Our younger dd, six years old, has been evaluated by a neuropsychologist and now a neurologist. Both did extensive testing, but she has not had a MRI or EEG.

Her symptoms -- clumsiness and SPD, mostly vestibular. She grew almost five inches in the past 12 months, and she is overweight. The pedi said that she is putting on weight because she is going through a big growth spurt. We just started working with a nutritionist. Her nutritionist also said this sort of weight gain pattern may be a sign of celiac. She gets OT for her SPD three times a week and was recently released from speech because she met her goals.

Her IQ -- 160 WJ-III cog for fluid reasoning, and 147 GAI for WISC (but the tester did not do extended scoring and won't give me the raw scores though she met the criteria for extended scoring under the testing guidelines)

Both the neurologist and the neuropsychologist said that our daugther is *not* on the spectrum, and that she has none of the core features of pervasive developmental delay. They said she needs to lose some weight and get past this growth spurt and her vestibular issues will improve, and that she feels offbalance because she is growing so fast.

The neurologist and neuropsych both said that our daughter's issues are caused by asynchronous development common in gifted children.

But she just started public school last week (at her inistence -- we even offered her cash or toys not to try school but she was determined and very insistent) Her new teacher, after one week of school, says that our daughter's behavior is similar to children she has worked with that had asperger's or autism.

The other thing that concerns me is that the nurse practitioner who worked with the neurologist said she thought our dd should have a MRI or EEG, but the neurologist came in after he read our daughter's IQ scores and said it would not be necessary because he felt there were other explanations for her symptoms.

Is it possible that because she is a girl with high scores they are missing the signs of autism or PDD? It seems that girls with asperger's are rare, and girls with scores like our daughter's scores are also rare. They may not see it very often, and therefore think that her IQ scores are the underlying explanation. I want to relax and feel reassured and yet, the teacher's words are making me worried.

Thank you for your help.

Also - she was homeschooled for kindergarten and just started first grade.

Treasuremapper, what are her social skills like? Can she carry on a reciprocal conversation on a topic that's not a core interest?

Are the specialists you saw people who see a lot of Asperger's, especially in girls? Our son's AS was missed for years by lots of doctors, and it is even harder to get a bright or gifted girl diagnosed.

You might want to visit http://www.aspergersyndrome.org/Home.aspx -- there is a lot of expertise both on the website and on the discussion forum there.

DeeDee

Do you think your daughter needs more services right now?

Are you happy with the OT? Is she showing improvement?

If she was to receive another diagnosis, what accommodations could the school provide? Can your OT make some recommendations to the school? Is the school aware of the SPD?

Does your child connect well socially to other PG kids?

My dd is 8 and also has SPD/vestibular issues. Her school tried to peg her as aspie when she was a new 1st grader and bored to tears. In our case, we decided that the neuropsych, ped, and OT all saying no to autism was more compelling than the school's theories. DD's issues have lessened with her growing comfort in school. OT and physical activity help a lot.

I don't mean to belittle aspergers/autism,nos-pdd, but I think if you go to enough specialists, anyone unique can eventually get a autism-like diagnosis. I'm not sure that diagnosis is going to helpful to all people. Then again, if your gut is saying investigate more, then by all means go for it.

Have you looked at this checklist?

http://www.aspergersyndrome.org/Articles/The-Australian-Scale-for-Asperger-s-Syndrome.aspx

You can see that some characteristics (like motor clumsiness) overlap, and the teacher may be focusing on those.

I would be more likely to trust the judgments of the neuropsychologist and the neurologist over the teacher's. Still, if you go through the checklist and find that the description strongly resembles your DD, I think it would be worthwhile to investigate further. Girls, especially very intelligent girls, are underdiagnosed for Asperger's because they are able to compensate for their weaknesses. My personal opinion is that a diagnosis is more than a label, it is a path toward understanding and helping your child.

Asperger's is at base a social skills disorder (with a collection of other associated issues).

If she is socially fine, good conversation skills with peers, can understand and articulate thoughts about others' feelings, Asperger's is a long shot. If these are problems for her, it's possible (not guaranteed, but possible) and worth investigating further.

DeeDee

I am afraid we have been through the mill, and so I have become rather cynical of teachers over the first 5 years of little'uns school career. Anyhow, sorry if you've heard it all before, but here is just the latest chapter in a long saga:

We went to the school to complain about serious bullying - the meeting took an almost immediate right turn into discussions about little'uns "problems". We left with no bullying resolved but with a request from the school that we engage a Clinical Psychologist to rule out Autism or ADHD. Luckily we had already been looked after by an EP who went semi-ballistic when we contacted her. The real problem is that the school either can't cope or doesn't want to cope with a child with an active alert mind who is desperate to contribute, out of boredom maybe - they want little compliant soldiers who sit quiet, have no vivacity, don't contribute. The school would rather rubbish my son than tackle a serious issue (Still unresolved by the way)

Anyhow, be aware that, in my humble opinion informed only by bitter painful experience, some teaching "professionals" (sic) are more happy to point the finger at your child regardless of how harmful or hurtful this is than to do the professional thing or what most of us would consider the right thing.

that's the end of my rant - I hope it helps

I have had a very intense week. Thank you for your post, Raddy, and thank you, all of you, for your insight.

I was called into the principal's office yesterday, and was surprised to find the school's autism specialist was there as well. They almost convinced me that our daughter has autism.

However, here is the thing -- dd is socially engaging, even charming and witty, when she likes people. She has not yet learned to be polite and then move away as quickly as possible when she does not like people. Instead, she is likely to say things like "would you leave me alone?" :-( We have worked on this, believe me.

She is in the gifted class in first grade.

The other thing that I noticed is that the "homework" for last week included learning the letters "r" and "s" with many, many exercises about "r" and "s." You know, the sounds those letters make, with pictures of objects and animals that start with the letters r and s. They are also working on using dots to count to ten.

Our daughter read Harry Potter by herself by the middle of kindergarten and is working on multiplication, including simple order of operation math problems on her own iniative.

After the meeting yesterday, I talked with her neuropsychologist and the neuropsychologist said that she absolutely does not believe our dd is on the spectrum. The neuropsychologist asked if they understood at all how gifted she is, and I said that during the meeting, the principal told the autism specialist that "mom says daughter is bright." The neuropsychologist said taht they just may not understand and that she will talk with the principal.

They will be able to offer more services, like social skills classes (she certainly could benefit from those) and more support for her spd, if she is diagnosed as autistic.

Do you think she needs the services they are offering? If so, you may want to weigh the option of taking their assessment for what it's worth (services) and letting them give her an IEP. There is no such thing as a permanent record, and the school's assessment is not an official diagnosis.

Of course, this would depend on how it's handled. You don't want them telling her she has a disability that you suspect she doesn't. But if they're telling you that she needs help with some skills, and they're offering that help, I'd consider it an option.

What testing did the neuropsych use to rule out autism? Did he give the ADOS and Conner's rating scale? In our experience, no matter how gifted she is, if her social skills are impaired in spite of your teaching and effort to work on them, it can be a sign that something more complex is going on. In your shoes I might even seek a second opinion privately to tip the balance between what school is saying with what Dr. Neuropsych is saying.

Every professional comes at a child with a "take" on things and a skill set for seeing certain issues and missing others. They ALL have blind spots. At some point you will have to choose which path leads to the best outcome.

Tough situation; but you're on top of it and I know you'll make good choices for your DD.

DeeDee

Edited to add: oops, I see now that you already have two opinions from outside...

It's so hard to imagine a perspective where the schoolies are doing all this in good faith, and yet, I think that they are. We are used to Harry Potter in Kindy kids, and may even have a few nieces and nephews who are like this as well. Our friends may have kids that are like this. But they are really really really rare. When you consider how many parents don't even bother to send their kids to school in the first place - then lots of educators spend their whole lives without ever seeing a kids like this!

Things may change for the better very rapidly once that phone call is made. I sure hope so!
Grinity

She did not have the Conners or the other test you mentioned. I will ask her neuropsychologist about those tests when I call her this morning. She had a ton of other tests, two pages of other tests, but I did not see those on the list.

Sadly, she had a meltdown in class on Friday and hit another child.

It was the end of the second week of school. Our daughter refused to work on the letter "H" any more. The substitute said she had to do so, and our daughter began to cry. When she started to cry, a little boy, the same boy who called her fat the week before, started mimicking her crying.

The girl next to her started to laugh at her, and our dd took her pencil and poked the girl next to her in anger. (this series of events was described by the substitute and our daughter and was very consistent, so probably pretty close to what happened).

After that, our daughter was sent to the principal's office to work it out with the girl she poked with the pencil.

She is insisting on going back to school, but she was sick today with a bad cold so I am keeping her home.

The homework for the weekend -- the numbers 11 and 12.

Treasuremapper, FYI, the ADOS is a social interaction and communication test that helps determine whether a person is on the spectrum or not. If the neuropsych didn't give it, I'm wondering on what basis they made their judgment.

DeeDee

http://www.agre.org/program/aboutadosg.cfm

DeeDee, I just looked it up. I will definitely ask her why she did not administer it.

WISC-IV
Conners Continuous Performance Test (sorry, she did take it)
Wisconsin Card Sorting Test
Wide Range Assessment of Memory and Learning (WRAML-II)
NEPSY-II
Grooved Pegboard
Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI)
Social Responsiveness Scale
Behavior Assessment System for Children (BASC -II)
Review of available records
Clinical observation
Clinical interviews

Previous Testing through education department at local university
WJ-III, cognitive and achievement
GARS
BASC

But I do not see the ADOS!

I looked at the Australian scale linked above. http://www.aspergersyndrome.org/Articles/The-Australian-Scale-for-Asperger-s-Syndrome.aspx

Her total score was 32 -- the high scores had to do with gross motor skills -- 9, 23, and 24 gave a full 18 points, and the remaining 14 points were spread over the remaining 21 questions, mostly zeros and ones and an occasional two.

She had several on the unusual characteristics under (a) ticked off, mostly noisy crowded places and articles of clothing (she has sensory integration disorder, mostly vestibular and auditory, so this is not a surprise).

I also checked off (c) - lack of sensitivity to low levels of pain, but she seems more sensitive now than she did as a baby.

Thank you for your help.

Treasuremapper, the other thing that can be very useful is the Vineland scale of adaptive behaviors. That can be very telling-- it pinpoints areas where a person is not on target with social, communication, and basic life skills.

The testing your neuropsych did doesn't seem to me to be well targeted for confirming OR ruling out autism spectrum disorders.

DeeDee

Thank you so much, DeeDee. I will ask her about those tests when I call her today.

If your child has been reading Harry Potter and is now in a class learning the letter H and numbers 1-10, it must be torture for her to sit through the day like that. Her brain must feel numb and it must be very frustrating.

I don't know how much a person can stand that...

It is great that you are doing what you can to help your DD. Keep at it. Don't give up. Come back here to vent if you need to. Best wishes!

I'm waiting to hear when the Tester is calling the school to protest the poor fit between your daughter's learning needs and the classroom.

Are there any alternatives to this particular school?

Sorry to hear about the pencil poking.
Grinity