On the binder: my whole family's relationship to objects and their organization is a bit hinky. It always seems easier to put things down and walk away from them than to put them away. We all struggle with binders and drawers and clutter. No idea if this is "broader autism phenotype" or just "us."
He does struggle a lot with simple things like dressing himself. It takes forever, even when he is motivated.
My family is similarly "hinky" (love that word) and I imagine it makes me a lot more tolerant than I should be, maybe? One learns to choose her battles.
Is the neuropsych exam still upcoming?
You make astute observations and you are thinking carefully about your son's needs and difficulties. I would, however, suggest that instead of playing the game of "is this behavior a symptom of X?" leave it for now to the neuropsych. List and organize all the behaviors and issues that you observe, and present them during the evaluation.
It is sometimes very difficult to tease apart the issues into different diagnoses. The game of "is this ADHD or ASD of EF or fine motor?" is fraught with subtlety and ambiguity.
I totally agree that I should not attempt to "diagnose" (but it is my nature, and also my profession...to a certain degree). I *think* what I'm doing is trying to prepare myself for what might happen.
Neuropsych is next week. She will work with him either all day or two days, depending on his energy level. She also said she is perfectly willing to give her impressions day of testing, to be followed by report at later date (thank goodness, bc I am so anxiety-ridden).
That being said, I've never experienced an evaluation for either kid that was totally satisfying, sometimes with obvious gaping holes: We took DS to the local university hospital in which a team of 5 faculty evaluators did a comprehensive evaluation. This should be the regional gold standard. The school looked at me with wide eyes amazed I'd gotten him in. It missed the boat big time. It was frustrating a demeaning. But it did get us one accurate diagnosis, which helped us progress on the most difficult issue, but because I'd spent so much time trying to piece together the kid myself, I was very resistant to a few of the other diagnoses. Once we'd progressed on that issue, then a subsequent evaluation (this time by the school, but with a hand picked evaluation team) got us something that seemed much closer to explaining the kid and helping us plan a path forward.
Yes, I am somewhat familiar with unsatisfying evaluations/treatment. I think I'm also being somewhat triggered by this whole situation--bc it is terribly reminiscent of what happened with my older DS, with a constellation of neurological issues, including a pretty devastating seizure disorder, which proved hard to treat. And resulted in what is almost certainly PTSD (for both of us, actually).
Some of the boundaries between parts of ASD disorders have been separated out as smaller sub disorders. My DS fits a profile (though I'm still not sure it's accurate) of having social pragmatic communication disorder with no other boxes ticked for ASD. Though, alas, I view his responses on the testing that diagnosed this to have been a consequence of other issues. The treatment for it, however, should be broadly similar, so this label is getting him appropriate (ish) services.
I would take "ish" at this point. To be perfectly honest--I'm tending to lean toward abandoning public school altogether and piecemealing a homeschool plan. I recently saw some photos of my son, just a year or so ago, and had to ask myself--where did THAT guy go? The happy, warm, smiling one. He insists he wants to remain in his program, but I'm likening it to a battered woman who continually returns to her abuser.
There is a *chance* that my use of metaphor is not helpful in communicating with the staff (I have not said anything as ridiculous as that. Yet). :P I'm not sure there is a good placement for DS and also believe that nothing good can happen in school for a miserable child (who does not know he is miserable).
At this point, my focus is on his emotional health (and mine). It's hard to imagine advocating for his educational needs when we are stuck at this level.
