Ok. I have some questions and I'm feeling a little lost.

My son was diagnosed aspergers when he was 3. He is 7 now and I'm not sure that is a useful diagnosis anymore. He has tested quite gifted on some brief tests. He has problems with handwriting. I'm just not sure where we stand and I want to have him reevaluated. I suspect he won't qualify for an asd diagnosis anymore and I wonder how much of his differences are simply part of his giftedness. I also want to know where the handwriting issues are coming from, whether it is fine motor or something else. :P

Does anyone have advice or anecdotes for me? Certain tests or assesments to request?

When DS was a toddler, we (against the persistent urging of pediatricians) would not let him get anywhere near anyone who would diagnose him with anything. We did not want to get stuck with a misdiagnosis that we may later regret.

If you're mostly worried about the fine motor, why not just get an occupational therapy evaluation?

It is hard to find psychologists or neuropsychs familiar with giftedness and with ASDs. There was a list posted here before that you may be able to find through search.

Does he have any issues with motor coordination or delayed motor skills? If so look into developmental dyspraxia/developmental coordination disorder.

DS is the same age and started out with normal motor development (for instance he could crawl at 8 months and walk without help at 10-11 months) but plateaued around age 2-3. He had a brain injury that seemed to make things worse and has gotten a lot better, but still has problems with things like hopping, catching a ball, holding a pencil correctly, writing neatly, etc. If the only problem is writing and not other motor skills it could be dysgraphia.
DD has ADHD and her handwriting is slow and she tests slightly low on fine motor coordination tests. But she does well with running, jumping, gymnastics, swimming, etc. It's just manual dexterity or bilateral coordination (in terms of fine motor) that's a bit of a problem, which is common with ADHD. She can write neatly but is really slow.
In your shoes, I would probably ask for a referral to a pediatric OT for an assessment (and possibly PT if you have any concerns about other motor skills). For a diagnosis of DCD you'd probably have to see a neurologist or neuropsych.

Thank you!
I tried to get OT for him. His pedi referredhim and our insurance denied it because OT is specifically excluded in our policy when it relates to developmental disorders!!! Crazy. I know.
Professionals working with him have always said he has fine motor problems, but I never saw much of it. He never did like coloring and his handwriting is very labored. His gross motor is good.
He hasn't had any therapy or an IEP for a couple of years now amd we really don't see hardly any signs of social impairmennt anymore.

I called and got an appointment for him with the doctor who diagnosed him and noted my questions about that dx, in July. I calledhis pedi for the referral. I am hoping to convincethem of the need for further neuropsych testing to see what we are actually dealing with here.
My curren t theory is that he has some kind of dysgraphia or maybe more like an expressive language, processing problem, and he' s highly gifted. Which makes his communication with people odd, and the process of writing arduous.
I'm not sure that I would call it aspergers anymore, although at the time, that diagnosis fit quite well. He doeshave sensory seeking behavior and always has.

I probably should have posted this in the 2e forum!!

The CTD program at Northwestern that he is attending now is reallygreat for him. AND, whenI told them about his handwriting problems they were completely unfazed, saying that many gifted kids have that kind of problem. They immediately used appropriate supports. Just because I asked!. It was such a relief to have them react that way i am so used to the public school beauracracy.

An OT eval can show the presence of motor challenges or weakness, but won't diagnose or show the root cause of what's behind the motor issue, and understanding the why is important in determining how to remediate/accommodate.

Given LRS' concerns with understanding where the handwriting issues are coming from, along with wondering what things she sees are due to giftedness or other, I'd recommend a neuropsych eval. LRS, I'd suspect you should be able to get a referral from your ped given your ds' history and your current concerns. blackcat mentioned dyspraxia - our ds has dyspraxia (developmental coordination disorder), and has handwriting issues that stem from it. When our ds was younger, there was a professional who felt he was on the autism spectrum based on his behaviors in a few interactions with him. We too that question back to our neuropsych who showed us a chart that shows how symptoms overlap between ASD, DCD and ADHD and was also able to show us in ds' testing the areas that showed strongly that he did not qualify for an ASD diagnosis. So I suspect a neuropsych could help you with clarity on your ds' current situation and challenges. We've also found neuropsych evals to be extremely helpful in understanding how to move forward with addressing whatever challenges exist.

Best wishes,

polarbear

ps - LRS, we also had the same issue with our insurance not covering OT, and our ds did not qualify for OT through our school district. When we had him in private OT, the therapist offered to put together a program for him that we could do at home in order to make OT affordable. We would pay for the OT eval and a few initial visits, the OT would put together a program of home exercises, and we'd check back in with very infrequent appointments to check progress and tweak/update the program. We didn't actually pursue this, we paid for a regular weekly program - but it was an option we considered.

That is a great option. We could definitely do this. I know of an OT clinic that I would like to take him to. I will call tosee about cost and appointments. We can definitely implement strategies for him at home if someone there can help us figure out WHAT to do!

I like that idea. I am going to talk to them. Thank you.

I agree that an OT wouldn't give you the same view of the overall picture as a neuropsych. If you want some things to try quickly, though, you may find that they offer a discounted price if your insurance doesn't cover it. We also just have occasional appointments to get advice on things to work on; I think that is common.

I am really questioning at this point if it is fine motor or some kind of processing, motor planning problem, or expressive language issue.
:P
I think an OT could definitely help, but I really want a neuropsych eval as well, because I'm not sure that his diagnosis of Aspergers is necessary or appropriate anymore.

I can't figure out if his traits are simply facets of his giftedness or actually asd or other diagnosable issues. So, I don't know how to address them. Now that I have realized that he is highly gifted, and started reading up on it, it is dawning on me that he simply fits the tendancies of very gifted kids and their intensities and such. I wonder if his diagnosing doc will be open to changing his diagnosis. She seems like an open minded type of person, but I don't know her well, and her speciality is autism.
He's very intense boy, amazing memory, unusual interests, overly sensitive, and very active. He used to seem like he had social impairments and repetitive behaviors, but he does not anymore, although he is obsessive about his particular interests!

Ok. So. Update.
No going back to neuropsych. It is not approved by insurance. He got to go there to get his diagnosis (aspergers) when he was 3, and got seen once again at 4.5 years old, at which point he was doing so well, she said she didn't need to do more follow up. We cannot take him back.
??
Gosh. Apparently when we got that dx at 3yo, we weren't aware that was it. Done. Period. At that appointment they didn't even do any actual evaluations, just observed him informally and asked us questions.

I think this is what DS's neuropsych was warning me about. He said that if I had taken DS elsewhere he might have been labeled with ASD just based on superficial characteristics and that a lot of places are doing this. They are not diagnosing based on core features of ASD in the DSM. DS has gotten MUCH better over time and he has not had interventions except for speech at school. As for your DS, they should never have given him a diagnosis without doing a thorough evaluation. Ugh. I wouldn't take him back to the same person, take him to a reputable place and start over. We took DS to a major university.

You are probably right.
I'll wait a bit and try again but find someone through his gifted program.