Gifted Issues Discussion homepage Forums Twice Exceptional Ds8, Developmental Pediatrician...Asp. denial?

Hi, posting back about ds8 whom I just yesterday took for an appointment with a developmental pediatrician.
We are trying to look into possible auditory processing problems for him, due to issues with hearing in noisy situations, attention problems esp. in noisy situations and some rote memorization issues (mainly math facts). Also I discussed his social problems - he has a friend or two now, but for a long time (1st and 2nd grade) he would wonder aloud why he didn't have any friends.

I think I might have been at the wrong doctors office.

It was a pretty long discussion, about 2 hours.
She suggested strongly that pursuing any issues with auditory processing problems would be useless.
Me: "he had a lot of ear infections when he was a toddler, no ear tubes". "He seems to be unable to understand me in the noisy car or a noisy classroom."
Dr:"But his hearing is fine now - so if he's fine, he's fine."
and "It is really hard to get someone to do an accurate assessment of auditory processing issues". "They don't really know what it is." (Meaning I guess that there are questions about the validity of auditory processing being a separate area of function than just plain old 'hearing'.)

This seems strange to me since they have an auditory specialist listed in the same office..., but of course during the conversation I was like, 'uh huh, ok. uh huh.' I hate when I do that!

The regular ped. had mentioned seeking info from the developmental pediatrician about pursuing the auditory issue question, and the social question. She also said it was fairly standard to screen for add when questions about attention come up and that asperger's might be an explanation for the social issues.

After explaining the social issues the dev. ped. asked if anyone had suggested asperger's. I told her that was part of what our pediatrician suggested we look at, although I wasn't 'seeing it' myself. Most of the questions from that point were about symptoms which I am familiar with being associated with aspergers.
She asked him to explain about Yu-Gi-Oh, his current favorite game/subject. He started talking about Yugioh in relation to some other similar card games, and it seemed to me that he did take a bit of a pendantic tone, but that is not how he normally speaks with me, nor with most other kids. He had the same tone the other day when he was explaining yugioh to one of his cousins, I asked him to be a little nicer and he adjusted his tone pretty easily.
He does sort of hold his body still, and I can see that he is 'arranging' his thoughts when he's got a 'big idea'. Anyway, so she asks whether he often speaks in a monotone; I said sometimes, but usually he is pretty expressive. (He was one of only 5 kids picked last year to have a speaking part in the 2nd grade play and was roundly complimented on his expressiveness - he was one of the only kids who didn't just quickly mumble his lines.)
She asked about asperger's in the family (yes, one cousin, possibly one of my brothers)
She asked about his coordination, which is good, we talked about his dancing.
She asked him some questions about how he likes school, she did a 'mood screen' with him to try to make sure the issues weren't making him downright depressed.

She was very complimentary and said he has got a lot too offer and if we could get past the social thing, help him with that, that would be her main focus. The math fact/computation thing she suggested I might pursue with the school, although if it's fairly insignificant part of the curriculum, they might decide it is not affecting him negatively enough to warrant an assessment for ld.

While we were talking he got interested in a floor puzzle of the states and was working that; he had like 5 pieces to go and she decides it's time to interrupt and have him do this mood screen. Well, we had to be fairly persuasive to get him to release the last pieces and sit up and do the paperwork..he didn't have a fit or anything but was not looking at us, just trying to continue the puzzle until I wrapped my arms around him and the doctor asked again if he would do one last piece and then come to the table. This more than anything had me worried...the dr. didn't say anything about it. Normally I wouldn't even have thought about it, but now I am questioning everything.

There's the long, here's the short of it:
Mood screen seemed to show basically a happy kid, some mild feelings of 'blah', as the dr. put it. Just sort of a drifty feeling, not too excited about many things. OK. (huh?)

She recommended some extremely casual counseling primarily to help him navigate some of these social issues and she said it might just help him in general to have someone he can talk to about some stuff.

She didn't want to definitely say 'Aspergers' then, or maybe at all, which I thought was about right...but maybe in 6 months we could look again at whether it would make sense to assess formally for that (not sure if this depends on his making progress in the realm of social interaction or what)

There was just a LOT of different stuff talked about. I came home COMPLETELY exhausted.

My main questions right now are: Does what she said about the auditory processing issue make sense? We didn't really talk about hearing testing under non-ideal situations (aka noisy)

Am I in denial about the aspergers? I really like the idea of some informal counseling to help ds with social skills so I will definitely try that, but I am just wondering if the dr. is trying to ease me around to the idea of aspergers. Not a lot of talk about these behaviors or social issues being part of the picture for some gifted kids. I had asked the receptionist if the dr. was used to dealing with gifted kids and got an ok answer, but now I have to wonder.

Thanks Dottie - yes, when I woke up this morning at 3:30 wondering about all this, I definitely thought...'they don't know what it is???' just seemed off. Way off.

How come 'they' seem to write about it in a bunch of books - and really it makes complete sense to me, although I am not sure ds entirely fits the picture. I will probably continue to look into it - starting with the book you mention.
Very much appreciated!

Hi,

I'm not sure if this is any help, but our DS6 had severe hearing loss when he was 3 due to "glue ear" following many infections (the audiologist said that it was one of the worst she had seen caused by glue ear). He had tubes fitted which returned his hearing to normal. Last year (2 years after tubes) we took him back to have his hearing re-tested. His normal hearing is perfect, but when there is any background noise his hearing deteriorates. The audiologist said that it is normal because when he was young his hearing was so bad that he couldn't learn to isolate sounds and focus on one sound, and that this would develop over time.

He can't stand being in a very noisy environment and when things are noisy he struggles to hear us.

As your DS had lots of ear infections, it could be a similar issue.

XX

My DH had a case of glue ear right after I gave birth to DS4. It's no fun! He had some hearing loss, too, though he regained most of it, thankfully. But he was an adult.

Hi Chris ((hugs))
Now you know why I get so worked up about 'only' letting one of the 'top 12 in the Country' type doctors check out our kids. If a person didn't 'know' these kids, well yeah, they do look weird when they start talking about Yugioh Cards! I've seen my son and his friends do this while driving to and from playdates, and I can tell you that it really does sound like they are talking a different langugae, fast and totally mysterious! And when DS tries to explain World or Warcraft, or Yugioh,(usually Magic the Gathering now) to me or DH, yeah, it gets pedantic. It is really complicated stuff.

For what it's worth.
A) I don't think she is 'prepping you' for an Asperger's DX
B) I think it stinks that she talked about the social stuff without putting it into LOG context.
C) She's way off base around the CAPD

So yeah, If it were up to me, I would refund you your time, your money, and your fears.

sadly - 'In General' different specialist 'DO' different diagnosises. Audiologist DO CAPD. Dev Peds DO Auspergers. Occupational Therapist 'DO' sensory integration, Dentist 'DO' cavities and gum disease, and will sometimes send you to a ENT to check for sinus infections.

In General - When all you have is a hammer, every problem tends to look like a nail, yes?

((hugs))
Grinity
Keep pursuing that CAPD! Maybe at a different office though....

Thanks everyone for the words of support. Yes my gut is telling me that this dev. ped. was not quite right on some stuff. I should be glad to just take the 'counseling rather than labeling' for social issues at face value - sometimes I do assume too much and end up needlessly worrying about stuff that the other person didn't intend.

Hi folks, just wondering about these test results for ds8...not as 'hoped', but not entirely unexpected as I have been seeing more and more on tests he is moving away from 'looking' gt and more towards 'completely not to be understood'.

Just some quick background -
Stanford Diag. Math test in 1st where he got a very high (maybe perfect, iirc) score in 'concepts' and a 3 out of 20 in computation...I was told not to worry about it.
K-bit in 2nd where he got verbal - 95th percentile, math - 87th percentile. He was able to get into the k-3rd gt program with these scores and some additional work samples, plus his reading was about 2.5 years above grade, per some testing done in 2nd.

He took a SCAT in the fall this year, I'll have to dig up those scores, but again verbal ahead of math, verbal was very solid but not quite qualifying for most jhu-cty programs. These scores were a little confusing as it seemed his verbal percentile might be way off the %95th for age/grade, but I figured maybe I was just interpreting it incorrectly. Anyway, it made me think ok maybe he's more verbal than I thought, always thought he was mathy or at least very visual/puzzle whiz/patterny.

I am ok with all of this, even his not being in the school gt program for next year, but I really think he would benefit from it and does seem to really really love it and is doing well in the 3rd grade program.

Next year's program eligibility relies partly on the CogAT and Naglieri scores, just received, not ideal...

Naglieri: 114, broken out: Pattern completion: 6/6, Reasoning by Analogy: 6/10, Serial Reasoning: 5/8, Spatial Visualization, 6/14. Seems like he was just going downhill there...
A respectable score, just not immediately qualifying him for this program, I think they need to see 130. (98th percentile)

Cogat (at least this shows a number attempted)
area....number....number attmptd...number correct...Percntl
verb....65........61 ................52.............73
Qnt.....60........36 (???)...........30.............35
NonVrb..65........57.................57.............88

comp: 64%ile

Although I was hoping for higher scores in nonverbal and on the Nag., the proportions seem to fit my ds as I have always understood him.

I am still interested in his trying for the gt program for next year (they won't really decide until May) so I will get with the school to see about more testing, possibly address the massive 'off' score in Quantitative with something untimed.
They might not do more testing this year, however. At least I have more of a leg to stand on for the ld investigation, maybe? Hm.

Suggestions? Interpretations?

My pendulum is swinging between complete confusion, and 'ok, these are screening tests, and not necessarily a real picture of ds' ability', etc.

PS, he just got straight A's for this grading period, including math (geometry, of course!)

thanks...

pps...I will likely end up getting thorough testing at the neuropsych that has been recommended to me, but now that the dev. ped. has said she would not pursue it, maybe ins. won't be so inclined to pay, but I would probably give it a go anyway.

I am curious if I call the dev. ped. with this info if she might more readily make a recommendation for further testing (outside school)