What would you do?

[chirurgeon]

My sister was in a conversation talking about her almost 4 y.o. nephew, in the conversation were 2 teachers. The little boy has a number of obsessive behaviors. If his shoes get wet, they can't be worn ever again. It takes days to transition from one season to another with clothes and p.j. He will only eat certain foods. He doesn't like to play with his cousins, my nieces 17, 13 and 10. He does however want to kiss everyone in the house good bye when they are leaving a family occasion. The teachers expressed the opinion he might be somewhere on the autistic spectrum. I don't know if my sister is planning on saying something to her sister-in-law. I believe the mother is of the opinion it is because he is an only child born to slightly older parents. I'm fairly certain the family doctor has not been told of any behavioral concerns. What would you do?

TIA
Kim

 

[SueM in MN]

i would tell your sister that she needs to tell the teachers to talk to the child's parents. If the teachers have concerns, those are the appropriate people they need to tell. If either you or your sister talk to the parents, about the teacher's concerns, I don't think it would go well. It may end up with you and your sister accused of going behind the parent's back to the teachers (even though it sounds like the teacher's approached your sister).
You could talk about some of the things you've noticed (without using the "a" word) and suggest they may want to talk with the teachers to see how he is doing there.

 

[chirurgeon]

Sue, I'm sorry, the teachers are not the little boy's teachers. They are friends of my sister's and the conversation took place at a party at my sister's home. It was just one of those conversations that happen when you are talking about family. I don't even think my sister was thinking about what she was saying. I could tell from the look on the faces of her friends what they were thinking. As my sister listed the thinks about her nephew and from my knowledge (a lot of it gained here on the DIS) I could tell they were think ASD. The parties of the conversation were not present.

Kim

 

[Earstou]

What I've done in similar situations, is to start a conversation about my ds' challenges with Aspergers, and the things he does...or to talk about an article I read recently dealing with autism. Something along that line.

I've had parents then ask me if I thought their child could possibly be autistic. If they don't say anything, I let it go. But maybe by mentioning autism, the thought has been put in their head and something will come of it later!
I had a nurse friend mention autism to me years ago, but it took years for me to convince doctors that my ds had Aspergers. Being extremely bright and hyperactive hid the autism part from many doctors. It took a doctor spending more time with my ds for it to be diagnosed.

 

[bookwormde]

Earstou

It is not that your child “hid it” just that his clinicians lacked the experience, and education in the subtleties of Aspergers.

Chirurgeon

Education is the key. Sometimes it is easier to introduce information on Aspergers, even if the child is elsewhere on the spectrum. It avoids the “autism” misconceptions. I would suggest that the closest person to the family who is concerned, give them a good book on the subject. If they read it they will have a hard time not seeing the indicators.

bookwormde

 

[chirurgeon]

Thanks for the replies. Maybe my brother-in-law can talk with his brother, the little boy's father. I'm not sure about the book thing, but I'm sure we can come up with something.

Kim

 

[mechurchlady]

I ma a 50 year old adult who never got any help other than a few tests by school psychologist or whatever. I can tell you that my life would have been a lot better if I had had some sort of training and help.

The key is for the child to get a proper diagnosis. It may just be SID for example and not Autism but whatever it is the kid needs to start now getting help. I recently told my friend about his kid who has food issues and speech problems. Dont worry what others say but thiink of the kid's future.

 

[bzzymom]

DS is almost 11 and I didn't pick up on the fact that he was obsessive about things until about a year ago. I thought of aspergers. The doctor has diagnosed him as having an anxiety disorder with obsessive manifistations or something like that, but not any form of autism. DS goes to a small private school and the teachers didn't pick up on things either. Looking back, there were some signs we all missed.

 

[BeckyScott]

I don't know how it works in other parts of the country, but...

Around here Parents As Teachers are sort of a gatekeeper to early intervention services. Since the child is still 4, he would be eligible. Since PAT is for any child, parents are more willing to use them. The PAT ladies are very well-trained in how to spot problems, if you kwim.

With us, it started out with our dr referring us to the local therapy center for speech delay. They sent the PAT lady first, the gatekeeper. She suggested a hearing test, which led to speech, which led to the other therapies. After a few months, those therapists suggested we might consider further evals, which led to a *real diagnosis*. It sounds complicated, but really they just kinda slid us from one thing to the next, very well, and not terribly overwhelming.

Now, how you get the child in question hooked up with PAT, I don't know. And if the child is headed to kg in the fall, it might be too late for PAT anyway. I have referred parents to PAT by not even mentioning any problems with the child, but just saying what a great program it is and I got lots of great ideas, etc etc, and how nice our PAT lady was and here's their phone number.

 

[Earstou]

Wow, your PAT program sounds much different than ours!
I had my ds in PAT, with the home visits and attending the play group. The PAT lady didn't pick up on ANYTHING, even though my ds was a little terror back then, ADHD along with Aspergers meltdowns.

 

[BeckyScott]

I think we may have had an advantage in that DS was obviously autistic. I didn't know that, of course, but in retrospect he was showing all the signs on the little checklist.

IIRC, her first visit he sat by himself, ignored her, and played "spin the car wheels" the entire visit. Hello, big sign! But you know I didn't see it myself.

Our family dr probably would have said something-- in fact he's the first one that said the A-word to me-- but a typical visit was only a few minutes and there were enough cool things in the room to play with, I guess it wasn't as obvious then.

Our PAT lady was also quite experienced, I think she'd been doing it since PAT was invented.

They're in a tough spot. I remember also, after PAT started, and we started having 3 or 4 therapists at our house every week... several months into it the SLP and OT suggested we might want to get an eval from someone out of town (i.e. in a real city). I made an appt at Children's Mercy for him, but it was 6 months out. We had a dr appt shortly after that, I mentioned to the dr that we were getting an eval, and he told me that he was pretty sure it was autism. I was horrified. Came home, got on the internet, found the checklist, yep, we hit everything.

The OT showed up at our house the next day, this was maybe only her 3rd visit, and I just flat-out asked her if DS was autistic. Bless her heart, she had no idea what to say to me. Because they can't really say anything, they're not doctors, but it was so perfectly obvious. After she himmed and hawwed around a bit, I told her I thought that was what it was. And she agreed. And when she left our house she called the SLP and basically told her I'd seen the light. But what had happened, is that they had been doing therapy like he had autism the whole time, they just didn't say anything, they couldn't, not until someone else had brought it up first.