Theory of Mind

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I am frustrated. Really frustrated.

We went for our son's ASD assessment on Monday. He meets the criteria on the ADI-R, but does not meet the criteria on the ADOS (he is 9) and she is "taking autism off the table". She saw his quirkiness, she saw a glimpse of how he has created this "structure" for himself that once you go outside that structure he shuts down, but he carried out a four point conversation, he demonstrated theory of mind (by attributing thoughts to a frog in a picture) and he wants interactions.

She says his quirkiness and odd behavior is due to anxiety and likely adhd. Executive functions are the pits, we know that, we accept that. He sat for two hours reading books and "chatting" with the receptionist while we met with her - this after him meeting with her for 45 min and coming out in a very agitated state because she had changed the game to her agenda.

Through the whole ADI-R, she would say "well, that's more like an attention thing, not autism". She says because his stimming is a method of regulating, it is not "autistic".

I would think that maybe I am crazy in not being able to mesh what I know of him with what I know of adhd, except my son's mental health clinician and his teacher (who has a son on the spectrum) AGREE with me.

So, background given - do any of your kids, at age 9 show some theory of mind. My son can ascribe emotions/thoughts to photographs, to drawings, but in real life? not so much. Cannot tell when someone is bored, continues talking about minecraft, minecraft, minecraft.

Can any of your kids, at age 9, have a conversation, an odd one, absolutely, but a conversation none the less?

I am aware of hyperfocus and adhd. Yep, he can hyperfocus. Absolutely. As long as it is in the structure that he has determined for himself. He can do pretty much anything as long as it is in the structure that he has determined for himself. Homework (on his own!, chores, etc. mundane!) Yesterday he shifted from minecraft on the computer to Killer Bunnies card game (ages 12+) for another 1 hour.

Told we don't see adhd at home because we do such a good job with behavior management??? told that we cannot compare siblings, even though we see way more attention issues with our daughter, who is raised in the same environment with the same expectations?

Trying to focus on my son's strengths, the gifts he provides us with each day, because I don't know what else to do.

BTW, to be clear, I do not want this dx for funding or anything like that. If I wanted funding or a category I would have let her put ODD into the report to bump him into a category at school even though she knows he doesn't have ODD...I want someone to recognize my son for the unique being that he is, but also to understand WHY he is the way he is. Does that make sense?

Am I in denial? Please. Tell me honestly. I need the honesty. I know if there is any place I can get honesty, it is here.

double post sorry

YES AND YES!! !

My son is spot on with labeling emotions in pictures, books, etc...in real life? Not so much. In fact he is consistently MISSING emotions of other people and it makes me insane casue he can correectly lable when we do it as a book or picture activity.

My son can have conversations. AS long as it is about what he wants to talk about. He CAN have a conversation if the other person is asking all the questions, otherwise he will start babbling off about video games, movies, etc...while missing that the other person lost interest a while ago, or has no idea what he is talking about.

I am afrid of the ADOS for this reason. My son is a completely different person in a testing situation, or a situation with one or 2 adults, given isntructions, testing situations, he follows all the directions and in ideal situations he has perfect answers for real life situations. YET in real life he isnt capable of using ONE of his beautifully thought out strategies. NO GENERALIZATION!! !

I am sorry that they didnt see this. It is TEXTBOOK!! ! Go to the library and borrow the 2 DVDs by Dr Tony Attwood on Aspergers, he talks abut JUST THIS THING!!

hang in there momma, get ANOTHER opinion or get the research from book and SHOW THEM!!

Cutiecrystal, you could have been writing about my son, and he is clearly Asperger's. I think you need another opinion. That dr. can't just explain away all your son's symptoms. Not everything is ADHD.

My son's theory of mind issues come out this way: He insists that I said something I didn't. He thinks I did b/c he doesn't question his own mind. If he wants me to have said it, or anticipates I would have said it, he is certain that I did say it, even if I didn't. Drives me nuts! Anybody know how I can explain to my son what he does?

So sorry for the frustration! I agree with the others . . . sounds like you need a second opinion. Which stinks, particularly if it means more cost.

We have our son's evaluation tomorrow, and this is exactly what I am worried about. I know my son is probably 'high functioning' Asperger's, but like you I want clarification and direction, as well as information for his school.

My son is quite a bit younger, so I do understand that makes a difference. If we give him more time, he may grow out of some of his quirks, but what we are seeing is that many of them are getting worse.

Recognizing emotions: my son can identify happy/sad/angry emoticon faces, etc. But when it comes to people: 'Mommy, are you happy?' ...'Are you sad?' He also cannot read when other children are annoyed or frustrated with him. It is quite sad to watch him as he thinks they are his 'friends' and that they are 'playing', but they are typically teasing him, annoyed, etc. Just because he can identify a picture in a book as 'sad' doesn't mean anything.

Theory of Mind: Well, he can play 'I Spy' and guessing games, yes. But he is quite often telling me he 'answered' my question when he didn't--he just 'thought' it. He also can't seem to understand that we don't 'know' what he is thinking. And he can't tell lies or keep secrets at all. It's kind of cute and funny actually how that plays out. There are other aspects, but it would be silly to dismiss issues with Theory of Mind just because he can play a guessing game.

As I understood it, a child doesn't have to have EVERY issue associated with ASD to be diagnosed, am I wrong? And, as Tony Attwood says, within those 'issues' there is also a broad range of how they are manifested or not manifested in each child.

Honestly, I am pretty convinced my son qualifies, though some of his issues are on the milder end. He has clear problems with generalization, catastrophic thinking, social cues, friendships/peer relating, sensory issues, rigid thinking, black-white thinking, perseverative thinking, and a few issues with language which we can't figure out because he is highly verbal.

We are on vacation right now, and the lack of his regular routine has seen increased meltdowns. The worst--and I don't know that we handled it well--was this weekend in Starbucks. It stemmed from sensory issues with the dessert we ordered, but we didn't know that at the time. The culmination was my son screaming, pushing over the table with our coffee, punching his father, red faced, teeth bared, screaming. All over a piece of cake. I wish I had known it--but he couldn't communicate 'why'--and then I would have just ordered a different piece/kind of the silly cake. The whole place was staring/watching, but honestly I didn't care. I only cared about my poor child and his rigid world he gets locked in sometimes.

Thing is, that's not going to happen at the evaluation tomorrow--not with a nice adult to play with him and pay one-on-one attention to him. Just super praying we get a wise person whose insight we can respect and who sees more than just the surface.

cutiecrystal, I hope you find what you need . . . hope it helps just to hear from other parents who have either already been there or who are concerned about the same things!

I agree that there is a big difference between recognizing a smiley-face drawing as "happy" and recognizing the same emotion in a human. Further, do they have drawings for "bored" and "embarrassed" and "indifferent" and the many other more complex human emotions? Because kids need to be able to read those, too, not just know whether someone is over-the-moon happy or completely miserable.
I think you should get a second opinion.

I really wish they wouldn't rely on the ADOS. My daughter can deal with the ADOS just fine, but in real life she definitely has signs of Aspergers or autism.

also, looking at a pic in a book is very concrete. There is a picture and you have to say what it is.
In the real world, people are talking, or crying, or yelling, or frowning, making facial expressions, body language, there are noises, smells, other things your kid might be wanting to do, TV on, toys out, etc...thru ALL that, they have to try and guess what another person is feeling. TOTALLY different then sitting in a room with a tester and labeling pictures.

i can see what others think if they describe it well, but beyond that i can not see how they came to think it. i do not know what drives people to think as they do. i can only see the surface in a crude and simple way.

I don't ever remember NOT having Theory of Mind. At least, in simple terms like ascribing emotion to pictures/characters.

Maybe it's less common, but plenty of high-functioning autistics and/or Aspies have verbal abilities. My father was hyperverbal, so am I, so is my 4-year-old son, who I suspect is on the spectrum as well.

What the professional community doesn't know is frustrating. Very frustrating. Autism speaks-- can sometimes speak for ITSELF-- and STILL it is difficult to find someone to listen!

the rest of the world has nothing to say,
that can change the way,
that my mind does play,

and if it is thought that i am far away..
from what you think
then you should blink..
and you'll not see it.....

and you'll live another day.
no need to pray.
no need to pay.

just you go away.

door locked

I got my sons diagnosis from a psyciatrist after taking my son to a therapist for a few months. Maybe you can go that route? I had all the testing from the district and all the input from the therapist...just an idea!

good luck.