100% clean, they didn't smell like ours, so we had to go home when we were visiting. This affected what school we chose - it had to pass her approval. laughing2.gif
She did grow out of some of these sensory issues.

* She has a lot of anxiety - so will ask questions over and over again. When she was younger, if I didn't use the correct words, she'd ask me again.
She had a lot of fears - her mind works overtime (could be ADHD related too with her mind racing) when she was a toddler she'd freak if a fly or ant went near her. She hated thunderstorms. She hated the swimming pools - she was petrified of the holes and drains.

* She hated me using different voices when I read stories to her.

* When she is feeling anxious, she is less able to make normal day to day decisions - so she will ask me - can she have a drink, can she go and have a bath (she still asks this sometimes and she is 15!)

* She's not able to assess the situation and then make a decision - eg last night at 11pm she comes and asks me if her sisters have brushed their teeth and had a bath - they had been asleep for a few hours!!!
When she was younger (maybe 8), she spilt a drink on the table. She yelled out to me that she'd spilt it - yet did nothing. In the time it took for me to come over, my then 3 year old DD grabbed a tea towel and was cleaning it up.

* She takes things literally - so if I say I will help her in a minute, she will wait exactly 60 seconds. Although, my DS (aged 6) did that to me this morning - I said I would play a game with him in a minute, and he came back and said he'd counted to 60. laughing2.gif When I said to him I was still busy, he was able to move on - with my DD1 - she can't move on, she will say 'but you SAID you would be a minute' and she will go on and on about it.

* She can go on and on about certain topics.

* One of the issues we've always had, is she will start talking over people - if she wants to talk, she thinks she should be heard straight away - even if 2 people are having a conversation. We did see a counsellor when she was younger (before her Asperger and ADHD diagnosis) and we tried to teach her to wait. If my other kids start talking, and I tell them that they need to wait - they will then wait - but my DD1 doen't see why she should wait.

* A lot of her issues are obvious at school. She has trouble starting her school work. She will waste a lot of time sorting out her pens in order, etc. Instead of just jumping in and writing, she will become anxious about not doing things perfectly. She doesn't like to repeat work - so for English, where you have to write a plan before you begin a piece, then write a draft, correct it, then write another draft, or the final copy, she will just want to write it out once.
If she finds school work boring, she might not attempt it.
In the past, if she had a list of activities/questions to do - if she came across one she didn't quite understand, she wouldn't ask for help. She'd just sit there, and wouldn't even skip over that question and complete the rest of the work.
Homework in primary school was a nightmare! It took her at least 4 times as long to complete. She hates homework - because it's school work, and should only be done at school.
She's in high school now - and if I ask her if she has any homework to do, she might say no - and that's because she has left the work at school, so therefore in her mind, she doesn't have homework to do at home.  rolleyes.gif laughing2.gif

* Other kids were quick to pick up that she was different, and boy can they be mean!!! They loved to take her hat off her - and saw how upset she'd get. They liked to move her things on her desk. Once in prep, she lined up first as soon as the bell went, and some other prep girls came over, and told her she was standing in the wrong spot, and they stood next to her and everyone else lined up behind them.
In Gr 1, she had some kids tell her the bell had gone - so she ran off to line up and waited and waited. She didn't think to look around and see other kids were still playing.

* My DD rarely shares about her day at school. The other 3 kids will fill me in on things that are happening.

* The end of the school day is hard for my DD - she finds school exhausting, and needs about an hour of down time - so it's asking for trouble if I take her somewhere after school.

* My DD1 doesn't know how to respond when someone gets hurt. She has to know how they hurt themselves - so if I have one of the kids bleeding and in need of a cuddle and first aid, my other kids will go get a bandaid or wet cloth, but DD1 will ask 100 questions. She thinks I should pay all my attention to her, and not the hurt child. She also becomes anxious if one of the kids are hurt - and this is often due to the routine being changed.

* She hates it when our routine changes. She gets upset if one of the kids are home sick from school. She now tells me that I need to take them to hospital.  rolleyes.gif My DD3 has Coeliac disease - and the smallest amount of gluten can make her vomit, and she can be sick for a few days.
* She has to watch her tv shows - so when The Simpsons were on every night, she HAD to watch them. If the programming got interrupted, she'd get upset.

One advantage of having an Aspergers diagnosis is that you are eligible for the Carers Allowance. Your child also has a HCC.

You might get something out of this.
http://www.abc.net.au/local/stories/2011/06/17/3246425.htm


#12 baddmammajamma

Posted 02 January 2012 - 01:05 PM

Awesome post, Zombie Mum. From everything I've seen/read in my involvement with various gifted groups & ASD groups, it is pretty common for giftedness to be uncovered before special needs like ADHD and high functioning forms of ASD -- but doesn't it suck to have your concerns dismissed by doctors, teachers, and even family members??!

2 Gorgeous Girls, here is a thread from this spring re Twice Exceptional children. There are some very compelling stories, as well as great resources, in it.

http://www.essentialbaby.com.au/forums/ind...howtopic=909709

#13 2 Gorgeous Girls

Posted 03 January 2012 - 01:08 PM

Thanks ZombieMum and Baddmamajamma. Your posts were both very useful and gave me a lot to think about.

#14 baddmammajamma

Posted 28 January 2013 - 11:40 AM

Bumping on a rainy day, with the start of school on the horizon. Thanks for all of the support over the years in helping me spread the word. original.gif

#15 baddmammajamma

Posted 28 January 2013 - 01:55 PM

Jameses Mum:

I wish I could offer you a hug in real life. It sucks when there are so many barriers and people standing in your way of diagnosis. The "there's nothing wrong with him, it's all YOU" angle is so horribly unhelpful.

There is a board on EB for parents of kids with SNs, including a pretty decent group of us who have school aged kids with ASD. My daughter has Aspergers & is a year younger than your son.

It is a protected board, meaning when you post things there, they don't show up in the general news feed. Please feel free to come on over. There are some exceptionally helpful, sympathetic & knowledgeable parents there.

http://www.essentialbaby.com.au/forums/ind...hp?showforum=83

You can just copy your post above if you don't want to go through the hassle of re-telling your story!

Also, please feel free to PM me. There are some good private groups, if you want somewhere to discuss your issues that is not quasi-public.

#16 baddmammajamma

Posted 23 April 2013 - 06:50 AM

Bumping in light of Autism Awareness & Acceptance Month

#17 baddmammajamma

Posted 25 August 2013 - 10:48 AM

Another updated & refreshed pinned note.




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