I never thought my son might be 2E but now I am wondering. Just looking to see if anyone had an insight on this.

My seven year old has recently started adding sounds into his words. Most often it's an "uh" type noise to the end of a word. He will do this anywhere from one word per few sentences to multiple words per sentence. It makes him more difficult to understand.

This concerns me. He has always had vocabulary well beyond his years (still does) and since age 2.5 could carry on adult-level conversations and be understood perfectly.

He does it speaking and reading out loud though more when speaking. He also has transient tics than come and go, like clearing his throat and sniffing.

He also has a hard time listening/paying attention to us and/or forgets immediately what we tell him to do if it's something simple (like "put on your shoes", as opposed to explaining a hard concept- which he never forgets). An acquaintance of my DH's played my son at chess last night and afterwards asked DH if my son had Aspergers. I had never considered such a thing. Any insight??

Background on him:

-has intense LONG attention span for things that interest him and gets offended if interrupted
-strong sense of "fairness" or justice
-highly logical
-reading since age 2, reads on about 9th grade level
-4 years ahead in math
-was #3 chess player in state for his age this past year

If you're observing verbal and motor tics, you might look into Tourette's and other tic disorders (http://www.tsa-usa.org/). You'll need a neurologist for this.

Do the tics increase/decrease depending on his emotional state/anxiety? Does he seem anxious at all in general? Has he always had difficulty paying attention to mundane directions or tasks? How is his joint attention (attending to something that someone else is attending to at the same time, usually for the purpose of common understanding of something)? Does he have difficulties with "reading" social situations, or social awkwardness? How is he with changes to routine? Does he have rigidity or special rituals?

1. I have not noticed the vocal tic (if thats what it is??) increasing. The throat clearing/sniffing seems to occur more when reading and seems to be linked to allergy season, maybe? Some days he does it almost every few seconds.

2. He is not anxious

3. Yes, he defiantly has issues with attention on mundane or uninteresting tasks. With LOTS of attention for interesting tasks, including *most* schoolwork (homeschool). He can focus on something someone else is focused on.

4. Does not read social situations that well

Sounds like a profoundly / highly gifted child 'normal' description for them. So, healthy, great, bright, brilliant, able to do wonderful work - the type that will have choices of academic / merit based scholarships.

Not an expert in Asperger's so in layperson terms, isn't that when they are totally missing a filter / social cues so you might sense it if a child says something that stops you in your tracks, some sort of red flag, that their comment was a sign of not understanding human emotion - if a child made a comment that was meant to be a joke but it stops the adult in their tracks (bone-chilling), but we are not experts on Asperger's. I suspect, especially nowadays, there is screening for Asperger's, whether people are aware or not. I think most adults could tell. So, it doesn't sound like Asperger's to our family. Hope it helps.

So it doesn't sound like it's a true vocal tic. If you think it's related to allergies, that's easy enough to check out at the pediatricians. (Or even, to some extent, just with OTC antihistamines.) You are not reporting anxiety or rigidity, and he has joint attention. That sounds less ASD to me.

Another possibility WRT the "uh" fillers is that he's reached a point in his cognitive development where he's much more aware of the amount of ambiguity in the world, and the difficulty of answering questions comprehensively and with absolute certainty. My EG/PG sibling went through a stage around age 8 (if I recall correctly) where the immediate answer to every question was "I don't know". So much so that we took to using that as a nickname. This from a person who had previously read the daily newspaper cover-to-cover to unwind after a hard day at kindergarten, and read from "A" to "R" (or thereabouts) in the Encyclopedia Brittanica for amusement. In your son's case, he may be using the filler syllables to slow down his response so he can have additional time to formulate a more precisely accurate response, or because he is trying to reconcile what he knows with the infinite amount there is to know.

Reading social situations is the one indicator you mention that is more associated with ASD, but you also have to consider what kind of interpersonal interactions he has experienced on a regular basis. If much of his time is spent with adults, 1) one must be careful to compare his social perception skills with those of an age peer, and not inadvertently hold adult-ish expectations for him; 2) he may not be receiving the same kind of feedback from adults that he would from age-peers, and consequently may not be having the same kind of social learning experiences. Most adults instinctively scaffold for children, which means there are fewer opportunities to compare strategies for their effectiveness, and thus to learn which ones to apply in which situations, with which persons.

I would observe his social reciprocity with those with whom he feels he is on a similar level, and not focus too much on the "little professor"-type conversation that often makes people think of Asperger's. Also, his self-awareness, especially in the social and emotional domains. One of the core deficits often referenced with regard to ASD is a poor "theory of mind"--being able to see from multiple perspectives, particularly to make reasonable estimates of what is going on (invisibly) inside people's heads. If we take as our hypothesis that his poor reading of social situations is a function of his learning experiences, rather than of an essential deficit in theory of mind, then we would expect that he would exhibit more developmentally-appropriate self-perception/self-awareness/insight than other-awareness (due to lack of experience).

Keeping in mind that he is only seven years old, how is his ability to reflect on his own thoughts, feelings, perceptions, and motivations?

I often get asked if my son is Aspergers. As of this week, I now have 4 different psychologists who all agree that my son is not autistic although he does shares some of the characteristics. We are in the middle of a full neuropyc eval and partly just to rule it out. One of the questions on the assessment asks if there is anything else that could cause the symptoms. There are lots of other possibilities, including ADHD (inattentive), Tourette's, language disorders, other LD's or just simply profoundly/high gifted. It's is not at all unusual for gifted kids to have inattention problems with uninteresting tasks and not have any of the above issues.

As for your son, I can't really tell from your post. Starting with the pediatrician and ruling out a physical reasons for the vocal tik as aeh suggests is probably a good start. These are simple things one doesn't want to overlook. When my allergies bother me it can manifest mostly with my constantly wanting to clear my throat. Allergies could also affect his hearing and that could affect attention.

Have you tried asking him? Does he know what he sounds like and does he have an explanation?

Ugh, I hate this. I get asked all the time if my DD10 has Asperger Syndrome (she doesn't, per multiple psychologists and a neuropsych). The most annoying is the Girl Scout volunteer I work with, to whom I cannot even mention DD any more because she has decided that DD must have Aspergers, and if I bring her up, the volunteer badgers me to get her diagnosed and treated. She has never even met DD!

I just cannot believe there are so many rude people out there. It'd never even occur to me to ask or suggest to anyone if their child has a particular condition.

One of my DD's toddler classmates was a classic case (early reading & spelling but read with completely flat tone and showed no emotions, no eye contact with anyone including with mom, showed no interest in peers or adults, had a very peculiar gait and body language, etc, etc) but I felt so guilty even thinking this and tried everything in my power to relate to this child as she is rather than a (possible) label.

I only have a suggestion for the tics. My son has had some tics on and off, some OCD,-type behavior. The tics were getting really noticeable and seemed completely involuntarily. I read somewhere magnesium helps with tics and such so I started giving him Epsom salt baths (for the magnesium). Within a week of starting the baths, the tics stopped completely. Completely. I have him take an Epsom salt bath now at three times weekly (usually more like 4 or 5) (I even brought it with us on vacation). I put at least two full cups in his bath each time and I have him soak for no less than 15 minutes each time. Really worked for us. Tics have not come back at all. Maybe try that to help with the tics at least!

One of DS's teachers asked it after the first day of school, and I was taken a back. I can see how she might see that, but it's not something to just throw out there casually. I really think it's the new "fad" diagnosis...some people will see it everywhere they look without really understanding it or what it entails. After that it was clear to her that he doesn't have Aspergers or ASD of any kind and she didn't bring it up again. One of my sister-in-laws who is a special ed teacher brought it up around the campfire at a family reunion...she wasn't talking about DS but one of the brother-in-laws. My mother-in-law mentioned how hard it was to get him school services (like a decent IEP) way back when in grade school, and my sister-in-law said "mabye if you had had him diagnosed with Aspergers it would have been easier..." Ummm....ok...and you're a psychologist, since when? It just annoyed me, and it annoyed his wife. I think this particular brother-in-law has some quirks, as do many males in the family (and he has a very high IQ which was documented back in grade school), but he's not autistic in any way.

I find it annoying and offensive not because I feel there is something wrong with having Aspergers but I really take issues with people who put themselves in the position of authority and power to assign labels to others when no one asked for their unprofessional opinion. It's really obnoxious.

I have a dear friend who has a daughter who I have known has autism since she was six. Her mom only shared that she had ADHD and learning disabilities. She went to a very good private school for children with learning disabilities and ADHD and each grade level had about ten kids. She got OT, speech, and social skills therapy and other therapies over the years. I couldn't believe not one professional said something about autism so I figured she knew but wished to share her challenges this way...or if she didn't, her daughter was getting all the same services (OT, speech, social skills, therapy with a psychologist, specialized learning in small classes).

About high school her mom started attending walks for autism and posting autism awareness posts and I mentioned my boy has Asperger's. She said her daughter was newly diagnosed. Her daughter graduated high school and is getting services as an adult now with autism. I think nearing graduation someone must have suggested that her daughter was going to need SSI and voc rehab and other things and maybe they should look into it.

I can't believe that her girl was never diagnosed all those years and professionals and it was so obvious. I would spend a few hours every so often with her and could check off criteria on the DSM list left and right plus some of the stereotypical behavior that isn't in the manual.

But it was never my place because she never asked my opinion to say anything.

On the one hand: yes, armchair psychology can be very rude and unhelpful.

On the other hand: this sort of thing is a side effect of a tremendous effort to make "invisible" disabilities more normal and part of the landscape. In the 1960s they were still using electric shocks to punish kids with autism and institutionalizing them, keeping them away from their families. We are now at a point where a substantial part of the population is aware that autism exists. That has to be a good thing.

One side effect is that "a little knowledge is a dangerous thing"-- that, knowing a bit, people try to deploy that knowledge. It's also too bad that the popular press gets it wrong, relying on anecdata or stereotypes so much of the time.

I do think most who bring up possible diagnoses are trying to be helpful and/or sympathetic, in the mode of "I see a challenge, let me offer ideas about it." Doesn't mean you have to take them seriously, of course. I usually thank them for their ideas and change the subject, or (in some cases) take the opportunity to educate them about what's really going on.

I think that's true in the case of actual disabilities, but the autism definition (esp. one in the previous version of the DSM) is so broad that practically everyone has a touch of autism. Korea now has a diagnosis rate of 3 percent? I don't think it's even just the general public getting it wrong and being massively confused, it's also many in the medical community.

Interesting article:

http://www.straightdope.com/columns/read/3154/how-did-autism-become-the-latest-fad-disorder

Here's my opinion on this. Personally people who offer their "arm-chair psychology opinions" need to keep a lid on it... Unless the person whose child is at issue specifically expresses concern and asks for insight, guidance, etc. They also need to keep in mind that they are NOT experts and do not necessarily know what they are talking about anyway. I think of it like this: my neighbor's child had a major problem with speech in that one could not understand a word he was saying. My child, younger, was talking circles around him. Did I stand next to said neighbor and say "Hey have you noticed your son can't talk?" offer up a bunch of potential dxs, and tell her to look into therapy? No, I assumed she did not need me pointing out her son's deficits and prying. Would anyone do that in this situation? (maybe but most would not, right? Because it's a more obvious issue unlike things like ASD, dyspraxia, etc.). If she had complained to me, expressed concern or whatever then I may have offered whatever my thoughts were. She never mentioned his speech not once to me. I had no idea what she was doing about it if anything. But I assumed she certainly didn't need me pointing out her son's deficits and, plus, I am no expert on such issues anyway. I simply went on treating her son like a the great kid he was/is. And, yes, apparently she was on it and she did get him therapy, etc.

When I first started noticing and researching my son's fine motor and motor/coordination problems and dysgraphia-like tendencies. I did it and did not tell my friends. I had a friend who also must have been notice something was amiss because she starting making comments saying she thought my son may have this or that, once I think she also mentioned that he may have a learning disability, etc. She would point out my son's deficits and then in the same hour mention how she thought her daughter, approximately the same age, was gifted. I was already noticing that something was wrong with my son's fine motor compared to her daughters. I did not need her highlighting it for me or my son! I already had a pit in my stomach. Her comments on my son were totally unwelcome and not in any solicited by me (in my opinion). She made me feel like she was comparing our children (and of course mine was coming up short), and that all she was noticing his deficits. It made me feel so yucky and I feared she would eventually make my child feel yucky. It was already a difficult time for me coming to terms that something may be wrong. We did not have a fight or argument or anything about it. I never brought it up to her. But I distanced myself and my child from her. It hurt my heart so much. On the other hand, with a different friend (and I probably felt more comfortable with this this mom anyway b/c she had/has a child with an ASD dx), I expressed my concerns and that mom/group was what really helped me get on the right path to figuring out what was up! But this mom NEVER not once made me ever feel like she was noticing anything about my son but his good qualities. Only when I opened the door to the issue did she speak up and she did it in such a great way! Not at all making any diagnoses or anything just offering her experiences and insight and saying here are some resources on how to get started checking into it. I am forever grateful. I never felt yucky.

I have noticed that people with neurotypical kids often yammer among themselves saying some other, likely non-neurotypical, child has "issues" and "don't his/her parents see?!" and speculate among themselves what the kid could have. Then they seem really keen on pointing out to said mom. It's often malicious gossip disguised as concern, in my view. It's just hurtful and most have no real idea what they are talking about anyway. I try to focus on the good/strngths of my friends' children and if a friend wants to chat about a potential issue with his or her child I will always try to help in the same tactful supportive way I was helped but otherwise I try to keep my mouth shut.

Since I started this thread within this thread I want to make it clear that not everyone who suggests Autism bugs me. There are different types of people who have suggested ASD for my son. And as my son does exhibit some of the standard criteria, particularly being very anti-social and clearly having on & off issues with anxiety. So I can understand it to some extent. There are friends I have asked for help and it doesn't bother me when they suggest it or bring it up. Particularly when they have a kid with ASD/Asperger's and have real concrete ideas of what the syndrome entails.

Then there are the teachers, school professionals that don't say the words since then they would be required to do something. But heavily imply that if I got a diagnosis there is more accommodations he could be given. It's partly the fact that they HINT that is the most annoying. And that they aren't professionals and can't really SAY. It's part of the fact that it seems more important for them to label then help that I find frustrating.

And then there is the family & friends who give unsolicited advice. Those are the people who I find irritating. Sending book & articles my direction, and hinting that that "it's so sad". The "it's so sad" part bugs me that most. If a kid is Aspergers or not, this is irritating. My son is still is a really wonderful kid if you can get him to warm up to you. Being labeled with ASD isn't like having cancer, it's not going to kill him. It isn't a disease that needs curing. And I get frustrated that society seems bent on "fixing" these kids more than understanding them. Trying to shove them into a square box rather then realizing that the square box isn't good for everyone. And basically trying to be arm chair psychologist who want to diagnosis not knowing the whole equation.

I hear you! And agree! I do think it is more the place of teachers, etc. to point out where they see the child struggling. Not offer a Dx (because they are not qualified) but to point out "I notice he struggles with this, this and this... we could do this to help, maybe look into an OT/PT/Psych eval, etc.," I don't appreciate it unsolicited from "friends." I mean, if you're noticing something, chances are the parent has too and is doing something, or researching or whatever. Also, some medications can affect a kid and you may not be privy to that, ykim? Which all goes along with not knowing the whole equation.

DD has ADHD and I kept asking teachers about it before she was diagnosed and they wouldn't give me enough information to even know what direction to turn, which was equally annoying. They talk about "focus issues" but I had no idea if they meant focus issues to the extent that it might be ADHD or just mild focus issues that any 5-6 year old kid might have in certain circumstances. Since they didn't seem overly concerned, for a while I figured DD must be fine, otherwise the teachers would be talking about it more. After all, they would tell a parent if they had a serious concern, right? Wrong! It would have been really helpful if they had said "I don't know if it's ADHD and we can't diagnose that, but I see some focus issues that are different than most of the other kids and you could talk to the doctor and ask about X inventory, and the school psych could come in and do an observation..." etc. etc. Instead they just beat around the bush, even when I asked directly about it and expressed my own concerns. What they should have done was offer to do an evaluation the second I mentioned I have concerns, and told me their own concerns (without offering a diagnosis), told me where to have an outside eval to get a medical diagnosis, and told us that we have a right to an eval (to the extent they can do)...but the district has no idea what the "child find" mandate is and they hardly ever evaluate kids, given the fact that they don't even know what the spec. ed categories are, so that never would have happened.

So given what I went through with DD and no one communicating with me, I was really surprised that a teacher would mention "Aspergers" in relation to DS before even getting to know him. So it goes both ways and there should be a middle ground. Teachers should tell parents that they have concerns and be direct about what they are seeing, but also say that they are not experts and that there is no way to know what is going on until a thorough evaluation by a trained professional is done.

Don't get me wrong the teachers are every so careful not to say the actual words, they just "hint" like you suggest. It can be very frustrating because they don't always know what they are talking about. Public School teachers can get in a lot of trouble with their schools if they try and diagnose a student, there are protocols and rules to be followed. Part of this is because if the teachers suggest it then, you as a parent can request the school do an evaluation. I had one teacher for my DD who when I told what I was doing outside of school she told me she was glad, and it's what she would have done if it were her child. But that she wasn't allowed to suggest that I get the private evaluation.

Just one thing I'll add here - this isn't directed at either blackcat or blue magic, just veers off a little bit on info that they've provided above. I've been in the position of having a child with issues we (parents) didn't recognize, and having a teacher make an assumption of a diagnoses that was incorrect. In hindsight, I believe she made the assumption in an honest manner, based on what she knew - she had seen quite a few kids with the other diagnosis and our ds had obviously *something* going on which shared a few of the symptoms. She shouldn't have mentioned the name of the diagnosis to us - for legal reasons and also because honestly it felt like an accusation and an excuse on her part and hundreds of other reasons it was just, not a good idea to say "I think your ds obviously has ….".

But the thing is - that teacher, unethically or illegally or whatever, mentioning that diagnosis to us, gave us an *invaluable* gift - she made it obvious to me we had to prove her wrong, and in going about that we found out our ds really *did* have a challenge that was impacting his life in a huge way - just not the challenge the teacher "diagnosed". For all that it made me mad at the time, today I am forever grateful that the teacher had the guts and nerve to suggest to us that our ds had "diagnosis X".

I think that teaching is, honestly, one of the toughest professions in the world. I have a number of friends who are teachers and teachers' aides or who work with young children. I can't tell you how many people I know in these positions agonize over children in their classrooms who are struggling in one way or another but who's parents insist the only issue is the classroom or the teacher. It's really tough to be in the place of having *some* limited knowledge and realizing a child needs help but not being able to communicate that either adequately or effectively to a parent for whatever reason. So for the parents out there who've had teachers suggest things that seem outrageous, it's ok to be indignant and annoyed and all that, but I'd also suggest not just writing it all off to "obviously highly gifted" or whatever, but instead think through, why is the teacher making this assumption? What's she saying *past* the diagnosis, what led to that assumption? Is there possibly something going on that's setting my ds/dd apart and that they might need some help with.

Sorry that is a bit rambling… but back to the OP… fwiw, I would ask your ds' primary care dr about the tics as a first step, and if you think they correlate with allergies, maybe ask for further allergy testing just to clarify. I'd also think through the social challenges you mentioned. As always, aeh has offered wonderful advice - so I'll just second everything aeh said!

Best wishes,

polarbear

In the big picture, the amateur false positives are just an irritation.

It's the professional false positives that are the real danger.