<p>A family member was recently told by the 5 year old’s pre-school that he needs to be tested for Aspbergers.</p>
<p>The local public school allowed her a meeting, but any attempt at diagnosis was done by reading descriptions not meeting and testing the child.</p>
<p>He is friendly and talkative, but has some social issues, especially blow outs when frustrated.</p>
<p>If you’ve been down this road, how would you advise a new parent to get the best Dx & Tx for their son?</p>
<p>See a doctor?</p>
<p>No pre-school personnel should be making that diagnosis. Do they have a psychologist on staff? Then it might have some validity, but otherwise, uh no.</p>
<p>At age 5, I might start with my pediatrician and then get a referral to either a developmental pediatrician or a psychologist. </p>
<p>In many large areas, there are centers for autism and spectrum related disorders. She could seek that out but I would definitely start with the pediatrician.</p>
<p>I agree with lastminutemom196…and would add to call your school district office. Even pre-K students with confirmed diagnosis can be eligible for services through the school. And early intervention can make a huge difference. I would start with the pediatrician for real testing, and call the school district as soon as I had the results.</p>
<p>The parents should put the request for an EVALUATION for Aspergers in WRITING to the school district. Include IN the letter that the their child’s preschool suggested that this evaluation be done. They should outline the specific concerns that the preschool had about the youngster. The public school is then required to schedule a MEETING to discuss this REQUEST FOR AN EVALUATION. The parents should get some clarification about what the preschool thinks is important to learn and how this could educationally impact their child. They should ask for an evaluation to be conducted at SCHOOL EXPENSE to confirm (or not) a dx of Aspergers, and help to determine appropriate educational programming. Parents should NOT be paying for special education evaluations that the school feels are necessary. If the district says NO…tell them to get that in writing too.</p>
<p>Here is what would happen where <em>I</em> work.</p>
<p>When the parent calls us or we receive a letter with these concerns, two members from our early childhood team would FIRST talk to the parents to get the concerns. We would then schedule a time to go and observe the child at the preschool setting. We would then hold the referral meeting and because we had observational data, we would be able to contribute to it. For suspected AS, our team would first do “in house” evaluations including speech language (with pragmatics being included), a psychological eval (including some checklists that are screenings for the probability of AS or ASD), occupational therapy (if the child presents with sensory/motor issues), and an educational assessment (to determine if educational skills are on par with peers).</p>
<p>Depending on the outcome of in house evals, we would then refer out…but we have an autism program with a teaching specialist and a ASD consultant IN our school. It would take a LOT for us to need to go outside of our resources.</p>
<p>If the school says no to an evaluation…get it in writing.</p>
<p>Then they should start with their primary care physician and get a referral to either a developmental pediatrician or a neuropsychololgist who has EXPERIENCE evaluating kiddos on the spectrum. </p>
<p>Once that evaluation is complete, they should contact the school AGAIN if there is a positive DX. Ask for a meeting to present the results of the evaluation. If the district DENIED payment or an eval at that first meeting, the parents CAN ask for reimbursement for the assessment costs.</p>
<p>I find it hard to believe that there is a school district on this planet that does not have some staff or a program for students on the Autism spectrum…or a relationship with professionals who consult with the district to help them with these kiddos. There are MANY students on the spectrum…and I gotta say…every district that I know of in my STATE has such a program or relationship.</p>
<p>You should also keep in mind that most people have traits that are in the spectrum for Aspergers. My great-nephew (7 years old) went to a top specialist in NY and the woman said that she didn’t really think he had Aspergers (although he had some traits which he could outgrow) but if his parents wanted classification for free school services she would diagnose him as such. </p>
<p>In many instances the diagnosis is not a definitive thing. Meet with the pediatrician but also research specialists in your area. This is not an easy diagnosis and will take testing over the course of a few weeks.</p>
<p>Good luck!</p>
<p>To the OP…in many states, health insurance will cover the evaluations for a child on the spectrum.</p>
<p>amtc, I hear what you’re saying…a lot depends on the expertise of the school personnel. NO ONE should be making this dx (including a private evaluator) who does not have extensive experience with evaluating and interpreting the result with the ASD population.</p>
<p>His family should check to see if their health insurance will cover testing. Although this is not the case for everyone, our health insurance covered a full workup at a local hospital’s pediatric mental health outpatient unit. IQ testing, testing for various disabilities, etc. I think the cost if insurance didn’t cover it would have been around $1,000 for the full workup (but that was several years ago). So it is worth asking.</p>
<p>It is not uncommon for kids with some Asperger’s traits to be VERY bright, so they should make sure IQ testing is included in whatever analysis is done.</p>
<p>Agree that school districts are usually not the best at this type of testing, they should seek private testing. And the child’s pediatrician is a good place to start for a referral.</p>
<p>Thumper you rock. This is why I love CC and continue to be on the parent cafe. I don’t need advice on this topic but if I did (or on most any other topic) I know I would find at least a few super intelligent people with specialized knowledge.</p>
<p>Let me say that I support services for kids with disabilities. It has been interesting to watch the field of autism in the last 10 years, however.</p>
<p>There are states which have passed legislation mandating that insurance companies pay for high levels of services for kids diagnosed specifically with autism. A not surprising result of this is that some professionals seem to be handing out autism diagnoses rather freely, sometimes at the parents’ insistence, to kids who have very mild atypical behaviors, or to kids who demonstrate issues that formerly would not have been associated with autism. (I am not saying this is the case in the OP’s example.) The incidence of autism has skyrocketed in recent years.</p>
<p>This contrasts sharply with practice 30 years ago, when getting an autism diagnosis was rather difficult, and usually involved a child with certain pronounced deficits. Even more difficult was finding appropriate services for those children (and adults) with severe autism. Actually, it is still difficult to find appropriate services for (particularly) adults with severe autism.</p>
<p>have your family friend read this article, which describes many of the features found in bright kids with Aspergers
[The</a> Little Professor Syndrome](<a href=“The Little Professor Syndrome”>The Little Professor Syndrome)</p>
<p>Tony Atwood has written extensively about Aspergers and offers some of the best advise for parents ever found.</p>
<p>"Dr. Tony Attwood is a British psychologist and the world’s foremost expert on Asperger Syndrome. Asperger Syndrome was first described in 1944, and became an “official” recognized disorder included in Diagnostic and Statistical Manual of Mental Disorders only in 1994. His other book, Asperger Syndrome: A Complete Guide for Parents and Professionals (1998) has become a classic in this relatively new field. Dr. Attwood spends his time writing papers about Asperger Syndrome, and running workshops and courses for parents and professionals. His website (<a href=“http://www.tonyattwood.com.au%5B/url%5D”>http://www.tonyattwood.com.au</a>) is full of helpful advice and links for buying materials for those with Asperger Syndrome. "</p>
<p><a href=“http://www.yourlittleprofessor.com/complete-guide-to-aspergers.html[/url]”>http://www.yourlittleprofessor.com/complete-guide-to-aspergers.html</a></p>
<p>[iTo the OP…in many states, health insurance will cover the evaluations for a child on the spectrum.*</p>
<p>The trick is, getting the evaluation to be medically based rather than educational.
Our BlueShield wouldn’t cover anything remotely educational.</p>
<p>As I understand it, the preschool brought in the parents for the “meeting” and the parents then pursued it with the local school district. That was a big meeting with lots of personnel, but it did not seem to the Mom that they were evaluating her son, rather reading what the pre-school teacher said.</p>
<p>How long should a proper evaluation take with the school district? Should she call and ask her local school district to make an appointment with their psychologist? This is SoCal so I would think they would have all the required people & knowledge.</p>
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<p>That meeting was convened to determine IF they had sufficient information to do an assessment. It was NOT the assessment itself. The school district would use the infor provided by the parents and preschool to determine what to do next. </p>
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<p>There are federal and state timeline guidelines that determine this. I can only comment on MY state guidelines…I do not know CA’s. In CT, we have 60 calendar days from the date of the referral meeting to do the evaluation AND reconvene to discuss the results AND determine whether or not the child has a disability AND whether the child needs special education services AND to get the kiddo into program.</p>
<p>The parent needs to contact the Director of Special Education for the school district in which she resides. She can explain that she is making a PARENT REQUEST for an evaluation based on the information the preschool has provided to her. This director should be able to tell her the procedure…who to direct the request to and what needs to be included. This request should be done IN WRITING. Personally I would either hand deliver it, or send it certified mail/return receipt requested. </p>
<p>The district is then mandated to convene an IEP meeting to discuss the referral. At that meeting, it could go a number of ways.</p>
<ol>
<li><p>The team could determine they have sufficient info and know what they are assessing for…and would have the parents sign a written consent to do the evals.</p></li>
<li><p>Team could determine they have sufficient information but do not have in house resources to conduct an eval and agree to contract with someone to do this.</p></li>
<li><p>Team could say they don’t yet have enough information to formulate a good assessment procedure and then determine what else they need to know (e.g. observation with peers, screening of K readiness skills, etc).</p></li>
<li><p>Team could say that current information doesn’t support a special education assessment (this underlines the importance of the parents providing SUFFICIENT info to the school district when the parents make the referral).</p></li>
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<p>A great book for them to read is The Oasis Guide to Asperger Syndrome: Advice, Support, Insight and Inspiration by Patricia Romanowshi Bash and Barbara Kirby.</p>
<p>Blow outs at 5? I did not know that they are symptoms of sickness that requires Rx. However if many kids in school on some kind of Rx to zombie them down, I can see where school is coming from. Apparently this kid has escaped Rx destiny yet, which is not fair from school’s prospective.
How about just trying to deal with blow outs? Ignoring tantrums at any age has worked wounderfully. Blow outs are the way to get attention. If blow outs are ignored, eventually kid will substitute blow outs by more age appropriate behavior.</p>
<p>Also, school is going into medical practice without appropriate license and training. Maybe school should get training in area of what kind of advice that they can give to families of thier kids.</p>
<p>Thumper has it absolutely right. Your public school district will have a “Child Find” office, often within the Special Ed department, and their sole purpose is to help identify kids with special needs and to help make sure that the child gets the necessary resources AND that supplemental services (developmental preschools, OT, PT, …) are provided AND that there is coordination for when the child enters public K-12 schooling. None of this should be at any charge to the parent. (This is a federal mandate.)</p>
<p>If you have private health insurance, you can also go the route of private assessment – if you have a Children’s Hospital in your in-network coverage they may have a group that does this too. </p>
<p>It would also be helpful to find an Asperger’s parents group in the child’s area, which would both give the parents some other adults to talk with and help to quickly identify possible resources in the community, and experiences with various doctors and clinicians. </p>
<p>There may also be a group for parents of students in Special Education that could similarly be helpful, and Special Education Advocates who can help cut through the process if the school district is not cooperative.</p>
<p>There can be a lot of other issues that can lead to emotional outbursts (beyond the normal four and five-year-old meltdowns) – I hope everyone can keep an open mind to make sure that a number of possibilities are considered. </p>
<p>I was just talking with my sister yesterday – my nephew has some significant issues related to anything that changes routines – and she told me what a tremendous help the school Occupational Therapist has been in helping him find unobtrusive coping strategies.</p>
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<p>All kids have some frustration. Some kids have more than typical frustration. The key is to finding out what the issues are, what is being done to address the frustration, and the like. The preschool is right to point out the concerns. HOWEVER, these concerns are in the realms of many issues with young children…not just spectrum disorders.</p>
<p>The school district will be looking at how this child’s issues, whatever they are, impact him educationally (this includes social interactions). </p>
<p>One thing to remember…school districts are REQUIRED to review private evaluations and CONSIDER the recommendations made. They are NOT required to implement all recommendations made by private evaluators. Schools need to look at the educational implications of the disability and implement free and appropriate interventions or accommodations to help the student.</p>
<p>Oasis also has information and links to many resources on their website. It’s a good starting point to begin the process of educating yourself…</p>
<p>[url=<a href=“http://www.oasisautism.org/index.html]Home[/url”>http://www.oasisautism.org/index.html]Home[/url</a>]</p>
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<p>Please. Do not even get us started. Behavioral issues can often be a symptom of underlying neurological conditions - another reason to get a complete evaluation, to determine whether other conditions are present and that are often seen in individuals on the spectrum, such as ADD/ADHD, executive function disorder, sensory integration disorder, visual or auditory processing disorders, or other LDs</p>
<p>There are a lot of good resources at Wrights Law [Wrightslaw</a> Special Education Law and Advocacy](<a href=“http://www.wrightslaw.com/]Wrightslaw”>http://www.wrightslaw.com/)
My friends’ experiences support that if you can get outside medical/psych diagnosis it is usually faster and more thorough. Schools sometimes for whatever reason drag their feet or deny there is a problem. It not clear if the school in the OP is doing that. There are some experts in dual exception kids, high intelligence coupled with learning disabilities. If that is the case it is worth finding a specialist with that emphasis.</p>