Worried sick about 3YO and aspergers

Question

My daughter turned 3 in March. My wife has been her primary carer since birth. She attended daycare very briefly for 2 days/week shortly after she turned 2, but this only lasted a month or two as we weren't particular happy with the daycare centre.

At the end of January this year (shortly before she turned 3) she started 3YO kindergarten. Because she is a March child, and the end of April is the year cutoff for determining what year children go into kinder/school, she is one of the youngest in her class (the age ranges from just-turned 3 to 4 1/2).

2 days into starting at kinder, the teacher told us that she was some seeing some behavioural signs which are common with children that have mild Aspergers syndrome. She doesn't really like to socialise with the other children, preferring to keep to herself and read or paint, doesn't respond to her name very often, and sometimes repeats herself when she talks.

We booked herself a consultation with a developmental pediatrician. The first consultation was a bit of a disaster; my daughter was in a terrible mood and the only way to console her was to give her my phone to flick through photos, which she did for most of consultation. Signs weren't positive, but we tried to end on a positive note at the recommendation of the pediatrician.

On the second consultation, she was a different child. She looked at the pediatrician and didn't appear to be showing any signs that she was suffering from an ASD. The pediatrician almost went to the point of saying that a child with an ASD wouldn't have acted the way she did at that second consultation, as she was adapting to her surroundings and appeared to be showing a level of empathy (appropriate for her age) towards him. She even reached up to him at the end for a hug. This allayed much of our anxiety, albeit temporarily.

We have also been seeing a speech therapist as we are concerned about her being difficult to understand when she speaks. After the first speech therapist consultation, and when we mentioned the "A" word, she recommended for her to go to her kinder with another speech therapist to observe her behaviour. We received a report about their observations and they had many concerns, mirroring what the kinder teacher had originally told us.

Whilst she appears to be awkward socially, there are some circumstances where she is much better. She has a cousin the same age who she gets on with really well (they were playing hide and seek together the other day). She gets along very well with her grandfather on one side of the family, being very interactive with him, building blocks together, great eye contact, great 2-way communication. At home (when she's not being defiant and having tantrums) she can be great with us, although the tantrums are getting more and more difficult to deal with.

When we read reports of the way she is acting in kinder, it really concerns us and stirs up our anxiety.

When reading about aspergers and other ASDs, you often hear about "red flags" which are certain behaviours to watch out for which could indicate a problem. There's no doubt that she is showing some of these red flags in certain social situations, but there are other times (in areas she is more comfortable in, or people she is more comfortable with) where she seems like she could be a typical (albeit shy and reserved) 3YO (call them "green flags" if you will).

Does this sound like the behaviour or a neurological "normal" (I hate to use the term) child?

Update

I didn't originally list all of the behaviours that the speech pathologist was concerned with, but some others that the speech therapist observed while she was at kinder were:

• When other children try to engage with her socially, she ignores them and walks away
• Doesn't ask for help when needed
• Randomly starts doing counting from memory (rote) (she loves numbers, but does have other interests)
• Talks in a sing-song rhythmic voice (high-pitched)
• Kept engaging in a certain activity when other children had finished (head-shoulders-knees-toes dance)
• Avoids eye contact with other children
• "Reads" books with her finger, and will turn through every page of the book running her finger along the words

Except for her odd voice intonation and love of numbers, I'd say some of her other behaviours can change based on the situation or circumstance, e.g. with her 3YO cousin who she seems to connect to better.

Answer 1

I am not so sure this is an answer, and I am not a medical practitioner, but you are drawing conclusions based on tiny bits of information, much of which is conflicting. Sometimes your daughter displays behaviors that are possibly indicative of a behavioral condition, and sometimes she behaves in ways that are absolutely "normal." The only real issues you describe are some problems with speech and some defiance/tantrums, both of which are not unusual in a 3-year-old. Other behaviors, like sometimes keeping to herself, repeating, sometimes not responding to her name, are not problematic at 3 years old, and are also age-appropriate.

It might help to keep a journal of behaviors you consider odd so you have a realistic picture of how often these behaviors happen in order to gain perspective. You may find that she doesn't respond to her name three times in one day, but she does respond 12 other times. Maybe she keeps to herself in one environment but is social in another environment. Watch for patterns and for events that might trigger certain behaviors.

Your daughter is in school for the first time, and this is stressful for someone so young. The little things you are seeing, the tantrums even, may just be her outlet. Until you can establish a pattern of behaviors or until any particular behavior becomes worrisome on its own, you might just observe and try not to worry so much.

Keep breathing!

Answer 2

This is not a direct answer to your question but a suggestion on how to gather more data.

If you don't know any of the other kinder parents, enlist the teacher's help in identifying sympathetic parents.

Approach them and ask for a playdate (one at a time). Discuss with them the issue and that you want to see if your daughter is just overwhelmed by the number of children. You want to try to foster a relationship/friendship with one or two other children as a bridge.

Have the other parents prepare their children by saying that your daughter is shy and may not want to play, but we'll try. Have them bring their own toys so that your daughter doesn't feel that her stuff is being taken. Then you can encourage show-and-tell, trading, etc.

Keep it relatively short, repeat if there's not a complete meltdown, and be prepared to cancel if your daughter's not in a good mood that day!

I'm divided on having the cousin there as well, but I think not--too distracting and too easy for them to go off by themselves.

Answer 3

Not a parent, not a psychologist or anything. But i've shown signs of asperger since i was a young child as well. In the textual record of my school behaviour even in the first grades, i can still see myself today. I changed, but in the core i am still the same.

I would monitor your childs behaviour and not rush to premature conclusions. She may simply be introverted, which makes someone less socially interested by default. Considering that most people i know who are born in late autumn to early spring are introverts too (possibly due to low happyness hormones, due to lack of sun, during pregnancy at a significant phase for brain development) and are just more of thought than people persons.

Mild aspergers can be good - As you probably already read a significant amount of them turn out above average intelligent. So you should not be all that worried. In case mild aspergers/introverted is the case - Don't force your kid to be overly social. Life has to offer many more interesting things to learn about than listening to all that pesky gossip.

My answer might not help you - But it's an attempt to show you, that even if your assumption is true, there is no actual reason to be worried :)

Answer 4

We are in a similar situation, except that we haven't talked with a pediatrician yet. My related question (At which age does it make sense to see a professional when suspecting Asperger?) was inspired by fear of exactly what has happened to you.

From what I have read so far, it is common that Aspergers symptoms are not always present, i.e., the child sometimes appears "normal". Furthermore, Aspergers is particularly hard to diagnose in girls.

So what we did is that we filled out a few tests (like the ASAS) and noted examples of behaviors both typical and untypical for ASDs, and we will have them with us when we go to see the doctor. This way we don't have to rely only on the child's behavior on that day, because, as previous experience shows, it is quite unpredictable. We'll see how this works out...

Answer 5

I have a child with a neurological difference (Tourette Syndrome and ADHD; he is 13 now). When we figured it out and got the official diagnosis, it was really helpful, because (1) it enabled us to learn about his differences and understand him better; (2) it helped us explain his differences to the school. Yes, there was a period of fear, but mainly, receiving the diagnosis meant we were given the key to understanding our child.

In general, I think a diagnosis is mainly useful as the beginning of a process to create a roadmap for helping your child make his or her way through life.

My son will be the first to tell you ways his differences are strengths. And it's all true.

Aspergers strikes me as a type of neurological difference where this strength-based way of looking at things is relatively easy.

I can relate to the anxiety you are feeling. Unfortunately it is leading you to take a daisy-petal-pulling approach. Similar to "She loves me, she loves me not, she loves me, she loves me not," your note-taking, and worrying, are taking the form of "She's Aspie, Aspie she's not, she's Aspie, Aspie she's not."

Her neurological differences may turn out to be significant or subtle as she matures, we don't have a crystal ball.

I suggest the following as a more productive way of journaling about your daughter's development:

• in what ways are her neurological differences getting in her way? In the way of family, peers and teachers?

• what environmental changes and what coping skills (on her part and the part of others) are being tried, with what results?

• what challenges are you, as parents, facing, and what types of support are helpful for you?

• don't forget to note down both some subtle and spectacular ways you derive joy from your daughter.

---

P.S. The devotion and thoughtfulness I could see in your post suggest that your daughter is lucky to have the two of you in her corner.

Answer 6

Don't be worried - be glad it'll be found soon if it's there!

I'm a woman on the spectrum, and I wasn't diagnosed until I was 22! If I had been diagnosed sooner, I probably wouldn't have had to have a depression and develop anxiety disorder.

To live with autism isn't that bad when you are treated as the person you are - autism included. It's only bad when people expect you to be "normal".

Feel free to email me with questions if you want to know more about being a woman/girl with autism.

Answer 7

My daughter (2 1/2y) has it, and the sooner the better for intervention. Her speech was very delayed and we started teaching her sign language to defuse frustration, but then she was doing full "four year old" sentences (at just 2 1/2) within just a few months from four half-sounds; the paediatrician was amazed. She is a typical aspie; the sooner you intervene to help her the better her adult outcome will be. She's a demon with numbers and calendars, can count to 40 at 2, forwards and backward. She's trying to read already

There is a book called "AsperGirls" you can get from Amazon; I recommend it to you. We also got her some pink child's ear defenders, she puts them on when it gets too much stimulation wise and she needs a time out.

Restaurants are do-able if we take a mini DVD player and let her eat the rest on the way home.

Its easy to read too much into behaviour, 3 year olds are only just starting to get social developmentally anyways. But as an aspie you can encourage interaction by giving her a focus; we paint her fingernails so she can show people and so interact. They prefer adults and animals as kids do random noisy things that frighten them.

Answer 8

As someone with Asperger's Syndrome, and currently finishing his first degree, I am glad to see people taking the road less traveled and actually seeking information early on, as too many hide from negative signs.

I was diagnosed late in High School(2001), and wish I was diagnosed sooner.

It is always a good idea to test your child to see if anything is abnormal in development, but in my view sometimes the obsessing over "flags" and "milestones" can start a bit early.

I am not sure if there are any guidelines for testing a child for A.S., as far as what age to start goes, here is my advice: If you feel something is wrong, if you have a nagging suspicion that the social/cognitive development of your child is not on track, seek advice. Do not always go with the first answer you get however. Do research on your own as well.

Answer 9

Woman tend to be more social than men. This same trend carries over with the ASD spectrum and Aspergers. Jokingly speaking, if the average man is a 5 out of 10 in social skills, the average woman a 7 and if autism deducts 3 points from your social stat, an average autistic man is a borderline recluse (2) but an average autistic female may just be that quiet girl in Chem class (4).

This, some have suspected, has lead to an under-diagnosis in women. You can Google "female autism" and you'll get articles like "Autism—It's Different in Girls" from Scientific America. Because we tend to diagnose men, the checklist of criteria overly focus on men. There are fringe groups that say we should have gender-specific definitions of ASD and Aspergers because woman fall through the definition crack.

With the prelude over, time to be more exact to your question

Does this sound like the behaviour or a neurological "normal" (I hate to use the term) child?

(Typical/Atypical or Inferior/Superior are the preferred adjectives, the former being the correct scientific terms.)

I'd personally say 'no'; however, the experts you associate with and who interact with your child are more knowledgeable than randoms on the internet that only hear your worst fears :) Even a male autistic man won't always exhibit all the key indicators to someone not trained to recognize them and it is quite common for women to miss even more. So it is not the amount of key indicators absent that matter but the amount present.

If your daughter is found to have Aspergers or any ASD, I'd not worry about it.

Being autistic does cause me a lot of grief and pain but mainly because the world is harsh. I feel deeply for people in wheelchairs and perhaps this analogy would help you better cope if your daughter has Aspergers: imagine if the paediatrician suspected that your daughter was a paraplegic. You'd be shocked and surprised. You'd look at all the red flags, realize some you can check off and some are iffy. You'd think about her future, worry for a bit, but realize she can still live a fully-functional life, smile at jokes, laugh, play some sports, go to school, and one day perhaps have an independent life and family. The only issue is that the world is not designed for her; daily she'll be ever subtle reminded that the world often presumes that people have two legs that work a certain way. But other than the world being a cold and harsh place, she'll be fine :)

(Writer's note: I'm casually using the terms ASD, autism, and Aspergers interchangeable. Partly for convenience and partly, partly because it wasn't until recently that Aspergers was removed from the ASD, and partly because they are close enough that women often get misdiagnosed for years in one category when they should be in the other.)