[QUOTE=snoopywoman]
OOPS
Anyway, I still think the evaluator was over-doing it and at that age it is SO difficult to get a firm diagnosis. I would get a second opinion - but maybe wait a few months. In the meantime, you can certainly get Early Intervention involved and start getting help for him!
What kinds of things are you noticing that cause you to be concerned? Or did I miss that too?
I"m not sure I said anything about my worries. :)
He doesn't respond to his name. I can have him on my hip and constantly call him and he won't turn. He didn't babble until 13 months old. He didn't say "hi" until just 2 weeks ago. He still hasn't used "mama" or "dada" in a meaningful way. If someone says hi he will just look away. He doesn't ahve a lot of facial expressions. He doesn't copy facial expressions except a smile. He has some eating issues in that he is very picky. I don't know when he is hungry or thirsty because he won't tell me. The only time he asks for something is if he sees someone eating. After about a minute of playing he will just start throwing the toys. He doesn't ask to be played with. When playing iwth him there isn't a lot of vocalizations or interaction. He learns a word then drops another. He hates social games and refuses to participate. He is extremely shy and nervous around strangers it is very abnormal. He won't imitate sounds. Doesn't always use words that he knows in appropriate times. Doesn't show a change in facial expression or attitude if someone is hurt. He doesn't seem to understand that crying means something.
I'm sure there is more but most of what I remember that is pretty consistent and spoke that something is wrong to me. :)
[/QUOTE] [QUOTE=snoopywoman]
I would get a 2nd opinion as well and also ask how much experience she has in administering the ADOS - how much training she has had and how many times she has done the specific module your son took (which I'm assuming was Module 2?).
[/QUOTE]
She is actually a licensed clinical psychologist specializing in developmental neuropsychology. I chose the MIND institute over the psychologist through the regional center because I thought it was the best choice. I have to wait another 12 months to redo which is what was suggested to me by the lady who adminstered the test.
any clinician worth their salt would not just rely on "scores" to make their
dx. The screening tests are just one of many tools used to evaluate a child's
behavior. The "red flag" for me is talking to you about her diagnostic
dillema. It's wierd and unprofessional.
JMO.
I do reccomend developmental pediatricians, as long as they specialize in
ASD, their evals seem to be more comprehensive than just administering
tests.[/QUOTE]
That is what I thought. She specializing in this and is involved in the clinical studies at the MIND. On the questionnaire and another exam he scored on the spectrum. She wanted to fully rely on ADOS. I was surprised.
[QUOTE=NorwayMom]The fact that he imitated her is a great sign, although it doesn't mean he isn't on the spectrum.
Seventeen month olds aren't necessarily very easy to test, I'm sure, but I think she crossed the line when she used that bunny to get his attention while saying his name.
Contact your local school district or 0-3 program, and get your child evaluated there, so he will get help for any delays he might have.
Good luck with everything.
Thanks :)
He is actually already receiving EI services. The regional center was the one that set this up because he scored to be at risk when using the M- CHAT.
[/QUOTE] Sarah scored right under the radar for autism on cars, and gars..and got a provisional autism label through the school~it was only when I had her diagnosed by developmental pediatrician privately did we get a diagnoses of autism. She never answered to her name or asked for anything..no mama till after 3 yrs. old and very picky eater..she didnt have repetitive behaviors and very passive so it was hard to analyze her..she also test well receptively but fails expressive..Best of luck and hope you can get a second opinion soon! Follow your gut:)That is not the protocol for testing. Before I even got to your description ofNo - they are not supposed to "help" much. Although if it only took one prompt that is much better than a lot of kids. I would not score that as advanced pretend play - especially for a 4 year old. My 3 year old could have fed the bear at age 18 months if you asked her to. I'm not trying to be glib here - just to give you an example as to how inaccurate I think this evaluator was. Having had an awful experience with an evaluator on my ds' 1st ADOS, I empathize. However, we were fortunate that she didn't know how to do the test and it worked in our favor - she way OVER-scored him.
I would get a 2nd opinion as well and also ask how much experience she has in administering the ADOS - how much training she has had and how many times she has done the specific module your son took (which I'm assuming was Module 2?).
This discussion of ADOS reminded me of the Newsweek article I posted last week or so. It's about a Kennedy Krieger study of 107 high-risk babies (ie siblings of autistics). They tried to see if it's possible to diagnose autism as early as 14 months.
They used the ADOS (among other things), although it's not mentioned in this particular article. And it wasn't like the researcher could just sit back and let the scores speak for themselves -- she actually had to re-train her eyes to see how autism looks at age 14 months, despite having devoted her entire professional career to diagnosing autism. If even she has difficulty, who wouldn't?
Here's what she had to say:
"I had to learn to retrain my eyes when I started to see the 14-month-olds. I thought autism at 14 months was going to look like autism at 36 months, the age at which people normally diagnose it. It's the same flavor--the social system is disrupted, the communication system is disrupted. But it's different in that it's not as pervasively disrupted. What I mean is that at 14 months, you can get kids with autism to give you a beautiful response to peekaboo. But you can't get the child to engage with you around more novel, new activities. At 14 months, you see more flickers of interaction. They were doing some looking at people and smiling."
Here's the link:
http://www.msnbc.msn.com/id/19588967/site/newsweek/page/0/
OOPS
Anyway, I still think the evaluator was over-doing it and at that age it is SO difficult to get a firm diagnosis. I would get a second opinion - but maybe wait a few months. In the meantime, you can certainly get Early Intervention involved and start getting help for him!
What kinds of things are you noticing that cause you to be concerned? Or did I miss that too?
"Current research indicates that the ADOS algorithm is not sufficiently specific for kids with nonverbal age equivalents under 12 months (and should be interpreted with more than usual caution through 18 months age equivalents)."
http://portal.wpspublish.com/portal/page?_pageid=53,84992&am p;_dad=portal&_schema=PORTAL
So, the ADOS should definitely only be one tool that the evaluator uses. I know several people who got moderate/severe dx at 18 months who ended up with much less severe dx by 2 and vice versa.
The fact that he imitated her is a great sign, although it doesn't mean he isn't on the spectrum.
Seventeen month olds aren't necessarily very easy to test, I'm sure, but I think she crossed the line when she used that bunny to get his attention while saying his name.
Contact your local school district or 0-3 program, and get your child evaluated there, so he will get help for any delays he might have.
Good luck with everything.
I'm fairly new here and am having a heck of a time sorting things out. I already have a 4 year old autistic son. He is high functioning and has been diagnosed since 3. I am also in the process of getting my youngest diagnosed. He is 17 months old. Today we went to the MIND institute. I'm lucky enough to live in the area so it was an easy commute. ;) They did the ADOS and a couple other diagnostic tests on him. After about a half hour of waiting for her to come back she informs me that she is having a diagnostic dilemma. She doesn't feel that his scores are solid enough to produce even an ASD diagnosis. He scored a 5 and I guess you need at least a 7 overall. In communication he scored on the spectrum but in play he didn't. So he is a bit scattered. On the parent interview there was an indication of being on the spectrum but on the questionnaire it didn't. She says that she believes that he has a social anxiety disorder and that he may have apraxia. This may be true. I see some things taht indicate her suspicion, however, I am a little concerned on how the ADOS was conducted. I wanted to get some opinions. I could be totally wrong in my thoughts so would love to hear someone to clear things up for me. :)
When she produced some cups and some spoons along with a bear and a doll he just sat there and tried to throw them. Then she showed him how to eat with a spoon and he repeated what she did (which I know is great) then she asked him to feed the bear and he put his head down. She got his attention and showed him how to on the doll and he copied. She scored that as advanced pretend play??? Thought that was a bit off. Then she went behind him and said his name, he didn't respond, then she turned on a robotic bunny and said his name so he turned. She wrote that down as responds to name. HUH? There were other things that I thought was a little unfair. She would ask him to do something he would just look blankly then she would show him and he would do it with prodding and he would get credit. Is that how they are supposed to do it?