Pre-Diagnostic Evaluation

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Hello all,

I come here because my son, my wife, and I are pressed for closure regarding his behaviour. My son, exhibiting dozens of signature AS traits now is considering the possibility that he might in fact be on the spectrum. He was never given services, because nobody ever "put the pieces together", if you will. Alhamdul'Illah, he has adapted exceedingly well to society and now is on track to enter the workforce. We simply seek understanding regarding his development, and why he behaved the way he has over the course of his life; why he was subjected to teasing; why he acted so differently. So, we do not seek to be granted any services, nor do we desire to get him help, as he has proven to us that he is exceedingly capable to lift up himself, and overcome his own obstacles (coupled with the fact that it is too late in his education for services to to any good).

Throughout his life, from his early infancy to now (his junior year of high school), his behaviours were seen merely as "oddities", as we were ignorant to most mental health issues. However, technology has advanced significantly over the course of his life, and because of this, we were introduced to information regarding autism and its related disorders. When he was born, we thought of mental disorders as a child being a complete shut-in and invalid (similar to the hunchbacks of old times). Now, with our new knowledge, we can compare his behaviours with the conditions documented by science, and have an exponentially greater respect and understanding of those unique and special individuals in our society.

Having done a very thorough reading about these conditions over many months, and doing online examinations in his name, we have identified Aspergers' Syndrome as strongly correlating with his behaviours. When first reading an article about the symptoms, I felt as though my son had written it! Together, we have done several online tests for AS in his name (taking the results with a grain of salt), and all of them stated that he is most likely AS-positive. I understand, however, that Asperger's has been removed as a diagnosis in the most modern references, as the DSM V has incorporated AS, Retts, and others into the broad Autism Spectral Disorder. Disregarding this, we still feel that the Asperger's diagnosis strongly fits, in almost all regards, to our son.

However, as you likely noticed, I used the word "almost". This brings me to the title of this discussion. Before spending the money it would take to get him tested, we wish to ensure that we are not presuming too much and rushing to judgement. There are several traits related to Asperger's which my son does NOT display. Thus, I come here, to a site full of people very well versed in Asperger's and the Autism Spectral Disorders, and a society in which a majority of you actually are affected by this disorder, in order to get preliminary words before getting into the rigorous diagnostic and examination process.

Before going through the list of pro-diagnostic symptoms, I would like to relate the much shorter list of anti-diagnostic normalcies. This list, although shorter, is equally convincing against diagnosis as the former is for diagnosis. In other words, the few symptoms he does not show compels us to believe he is not an "Aspie" with equal weight as the list of expressed symptoms compels us to believe that he is. We also understand that, without professional review, it is extremely difficult to be certain about these kinds of issues. We refuse to make any premature judgments, nor any self-diagnoses, because we respect the integrity of the Autism diagnosis, and recognize that such a diagnosis is not a toy.

However, with this post, we simply intend to get a preliminary understanding as to our situation, and whether it is safe to rule out Asperger's, whether another condition is more likely, or if you feel that he is most likely neuro-typical. We also understand that many Aspie traits are common in children, and in isolation are not definite indicators of anything. For example, I understand that toe-walking is not all that uncommon. However, the sheer quantity of AS traits, and the fact that they persist in him to this day, is concerning to us. So, I do not wish to come off as demanding an answer which you will be unable to provide -- I understand that at this stage, what I will hear is speculation at best.

(On a side note, before posting two large lists, I would like to apologize for my wordiness, as English is not my first language). And, because the lists will take up much space, I might as well send my sincere appreciation, many thanks, and regards to all those who will reply to this message. Truly, I am thankful to you all for the openness you give, and the invaluable information you provide.

Sincerely Our Family,
Mr. Lilam Jazeefa al-'Aqeed,
My loving wife, and devoted mother, Mrs. Fatimah Sayeed al-'Aqeed bte. Umar
and my Son, the embodiment of my hopes and prayers, Mr. Uthman Jibreel al-'Aqeed

______________________________________________________________________________________________________________________________

The symptoms which are not shown are:

-No motor developmental delays
-No trouble with empathy / sympathy
-No choreiform
-No apparent hypotonia
-No apparent difficulty reading faces
-No pauses / breaks in speech
-No stuttering / shaking
-Very expressive voice
-No hand flapping per-se (only hand clasping / whirling)
-Eye contact intermittently
-No interruption
-Very little conversation-hijacking
-No echolalia


With regards to his aforementioned social improvements, he has become comfortable enough to establish new friendships, and no longer experiences school-related difficulties. He has come out enough to even begin to tutor others around him.

____________________________________________________________________________________________________________________________________________


These absent symptoms, as you can see, are very rare in the case of a positive Asperger's diagnosis. However, I will now show you the significantly longer, and equally powerful, list of symptoms he does exhibit. Also note that we have a family history of Autism; my first-cousin was profoundly autistic (peace be upon him).

These are:


-Stress upon environmental changes (cried for days because a wall was repainted)
-Extremely few childhood friends (fewer than 10 from grades Preschool - 12)
..........^Teasing and bullying in school
-Constantly compulsively categorizing / making lists
-Tensing muscles
-Lack of gesture reciprocation with peers
-Listening to the same song in excessive loops
-Songs constantly stuck in head
..........^Constant humming / singing
-Excessive interest in mathematics and the sciences
-Pacing / Rocking / hand clasping / leg bouncing
-Repetitive obsessions for years on-end
-Social isolation / Little interest in peers
..........^Spends almost all free time in our home, rarely going outside by his own free will
-Frightened by loud noises
-Advanced vocabulary by early age
-Lack of athleticism
-Lining up objects / ordering
-Speaks in tangents
-“Tuning out” / staring into space / daydreaming
-Memorizing things compulsively
-Collecting things compulsively (Vacuum cleaners / Playing cards / Puzzles / Memorabilia etc.)
..........^Would throw tantrum if not allowed to
-Spinning wheels repetitively
-No participation in preschool : simply paced angrily in corner.
-Lack of respect for hygiene
-Threatened to burn down school on numerous occasions
-Resistance to change
-Intense dislike of parties / social gatherings
-Clumsy / Trouble with balancing
-Toe walking (continues to this day)
-Very acute hearing
..........^Difficulty filtering background noise -- constantly asking “what?” in cafeteria, et al.
-Delay in adaptive skill milestones
..........^Pacifier addiction (up to 5 years old)
..........^Stayed in stroller till 11
..........^Did not sleep in own bedroom until 12
..........^Delay in toilette training
-Refusal to go into play area (5/6th grade), preferred to sit all alone in lunchroom.
-Refusal of / disinterest in playdates
-Hoarding
-Lack of social awareness
..........^Unaware of dangerous persons around
-Ease in complex tasks (calculus / philosophy) & Difficulty with “basic” (tying shoes / phone use / shopping)
-Laughing a rarity
-Drawing characters with blank faces
-Intense dislike of physical contact (hugging / shaking hands / etc)
-Refusal to drink from same straw / eat from same utensil as another person
-Very formal behaviour
-Cried very often / easily upset in youth
-Tantrums
-“Angry child”
-Extremely prone to misplacing things / disorganized
-No difficulty speaking with adults; significant difficulty interacting with peers
-Looks at ground while walking, not at others (and fortunately finds money as a result)
..........^Dislike of the mall -- goes anyway because money is always found on the floor
-Speaks with different accents constantly
-Sensitive to criticism
..........^Sore loser
-Nicknamed “walking encyclopedia”
-Often called a “vulcan” due to lack of emotional expressiveness
-Often taking things literally
-Answers questions is odd ways: When asked to name circular things, responded with “the universe”
-High IQ
-Prone to correcting others, “actually…”
-Excellent long-term memory / Poor short-term memory
-Difficulty remembering names
-Fatigued by social occasions
-Bruxism
-Spent kindergarten in a cubby hole
-Difficulty with directions (writing on wrong side of paper / not knowing L and R)
..........^Extremely easily lost
..........^Difficulty finding objects even when location is specified
-Synesthesia
-Rigid adherence to rules (no swearing / never late / etc)
-Expecting others to also follow rules
-Restrictive dietary behaviors (eat only the cherries in a fruit cup / PBJ every day)
-Abnormal dietary preferences (whipped cream pizza)
-GI Problems (especially in crowded restaurants)
-Easily tired

if there were any advantage for him to be diagnosed (disability benefits, accommodations in school or work), the characteristics you describe would make me seek a diagnosis.

your English is better than most americans. it's just a bit formal.

I have deep respect for the research and reading that you have put in with regards to your son.

Personally I think that many of the "doctors" in the USA, who give dx's, will also be looking to find anxiety, and depression in their patients, so that they can put them on pills, and so have them coming back every month for the rest of their lives for "check ups. That said, I your son has Asperger's.