Autism Assessment for School-Aged Children
Archived Q&A and Reviews
My 5 year old child who just entered Kindergarten is getting into a lot of trouble at school. He is being evaluated by a school psychologist who is telling us that he could be suffering from one of the autism spectrum disorders and advised us to get a medical diagnosis. I am devastated after hearing this.
We have seen several ''specialists'' since he turned three because we realized that he had some issues and we got several different opinions ranging from ADHD to Sensory Processing Disorder. I dread going to another doctor now but I want to do whats best for my child. If I get recommendations for doctors in the bay area who specialize in recognizing or ruling out Autism Spectrum Disorders, I would be so grateful. I have been researching this online and my child doesn't seem to fit into any of the five categories!
I would greatly appreciate responses from parents who have gone through similar experiences. Thank you. Sad and frustrated mom
If you want to find out if your son falls within the Autism Spectrum Disorder, I'd recommend going to see Dr. Bryna Siegel at the Autism Clinic in the UCSF Psychiatry Department. She's an expert in this field and will tell you if your son fits this diagnosis. I took my son to see her 14 years ago and even though he didn't fit it perfectly, she decided that he had Asperger's Syndrome. A diagnosis is heartbreaking news, but there is a lot of help out there. My son is now 18 and getting help to attend community college. Here's the website for the clinic: http://psych.ucsf.edu/lpphc.aspx?id=438 Nancy
our pediatrician referred us to the Regional Center of the East Bay; our experience with them thus far has been really great. They sent out an initial specialist, who is now referring us to a medical team (psychologist and pediatrician) that specializes in the autism spectrum. if your child is diagnosed, he/she will be eligible for free services. look them up on the web. anon
I know how difficult this is for you, but it's good that you're trying to get an accurate diagnosis so your child can get appropriate interventions. Since there is now a much greater awareness of ADS, there is also a tendency to over-diagnose. Be aware that it is difficult to accurately diagnose a child with an ASD in an office or clinic. Who ever evaluates your child should do an in-depth interview with you about your child's early development, focusing on three areas (social, language, and behavior). Many children with ASDs are first misdiagnosed with ADHD, and many have sensory integration disorder. However, with early appropriate intervention, they can make LOTS of progress. There is a huge range of symptoms, and no two kids look alike. Many are very high functioning and need varying amounts of support.
I have a child with an ASD, and I'm a professional in the field. I've been impressed with evaluations done by psychologists and psychiatrists at Children's Hospital, but I've found psychologists at Kaiser Oakland and Santa Theresa a little too eager to diagnose after an office visit and not enough investigation into kids' behavior in their natural environments. However, private practitioner Mansoor Zuberi, MD, in Walnut Creek has a lot of experience with kids on the spectrum and knows how to evaluate them.
Are you working with an occupational therapist for the sensory issues? Some of them can give feedback on ASDs. I've heard good things about Susan Campodanico at Alta Bates. Speech and Language Pathologists can also help identify ASDs.
You might ask for a second opinion within your school district. An IEP team can determine special education eligibility without a doctor's diagnosis if the school psychologist and speech/language pathologists are experienced in identifying ASDs.
You're not alone. Good luck! Been There
My son had similar issues. We currently see Dr. Brad Burman and are very happy with him. I highly recommend him. He is far and away the most competent of any of the professionals/physicians we have seen. Take heart: more information is better and there are abundant resources for these kids. Good luck Anon
Hi. Please contact Oakland Children's Hospital. They have an autism screening process which should be able to answer your question as to where your son is quickly. Good luck. me too
I wish I could recommend a doctor for you- our son goes to public school so he was diagnosed by a psychologist through the school district. I just wanted to let you know that going through more than one diagnosis is very common.
Our son has PDD-NOS, an autism spectrum disorder. His symptoms mainly consist of language delays. Here is his ''diagnostic history.'' Twice we were told he had no language delays. Then we were told he had Sensory Integration Disorder, but fortunately not autism. Then we were told that he had sensory issues, an autism spectrum disorder and significant language delays. Each professional had a different opinion. We took him to an autism language clinic where we were told that he was not autistic, had no language delay, but that we should take him to the pediatrician for medical advice because he was ''non compliant'' during the assessment.
If there is anything I have learned it is that it is important to ask exactly what assessment tools are being used. I felt that the more informal the assessment was the more off the mark it tended to be. The psychologist at OUSD used the ADOS- the autism diagnostic observation scale. The key word is ''observation''. I still think it is somewhat subjective. I'm not sure my son is on the autism spectrum but at least he is getting plenty of language therapy.
Have you looked up the DSM entry for Autism? You can find it on the internet. If you haven't already seen it you might find it helpful. Autism really is a broad spectrum. I would also recommend reading ''The Misdiagnosed Child,'' not as fodder for arguing with psychologists, which I have found futile, but to learn about the various disorders, how they overlap, and how one can be mistaken for another.
It sounds like you have financial resources, which is wonderful. You might want to get a neuropsych eveluation. Don't give up looking for answers. Good Luck!
In your post this sentence screamed out to me ''I have been researching this online and my child doesn't seem to fit into any of the five categories! I encourage you to trust what you know deep down and here is why.
My son started Kindergarten this year at Harding Elementary and was in a very similar situation to what you are describing. He is highly sensitive and was easily frightened by the teachers and was acting out. The school teachers and the Principal handled it extremely poorly, telling me there was something wrong with him, that he was not ready for kindergarten and that he needed to be medicated. I did the trip to the Doctor and set up Psychologist evaluations and started to believe what I was being told. However deep down in my gut I knew that he did not act like this with us at home and trusted my instincts that there was nothing wrong with my child.
The first thing I did was move my son to another public school in the school district that was on a faster pace in learning and had a calmer environment. I am happy to say that he is excelling and not exhibiting any of the behavior problems that were happening in the other school. NEVER has he acted out at this new school. Turns out he was bored at Harding and scared of his teacher and the unsafe environment they had set up for the Kindergartners. His acting out was his message to us that it was not the right fit for him. I cannot tell you how relieved we are that we chose to try another school before we were convinced by the teachers that he had a behavior disorder and I really encourage you to look at other schools for your child. If he still has the same problems at a new school then maybe you need to go down the path of looking at diagnoses but please remember that some schools seem to think it easier to label & medicate children (especially boys) than to teach using a variety of methods that encourage every child to learn.
The whole experience was one of the most stressful times in my life and it was truly the public school nightmare that I feared. I completely understand the turmoil you must be going through. If you would like to contact me off the forum I'd be happy to talk with you more - my email address is included. Carolyn
Hi there. I feel your pain. We were told that our daughter might be slightly autistic. We went and saw Anita Barrows who specializes in this. (Our doctor recommended her.) Within 10 minutes Anita told us that our daughter is not on the autism spectrum and that whatever is going on with her is workable. That was four years ago. She also told us that she has seen lots of kids like our daughter and many of them ''out grow'' their differences by the time they are ten. Our daughter is now eight and it seems like Anita's predictions are coming true. Our daughter has received help from OTs etc and is doing very well. I would definitely make an appointment with Anita. She is a wonderful person to work with. Good luck. I have been there
Oh my gosh! I can totally relate to where you are so I just had to respond to your posting. Last December we were told that my son could not continue at his private kindergarten without a shadow aide. His behavior included not relating well to other kids, hurting other kids, yelling at the top of his lung for 20 minutes, and running outside and hiding in bushes when he knew he had done something wrong. He had to sit in a chair outside the group at circle time because he said the other kids were too close. They had a teacher with him at all times to make sure he didn't hurt other kids. They had tried all kinds of things included the favorite sticker chart and nothing was able to change his behavior at school. But, like your son, he didn't really fully fit any of the disorders.
Knowing that there was no way we could afford a $50/hr aide to attend school with him I went into SuperMom mode. We consulted a child psychiatrist who observed him in the school setting. He initially suspected Aspergers but ruled that out in the private session, then tested him ADHD and that didn't really fit either. There was a lot of aggression but when he was in the right setting he could totally function fine and could fully concentrate when he wanted to. We also had him evaluated by an OT for SPD and there was no clear diagnosis there either. I tried to get an appt with Dr. Brad Berman, a recommended developmental pediatrician. but the first available was 9 month out so that wasn't an option.
I read every single book I could find on ADHD/ADD, Austism, Aspergers, allergies, and SPD. One that really blew me away was Healing the New Childhood Epidemics by Dr. Kenneth Bock...it kind of follows along the lines of Jenny McCarthy's experience with her son.
But- again - it seemed my son wasn't autistic or ADD but something was definitely wrong so I took a little bit of everything from all the books and threw it all at my son to see what might make a difference. I did lots of probiotics to work on his gut, started daily fish oil capsules (Dr. Sears kind), and was diligent about multivitamins every day. We started giving him a high protein yogurt smoothie with fruit every morning for breakfast - that was from the ADHD books. I was ready to embark on the gluten and dairy free diet as a cure but it was SO intimidating. A good friend recommended removing everything artificial from his diet - she said it had really helped with her son and his SPD. I decided to first to start with the removal of the artificial stuff would make a difference - that was much easier to handle than gluten/dairy free. We read labels for everything we gave him and made sure it was free of artificial color (including annatto); artificial flavors, artificial preservatives and artificial sweeteners. It is a lot easier than it sounds -just shop at Whole Foods and Trader Joes. I was meaning to have him tested for wheat and dairy allergies but never got around to it - would have been my next step.
Well, we enrolled him at the public school mid-year, fully expecting to be utilizing their assessment and treatment services for special needs kids. He had an amazing teacher and a wonderful school and who would have guessed - absolutely no issues. Well, okay, I think there were a couple minor issues in the first month but that was all. Now, almost a year later we have a child in first grade who completely normal and is doing fantastic - we are getting notes from the teacher saying what a joy he is to have in class. When I get those notes I think back to where we were last December and how far we have come. I even cancelled my appt with Dr. Berman because it would have been pointless. My son now says he is allergic to artificial stuff and makes sure I remember his vitamins in the morning. He will still have something questionable once in a while at a party or such and we often see a direct result in his behavior, but it is a temporary spike that we can deal with. I don't know if any one thing or the combination of all the things we did that made a difference but we are sticking with it and are thankful for every day.
Please email me if you would like to talk more about our experience - I couldn't fit everything in the space of this newsletter - even in 3 parts! eva
I know that hearing the ''A'' word applied to your child is frightening. Please know that the autism spectrum is truly (almost unhelpfully) vast and is often applied to children that have any number of challenges that impact social communication and interaction.
My son was identified as being on the autism spectrum at 3 years old. We qualified for services from our school district (OUSD) and through their language-enriched preschool program, he has made extraordinary progress. He is a smart, funny, social, quirky kid and I would not change anything about him.
In my experience, seeing someone who specializes in ASD is your best bet. Pediatricians tend to dismiss concerns unless they see things like no eye contact or no speech: the more profound markers of autism. Our son is affectionate, verbal and outgoing - very unlike the portrait of autism you're used to hearing about - and our doctor assumed for that reason that he was fine.
Also know that you are not alone. There are a lot of families who have gone through the same thing and are happy to provide support and share experiences. Remember, your son is still the same great kid he was before anyone said the word autism. Please feel free to contact me if you'd like to connect directly. Christa
I would recommend a Developmental Pediatrician. Unfortunately, seeing one could take some time. They usually have long wait lists. I know of Dr. Deborah Sedberry whose waiting time may not be as long, a few months. Also, Dr. Brad Berman is an excellent Developmental Ped, but can take up to one year for new patients to get in. Both Doctors are in Walnut Creek. Cheryl
Hi Sad and Frustrated - I'm looking forward to the responses to your message. I, too, have a (now) 6 yr old who entered Kindegarten and starting receiving diagnoses that ran the gamut. My little guy doesn't fit in any one category either and it is SO frustrating trying to get him help when I don't know what he needs or where to turn. He also has some sort of sensory disorder and has been labeled autistic to aspergers to ADHD.
I wish I had someone to refer you to but I haven't found anyone yet. And all the specialists I've seen all have different opinions. I just wanted to say you're not alone and it is scary, frustrating and sad. I wish you the best Navigating the IEP
Since autism is genetic and results in specific brain changes that can be seen on an MRI, has your child already had an MRI to confirm the diagnosis of autism? Is there another case of autism anywhere in your family? Is your child's father older than average?
I hope you can rule out autism. My friend who is an older teacher thinks that many boys are being diagnoses with borderline disorders when all they really need is more exercise and more intense exercise. Remember when boys used to ride their bikes and climb trees all day? Hopeful
The Regional Center of the East Bay, or whatever area you are in, does free evaluations for ASD (Autism Spectrum Disorders). Their clinicians are generally considered experts in the field. You can go to regional centers on google and find the one for your area. It is better to get a definitive answer than to wonder. Even if your child does not have an ASD, the regional center psychologist can give you recommendations. There are several physician's who also diagnosis ASD but I understand their waiting lists are 8 - 10 months and regional center has guidelines that allow only 120 days. Please call them as soon as possible and keep calling if you do not receive a call back from them. Ask for intake. Someone in the field
I am a speech-Language Pathologist, and I work with children who have language difficulties. I'm not experienced with autism specturm disorder or I could recommend my own therapy service, but I can recommend a couple of clinics that have a very good reputation for ''getting to the bottom'' of making a diagnosis, whether that is on the spectrum or not.
UCSF has a clinic that is designed especially to diagnose autism spectrum disorders. They have a multi-disciplinary team to assess, including an MD, psychologist, speech therapist, physical therapist, etc. I think it's important to get a correct diagnosis so you can provide your son with the help that he may need, early! Don't wait or give up.
Another place to look into is the Bright Minds Institute. Dr. Fernando Miranda is a neurologist that I work with in a hospital setting with adults. He is the founder of the institute and has been featured on Good Morning America talking about autism and how we are diagnosing children with all types of disorders that involve how the brain works, but we are not regularly doing any imaging of the brain to add to the anectodal evidence and behavioral observation. They have a Web site you can find their information and number there. They also have a multi- disciplinary team to do the assessment.
Best of luck! And do not get frustrated, you are doing the right thing by trying to find answers so you can help your son, and you will find them! Kirsten
there is a helpful yahoo email group at autisminterventionbayarea [at] yahoogroups.com christine
You got lots of good advice and referrals; I hope they help you get what you need for your son. I just have to share that our experience with Brad Berman, developmental pediatrician, was not helpful at all. We spent a lot of money for an evaluation but got no more information than we came in with. This was several years ago, but he missed our son's Asperger's diagnosis. So unless, he's gotten better at identifying the milder forms of autism, I'd recommend finding a specialist with more experience in the autism field. anon
our son had what seemed like an asperger's diagnosis last year. the first expert claimed he had it, before meeting him practically, the next few claimed he didn't and once we read more that made sense to us too. my understanding is that autistic kids do not have a sense of themselves as being like other people--so teaching them behavior by using empathy does not work, it is not a way to help them understand how to interact socially. it is a common route to teaching kids these things, and totally dead ends with autistic kids. beyond this though are a wide range of kids who are developing socially at different speeds, who are not autistic. there are signs on the buses also saying a kid is diagnosed with autism every 20 minutes. it appears to me that there is an epidemic of autism diagnoses going on--this is catching kids who need special help but also kids who are just not ''average'' socially. it appears to me that lots of kids are on medication, too, so that ''normal'' is harder to be these days. we took the approach--what if he had aspergers, and looked into programs, talked to lots of experts. having a kid learn social skills is a good thing with or without autism diagnosed. we found there were things that we could teach him to help him better understand how to interact. in particular there is a book social skills for special kids and also a bunch of jed baker books (picture books). these were useful and fun, even though the label turned out to be wrong. but the drastic measures that were being suggested to us by the well meaning doctor were unnecessary and would have been devastating to us as a family, stretching us beyond what we could handle. and all the people saying we were being bad parents by not dropping everything and taking him out of school for these programs etc...they meant well but they were wrong. it was very hard. if your son is autistic, he has lots of company. if he was diagnosed as such but isn't, probably he is just maturing slowly socially, so there are some (maybe similar) tricks you can learn to help him handle social situations and to know he *can* handle them. hang in there, either way, there is no reason to think his life won't be great! anon