Gifted Issues Discussion homepage Forums Twice Exceptional 504/empathy -longish

DD (just turned 11!)was in the car on the way to school today when she realized that she did not have her school binder. Usually we have it all packed up the night before, but DH is out of town so we are a bit out of wack. Anyway, panic ensued when she realized that she would be late, AND she couldn't find the binder at home. She began sobbing these huge gulping sobs and just kept crying "I'll be late!!!!!! I'll be late!!" I tried to be calm, but I was really feeling awful for her and hatred towards the school for giving out lunch detentions if a child is late to school. Anyway, we got to school with 5 minutes to spare. The lady at the front office told me she would send a note to the 1st period teacher to make sure DD was ok after I explained about the meltdown and DD's 504.

My question is - DD11 does have a 504 for ADHD. Age-wise she is a young 5th grader. Grade-wise she is in 6th. She has done FABULOUS this year with getting her homework, lunch, etc back and forth to school. I can count one time where she forgot her agenda and about 4 times she forgot to bring home her lunchbox. This week she has received a zero for missing homework which she claims to have turned in (teacher cannot find it/DD refuses to talk to him again after he told her he did not have it). Today she almost forgot her binder. How strongly do I advocate (help?)for her at the school? When do I wave the 504 flag? In addition, I have been given conflicting advice on mentioning DD's grade acceleration. Some here say their schools do some hand-holding with kids who have been accelerated. Some parents say to not bring it up with the teachers because the kids should be able to deal with it. Thoughts?

Next part: DD is now seeing a psych. to help her with social skills. As posted elsewhere, DD really wants friends but finds it hard. Psych. brought up DD's lack of empathy and how that makes it pretty difficult to connect to others. Psych. brought up that DD "studies" people vs. engaging with them (DD journals personality and behavioral traits of the popular) I stated that DH and I had wondered about Asperger's (even typing this makes me hyperventilate). Psych. said something like DD has Asperger tendencies in terms of social skills and lack of empathy. She also said that kids on the spectrum do have emotions although many people don't understand that.

I ran out of time to talk more to psych. so went online to look at Asperger's symptoms. While she struggles with social stuff and empathy (which she knows she is not - she happily agrees that she should never be a teacher or a doctor because she has little patience with people)and obsession with Minecraft, electronics, researching topics online, DD doesn't seem to fit the bill for a lot of the other symptoms. One site mentioned problems with pretend play. DD used to love to play pretend with older DD (they still do sometimes). Anyway, I wonder where the line is drawn between the spectrum and someone who struggles socially and isn't very emotional.

DS13 has Asperger's, just diagnosed last year. I am no expert (but am trying). A couple of things I notice in your post:

--lack of empathy is not a diagnostic criterion for ASD and I would be a little wary about a psych who uses that descriptor. That's a really controversial piece in the autism conversation. Empathy and perspective-taking are two entirely different animals and thinking a kid lacks empathy leads you down a different road than thinking a kid struggles with perspective-taking will.

--just because a person doesn't see herself in a helping profession, doesn't mean they don't have empathy. My DS has said he wouldn't want to be a doctor or pilot or anything where "other people's lives depend on you" because of the pressure.
A LOT of non-autistic people would not want a career that was focused on interacting with other people.

--the description of studying social behavior does sound like some anecdotals I've read about females on the autism spectrum. It seems reasonable, too, that a child with burgeoning awareness of being socially awkward and an analytical personality type might utilize this approach. JUST having social difficulties is not diagnostic of ASD.

--as for "waving the 504 flag:" it's probably a good idea to document these things, in case you need the documentation later to advocate. Especially since it sounds like these are occasional issues and not pervasive, it might help you establish some sort of pattern.

--as an observation: the child you describe doesn't exactly sound "unemotional." More like an unusual profile, with some trouble managing emotions at times. She also sounds like a fairly typical, driven, anxious, gifted young adolescent. It's hard to know what's causing what, isn't it?

It sounds like she's had a really good start and is managing MS well! Don't freak out about the ASD stuff. Whatever it is, it is what it is. If you already have a pretty good handle on where her challenges lie, it probably doesn't matter too much what the label is at this point, since she's functioning well.

My two cents, possibly worth slightly less.

You've received excellent advice from eco, in the previous post.

I have only a brief moment but wanted to respond to one tiny part of your post There can be a large discrepancy between a person feeling/experiencing an emotion such as empathy and a person demonstrating/expressing empathy. It is my understanding that those on the spectrum may be observed as not demonstrating or expressing an emotion such as empathy, however they may feel emotion very intensely, including an emotion of empathy.

When a child does not seem to be demonstrating empathy and the situation seems to be one which would elicit empathy, it may prove insightful to ask the child what their thoughts and feelings are about the circumstance at hand.

Here's a quick summary of ASD diagnostic criteria, as presented by the CDC.

You may wish to keep dated documentation at home in an advocacy notebook, and then you will best be prepared to mention any possible incidents of non-compliance and resulting impacts, in a low-key, factual, and collaborative manner.

Age could be mentioned as a simple fact, but you may wish to avoid "playing the age card" (ie: presenting her age to seek special favor or entitlement) especially when her issues may be 504 issues and not age issues per se.

This is not from my professional perspective (that's actually been covered pretty well above!), but from my personal one: I was in a similar grade placement, at a similar age, and while not as motivated a student as your DD , what does strike a chord is the description of sociological studies on adolescent behavior, which is exactly how I managed peer social relations at that point in my life. I don't think I've ever been described as lacking empathy by my clients, co-workers, or friends (except for my spouse, who thinks I should coddle Someone's aches and ills more--but that's something else entirely!), but I definitely dealt with the developmental gap between pre-adolescent and adolescent by studying and categorizing my schoolmates. Actually, in high school, it transformed into social currency for me, as I was perceived as a reliable source of objective, rational, drama-free advice on social interactions, by a number of peers.

And of my sibs, the one with the least patience for people (especially ignorance and incompetence) is in medicine, and quite effective as a clinician.

So not only are these behaviors not necessarily indicative of the autistic spectrum, they are not even intrinsically absolute predictors of suitability/unsuitability for helping professions.

You said that even typing about Aspergers is making you hyperventilate, which I assume means you think it is a bad thing. If she is diagnosed with Aspergers, it's not a new thing, it's something that she has always had which just stayed under the radar. It opens up new oprotunitys, and gives you an explanation for some old behaviors and issues. It would help you deal with some of her issues better, and will give you a better idea of what to watch out for in the future. Aspergers is not the end of the world, it's a new beggining.

Both of my children have been diagnosed with ASD (would have been Asperger's before that was removed from the DSM). Let me echo what AnnieQuill said - it's not a bad thing, and it's not a new thing. It's an aspect of her personality, but she is the same kid you know and love.

That said, have you looked generally at information about Asperger's Syndrome, or have you looked specifically for information about how AS presents in girls? There is a fair amount of evidence at this point that its presentation in girls is not that same, and its incidence in girls may be higher than previously believed because of the differences in presentation.

Does your DD have any sensory issues? DD12's school counselor referred to the "unholy triad" of ADHD, anxiety, and sensory processing disorder as being characteristic of undiagnosed autism. If she has all three, I'd consider asking an autism specialist to rule it in or out for you. It's better to know, even if you dread the answer.

ElizabethN makes a good point (and I'm irreverently laughing at the unholy triad thing). You can find a lot of online info about female ASD (my son's dx isn't officially Asperger's, bc that's not used any more, but his NP said "it fits a pattern that would previously have been called Asperger's)." I think the biggest difference is that kids with Asperger's did not have language delays in the previous DSM--not 100% sure about that.

You won't find anything in the DSM nor will most clinicians have any idea whatsoever about how this presents differently in females. I work with a therapist who specializes in play therapy for ASD kids who has never heard any of that info.

I don't know exactly what to think about sensory issues, because I don't feel confident there is a serious distinction between pure sensory and anxiety issues.

In our case, it would be an unholy triad between ADHD, anxiety, and social communication issues. The social stuff, though, isn't framed like that. What I've heard is stuff like: rude, disrespectful, insensitive, etc.

This isn't DSM either, but does your DD have trouble with being very literal? DS has a lot of trouble with interferences. This becomes more and more evident as other children make developmental leaps, and he does not.

Here is an example of how literal thinking can cause big trouble: DS was sent to the hall for an entire class period when his teacher asked him (after asking once before), if he was "ready now" to do his task. DS responded, "no." You can see how a teacher would consider that very uncooperative--gifted kid knows that question is rhetorical, right? Um, no. If you dissect your DD's social interactions, and notice that through this particular lens, you can explain most of her struggles--that's a clue.

My son was diagnosed as ASP at age three because he had sensory issues like unable the tolerate sticky glue, sunlight too bright outside, horrible meltdowns if teacher woke him up from his nap, inappropriately touching other kids, annoying others, etc.
We were devastated that his diagnosis was Aspergers. Felt like it was our fault and we blamed each other for his genetic problems. Over the next few years, other clinicians said he had ADHD and not asp. We were relieved! But recently he was tested again and the NP said he is ASP. This time however, we weren't in denial, nor upset. He is who he is and a diagnosis doesn't change that. We are trying to understand him more and help him through his struggles. This is the life and struggle of a 2E kid.

I have so many thoughts going on in my head about all this, but a few items I can remark upon - empathy. She's always fallen short on this one. The therapist picked up on it right away. DD this weekend stated that she didn't want to work with anyone because she didn't like people. That hit me hard. I asked if there were any that she liked? "Maybe".

As for the 504 business - I started a file so I can keep track. Thank you for the idea.

Unusual profile? To me, absolutely. I can figure out my DD12. Even at my DD12's most explosive crazy or sad times, I can understand what is going on. DD11 is a mystery to me. She asked me to have a private moment (shut ourselves in the bathroom). She demanded to know "Why do you want to know my personal business?????!!!!" I explained that people who care about each other talk and share. She seems to be baffled by the idea of sharing what goes on in her head. Often when I ask her questions, I get the "I don't know." answer. Anyway, I told her that no matter what she does, where she goes, I will always love her. Interestingly she crawled into my lap during prayer time a few minutes after our "private time".

'she didn't want to work with anyone because she didn't like people.' This is incredibly understandable. For one, group work is a pain in the rear even if your normal, and if you're gifted? You're expected to do the majority of the assignment without help, or at least that's what the rest of your group expects. And if she dosn’t like people it's perfectly okay, it's called being an introvert. And for introverts, people are exausting. It's okay, there is absolutely nothing wrong with her, she just dosn’t like people. And dear god, if you bring her to a party, give her your electronic device so she can find a quiet corner and zone out.

Sorry if this came out as a lecture, it's a really big button for me.

At this point we really have no idea if DD would be diagnosed on the spectrum, but it just feels so unfair. She has a health issue that has caused problems/she's a pipsqueak that hates being short/she's diagnosed with ADHD. We will love her no matter what, but I just wish she could not deal with one more thing. Yes, I'm whining. But I also so want her to be "ok" and grow up to be successful and content with herself.
Oh, I did look up autism in girls. It sounds like a "soft" version of boys.
Also, a lot of sites on Aspergers listed symptoms that sound a lot like highly gifted kids - sensory stuff, big vocabulary as a little kid, crazy about learning certain topics.

What is weird about her stating that is she LOVES parties. She gets crazy and wild and appears to have a blast. She so wants to have friends (see other posts). It's just painful because she really doesn't relate well unless there are games or Minecraft. I wonder if she has been so hurt by people that she is claiming she dislikes them. DH? Oh yeah, give him a tiny corner and a glass of wine. Now HE is an introvert.

'One more thing' it's not one more thing, it's already there. It's not new, it's an old thing with a new name and an 'ohh that makes sense' moment. And clues on how to deal with it. It's not new, it's already there, just going under the radar. And you can't change that by ignoring it. It can be scary, but ignoring something so you don't have to deal with it will only make it worse. And eventually you won't be able to ignore it any more and you'll wish you hadn't ignored it at all.

You know, that's the wierd thing, some introverts present as extroverts. I know I do. You can be all about the people, having fun and talking a lot, and still go home and have to recharge for a few days. I'm okay with people, untill all of a sudden I'm not.

Okay, first if she has been diagnosed with ADHD, that means that she is probably missing social cues. If someone is missing social cues, they may appear more delayed in social development. Minecraft can be a great buffer because it can be what you want it to be and is kind of like a universal currency for kids. Most kids love Minecraft, so it's a ticket to acceptance.

Like aeh, as a child I documented and dissected social situations because I wanted to understand how they worked- I had had some bad experiences and wanted to figure out how to improve my outcomes. Both myself and my brother went through this stage, and now we are very good at reading the room and are very good at social situations.

Also with labels, they are just that. Ways of looking at a particular thing and trying to determine what you need to do to help your child. Getting a label is important if you need services, and often useful in trying to understand what challenges your child needs help with. But labels can also keep you from seeing the whole picture that is your kid. I had a friend who worked in special ed - she told me to be careful with labels, because she had one kid there who had TEN labels…

There is a really good book you might want to read if you haven't already read it, Eight Keys to Raising the Quirky Child.

This is sooo true. It's common to label people as introverts (don't want to be around people) or extroverts (have to be around people), but there truly is a range... even within the same person! Susan Cain's book "Quiet" or her website (I think it's QuietRevolution) really helped me understand this for myself and others.

DS is, evidently, very "socially motivated" at school to the detriment of actually doing schoolwork. At home, he isolates and has no energy left for anyone/anything and isn't interested in having friends over, etc. He is gregarious when around people, though.

As for "not liking people," I would take that with a grain of salt because you say she really desires friends. She may be having trouble articulating something else, feeling disconnected, or even hurt.

I hope she finds someone special to befriend. Girls that age can be so awful--it's not surprising to me that a gifted, younger girl might have difficulty in that scene.

I agree that a lot of the Asperger's traits also seem like gifted traits. I realized DS was different-more-than-gifted when he went to full-time gifted program, and continued to "stand out," behaviorally.

You are allowed to think it's unfair to contemplate "one more thing!" Of course you wouldn't want life to be more difficult for your DD. I do think the ASD framework changes how you approach some challenges. That's the helpful piece to me, not the label per se, but how you think about the nature of it all and intervene supportively.

One of my college professors said if you see a string of diagnoses, you can almost be sure that the diagnosis is incorrect. DS' 504, they keep adding on more. The big picture is ASD. The other stuff is related. So complicated!

I agree with this completely. I'll also point out that technically, it's not "one more thing," but "one different thing." Your daughter's ADHD diagnosis would end up being an "included condition" of ASD, so she'd have the same length list, but with better understanding for you of what it all means.

I understand the 'not one more thing'. It is exhausting for you all already. While it would be something that had always been there it is different actually knowing. I wouldn't worry about feeling negative about otbers at this point - she has had a rough year.

Eta. Not showing empathy does not mean not feeling empathy.

Aaaah, I just want to hug every last one of you. Thanks for all the ideas and support. I will let you all know what we discover about DD.
BTW - DD so sweetly wanted to walk with me tonight after dinner. She reached for my hand as we walked out the door. We meandered down the trail and saw 3 bunnies nibbling in the grass.

Sending lots of hugs, greenlotus! We all want nothing more than to make our kids happy and see them thrive, and it can be so hard to see the obstacle pile in front of them seem to just keep growing. Labels, however - even if just in our own heads - can actually be a powerful reducer of obstacles if used constructively.

As it turns out, my own DS seems to be slowly but steadily outgrowing a lot of ASD-ish characteristics over the last year. However, as eco and others suggest, looking at his challenging behaviours through an ASD lens has been really helpful. Whether he is technically diagnosable or not, the behaviours were there and he needed help. I had to put a lot of effort into making myself explicitly respond to many more things as "can't", not "won't". And then react with "how I I teach him how to do this, and support him in the meantime?" rather than seeing behaviour as deliberate and therefore requiring discipline - or just the dreaded You Must Try Harder.

It really, really changed the way I see things, and therefore the way I respond to what can look like - but actually isn't - rudeness, defiance, ignoring me and other not-OK behaviours. And it's made a huge difference - in my sanity, as well as in my ability to help DS grow. Using an ASD lens and starting with a default assumption of "can't" not "won't" has also been quite helpful with a variety of DD9 challenges (and actually rather illuminating with DH - though he seems less likely to be growing out of any of it ).

On a different note, I have two kids with some notable social challenges (apple? tree? eep). DS is extremely shy, socially anxious, but seriously extroverted - he always wants other kids around (if if he doesn't quite know what to do with them). DD, in contrast, is not even slightly shy, will happily start up a conversation with complete strangers, eagerly visits anyone, anywhere - but is deeply introverted, exhausted by people, and needs major recharge time. While we tend to equate introverted with shy, I am really learning how big the difference is!

So what if a kid has an advanced sense of humor and thinks things that are absurd are hilarious? Enjoys sarcasm? Makes up jokes (which adults would think are stupid jokes but probably advanced for his age). Would that be impossible or unlikely if there is ASD? DS seems very advanced w/ his humor and loved books like Captain Underpants when he was only 5 or 6. He giggled all the way through Monte Python. Other kids who are 9 years old probably wouldn't get it at all. But other things about him scream out ASD, like his poor eye contact, awkward conversations w/ peers, etc. Part of what makes him come across as awkward, though, is his unusual voice prosody, but he was just diagnosed with verbal dyspraxia which would explain it.

blackcat- age peers can be scary for a gifted kid, especially if they don't get your sense of humor. Nothing like hearing crickets when you are telling a joke you find hilarious. So poor eye contact and awkward conversations with peers might be related to that.

His eye contact isn't great even w/ us. He makes good eye contact when he is listening to someone talk but when he talks he tends to make eye contact for only a couple seconds at a time.

But yes, he has mentioned that the kids in his class don't understand his jokes. He knows not to talk about certain subjects (like history) because they don't care and don't get it. On the one hand I'm glad he's no longer babbling about topics that no one else cares about, but on the other hand it makes me sad.

I'm pretty sure the teachers in the school all think he has Aspergers or something similar, just because of the more superficial characteristics like his voice, eye contact, how he says he has no friends, etc. I wish we could just rule it out once and for all rather than people wondering about it if that's not actually the issue.

blackcat have you read 8 Keys to Raising the Quirky Child? Someone else recommended it to me a while ago and it really helped me with regard to my DS...

My DS is hands down hilarious. His humor is his social language. I wouldn't discount an ASD possibility in a highly verbally gifted kid.

I agree with eco, my ASD son is hilarious. He was reading Captain Underpants at 4, and appropriately using the humor from it. (I will never forget him walking into the kitchen and saying, "Hey, Mom, what's 50 feet long and smells like pee?")

If you want to rule it out once and for all, get an evaluation from a respected autism expert. If he says it's not autism, make sure that his teachers know he has been evaluated and the expert says it's not autism. Our health insurance covered this with nothing but an office visit copay.

I wouldn't assume the teachers are wondering if he has Aspergers - but I wouldn't be surprised if the teachers don't understand what's up with him. As you probably already are aware of, there are quite a few overlaps in symptoms/behaviors between autism and dyspraxia. If *you're* wondering if he has Aspergers, then I'd suggest having him evaluated and dig into it - to answer your questions. If you're worried that his teachers think he's got something going on (Aspergers or whatever), the thing that's most likely needed there is education - give them information on what dyspraxia is and how it impacts your ds.

While poor eye contact and difficulty with communication with peers *might* be associated with ASD, they might also result from communication challenges associated with dyspraxia. If you've got questions yourself re which is it, I'd probably start back with the professionals who diagnosed dyspraxia and get a good understanding of why he has the dyspraxia diagnosis. Then if you're not convinced that dyspraxia explains his challenges, pursue an ASD evaluation.

Best wishes,

polarbear

ps - if he was diagnosed with verbal dyspraxia by an SLP rather than through a more global neuropsych type of eval, then a further eval may be useful. Dyspraxia can manifest in many different ways, and collections of symptoms/behaviors can vary tremendously among dyspraxic individuals.

We took him to a university neuropsych when he was six and he said autism was unlikely. His pragmatic language was good, the "Theory of Mind" test was good, and the parent/teacher rating scales were in the normal range for the most part, with some elevations (but nothing that would make a diagnosis clear cut). Neuropsych diagnosed him w/ DCD. He also had some informal autism evals when he was younger (a toddler and then again when he was three) and both times, we were told that autism was unlikely.

DS doesn't have any big sensory issues, except that he can't stand it when people chew gum. He used to flap his hands when he was excited. He has never had any repetitive behavior like lining things up, or obsessions with things. He loved things like carseat buckles and was fascinated with them, but if someone took the carseat away it wasn't a big deal to him. He does not have a lot of anxiety and has never had a real temper tantrum because he doesn't get upset enough. But he does come across as awkward. Sometimes silly when he shouldn't be, or doesn't continue conversations w/ people if he's not really interested in the topic.

I guess I don't really understand how a child with autism could have a good sense of humor if one of the main characteristics of autism is that they take things literally and have a literal use of language. Can someone please explain? I think that in an older child or adult, they could learn to understand puns and whatnot over time, but in a young child, you wouldn't expect them to actually be advanced in this if they have autism. Or at least I wouldn't.h

polarbear, you are right. There seems to be quite a bit of overlap and I did just give the school some articles. It turns out no one had really read the info in his file, for instance the neuropsych report, and I kept feeling like they were hinting at autism.