HELP with preliminary results from school evaluation

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So i got the draft from the psychologist today. I am not happy about the results. There were several surveys done by the teacher and I. Every survey that had something to do with ASD showed that he fell within the diagnostic range for ASD. The teachers and my surveys were scored very similar. No discrepancy at all. The whole report was like "shows characteristics of ASD diagnosis"
He says my son qualifies for special ed under the emotionally disturbed criteria.
I then get down to the diagnosis area and he throws out a diagnosis of Disruptive Mood Dysfunction Disorder, and ADHD impulsive, severe.

How can he show so many signs of ASD yet not get the diagnosis? I meet with the psychologist Thursday to go over the results but in the mean time i am driving myself crazy trying to figure out where he got the DMDD diagnosis if he clearly fits better in ASD
He said he would probably qualify as ASD in a few years when reevaluated??

Mom -- thank you for taking such a loving interest in your child. Now is the time for you to be your child's advocate and to demand that his I.E.P. focus on ASD.

Here is something I just found online:
"DMDD is a unipolar (not bipolar) mood disorder characterized by very severe irritability. Any parent of a DMDD child can tell you that their problems are not simply normal, developmentally appropriate “temper tatrums.” Kids with DMDD are already in need of treatment, they’re just not getting the best treatment that they could be. DMDD shares qualities with ADHD and ODD but also reflects substantial emotional concerns as severe as any bipolar disorder."

However what appears as DMDD (meltdowns, ODD, emotional concerns) is, for your child, actually just one facet of ASD. So to treat your child with DMDD alone would be a partial treatment at best, because the totality of diagnostics points to ASD.

Be your own child's advocate and do not take no for an answer. This DMDD diagnosis is, according to your post, simply outrageous and irresponsible.

Thank you or your reply! You said exactly what i think about the whole situation. I feel like it would be a disservice to him to misdiagnose him because he has a little bit of inconsistent behaviors ( psych thinks that he has a lot of on purpose behaviors at school) We have been fighting with them for 3 months so yes he has some issues with the school staff that is probably coming out as on purpose behavior. He is stressed to the max at school so he is in constant fight or flight mode.

I have extensive experience with psychotherapists. They are haughty morons. Keep pressing your case until they acquiesce. Say their results are unacceptable. And if they do not budge, demand more tests. Do so politely. I think that they'll come around to your way of seeing things.

Constantly point to the ASD portion of the results. Do so again and again until they acquiesce. They don't want to be sued for malpractice.

Thank you. That is my plan. I am going to highlight every result from me and the teacher that points to ASD. Through the whole thing I was sure that he was getting an ASD diagnosis until I got to the end where the preliminary results were. It was blaringly obvious. I definitely going to ask how he got to the DMDD with so many obvious ASD signs.

"Emotionally Disturbed" is the big clue there. ASD is not defined under the ED category. It sounds to me like ED is the result they wanted and then they filled in the path to get there.

I think that by trying to lump your child in that category they feel like they can get away with more punitive procedures and less accommodations than would be called for under an ASD diagnosis.

My son has had an AU diagnosis since pre-k. Last year (2nd grade) he had to deal with a lot of changes mid-year that screwed him up and caused behavioral issues. As soon as they started addressing it in earnest, I could see the district was trying to make a case for ODD.


I would be very wary of letting them pin anything non-spectrum -related (other than maybe the ADD) on your child.

Other people probably have more direct experiences. I pulled my kid out at the end of last year, before they could get too much in motion. I bet others can provide more concrete info, as opposed to what are just my suspicions.

(By the way, I am homeschooling now, and though we still have compliance issues, his behavior is so much better b/c guess what? his stress level is way down. It think with AU/AS so many of these issues are stress-related which has nothing to do with these other diagnoses.)

With a mental health impairment, district can spend less money. No OT, PT and speech. Because whatever psychobable was written down, it is not a developmental disability.

Isn't DMDD a new diagnosis under the DSM V? I call BS on this one.

It's cheaping out on services.

Keep their feet to the fire!

Have he had the ADOS (autism diagnostic observation schedule) done? You may need to get it done privately and then use it to challenge his classification. Unfortunately there is usually a months-long wait for this testing.

Thank yall! I think the district is trying to minimize their costs also. They did not do ADOS the did the GARS-2 and the CARS-2HF. I don't have the GARS2 results yet but he scored 21.5 on the CARS2 which placed him in the minimal symptoms of ASD. The Cars2 was something that the psychologist did with the school in a meeting to show them the spectrum behaviors. The problem is that they think most of his behaviors are discipline based and they arent.
The psychologist went from talking about spectrum behaviors to throwing out a mood disorder. I can only imagine that the district had something to do with that change of path. I have no doubt that he is very HFA but that doesnt mean he isnt on the spectrum at all and has a mood disorder.

I'm not sure how things work in the US (I'm from Canada) but my son's pediatrician made his diagnosis based on reports that came from our local resource teacher program, psychology testing, and probably most importantly the ADOS test as mentioned (Which took 6 months on the wait list). Does your son have a pediatrician?

Yes his pedi is not comfortable diagnosing Autism but he might be after I show him the reports from the psychologist. I am taking him to a neurologist too as soon as I get a referral.

I'm not defending these idiots-- probably they ARE just trying to cheap out on services-- but have you considered the possibility that, in the wake of Adam Lanza, they're trying to PROTECT him??

Seriously-- as parents, our first impulse is to FIND the problem and FIX the problem.

But-- ASD is a label they can't lose. A HIGHLY STIGMATIZED label they can't lose.

EDs and BDs can be gotten over. DDs you are stuck with for life.

If it will get anything like services, and if they help at all, I'll accept ANY other label for my kid (even if it's only a partial solution, the fact is that all we have for ASD, particularly high-functioning, is partial solutions).

Anxiety disorder?? OK. There are lots of anxious people in my family. Eight months of watching your mother die by inches, followed by a year of getting beaten by your grandfather-- sounds like enough to give a kid an anxiety disorder to me.

ADHD?? Absolutely-- hey, I think it runs on my husband's side of the family.

ODD?? I don't think they're going to come up with that one-- the kid wants to comply, even when he can't-- but-- WORKS FOR ME.

Whatever gets the kid a little bit of compassion and a little bit of teaching...

...and DOESN'T have the potential to ruin the rest of his life, no matter how 'recovered' he becomes, in three little letters.

Thank you for your different perspective. The only issue I have with the Dmdd diagnosis is that it seems like if you give a child that is already struggling with school a label like "disruptive" they will keep treating him the way he is being treated. Like a child who chooses to act up and have meltdowns at school everyday.

I actually think our school would look at an ASD diagnosis and "understand" him better but to say he is ED is like telling them yes you were right he is just disturbed and acts like that on purpose. I worry that he is going to have a breakdown because at school he feels like a "bad kid" because that is how they treat him. I don't want to worry about my 6yr old wanting to end his life because he is a "bad" kid.

When doing a project at school where he was to come up with an Indian name for himself I asked him okay well what do you do so that we could come up with an action part of the name. He told me "do bad things" That is all that my 6yr old thinks when he thinks of himself because of how he is treated at school.

There is also the possibility (probability, actually) that your child has both an ASD and a mood disorder. I say probability not because of anything I've read here but because it's an EXTREMELY common co-morbidity.

Problem is, if you categorize a child's behaviors as a mood disorder, that gives you fewer tools. We actually had the opposite experience you did (in the early grades, my son was doing very well socially and it didn't fit with my narrow idea of an ASD.) I can tell you that the accommodations offered to him when they agreed were not sufficient.

Has the school done a functional behavior assessment? Often, if a child has ASD and you chart the antecedents and results of their behavior, you can find needs that have been missed - if your kid is on the spectrum, this is the sort of documentation you will need to deal with the psychologist.

All that said, we didn't get anywhere until we took my son to a multi-disciplinary hospital-run program for developmental disorders and had them test him (they did the ADOS as well as the TOEPL) they found he was not only classic AS, but had a severe pragmatic speech delay that was driving most of the behaviors we thought were a mood disorder.

If you can't afford a private assessment, ask the school to test his pragmatic speech (usually the TOEPL) and also for a full assessment by the OT for any sensory or coordination issues. That may get you the services you need even if you don't get a label that makes sense.

One thing to keep in mind - a trick our school used to cover up the pragmatic speech problems - my son scored a 52 on the TOEPL, and we were told that since he was 2 points above average, he didn't qualify for services. The private practice we went to noted that pragmatics are not measured alone, but by the gap between his pragmatic speech and his regular speaking skills - meaning, my son was able to articulate perfectly and had an enormous vocabulary, and that led people to assume he understood clearly when he didn't understand almost at all. This caused a lot of his frustrated behavior.

The other thing that the school didn't tell us (and a reason to ask to observe the test) is that, while my son scored a 52 - it meant that he scored 100% on about half of the skills, and 0% on the others. He definitely needs the therapy.

The school did not request an FBA but I did and the psychologist said it wouldn't be too hard to work that into the process. I don't know why the school didn't request one and that just reminds me that they think the function of all behaviors is purposeful. They don't even consider that there are reasons behind certain behaviors.

I have a lot to discuss with the psychologist tomorrow and I'm just praying that this meeting goes well. I just want to make sure he gets what he needs at school. I'm not overly concerned with what label they use that gets him that help. I just don't want the school to have any more reason to think that my son is playing games with them when he is overstimulated and has no where else for his energy to go but to run around the classroom.

BuyerBeware,

You are way more optimistic than I am. (This is my bias, based on my own experiences with The System TM)

I do not know how permanent these labels are or aren't (They are quick to drop AU/AS educationally, if they can to get away with not giving you services, or so I hear) but I doubt they are trying to protect him. I think the labels they are proposing are the kinds of things that get you harsher, less compassionate treatment even taking the Lanza thing into account.

We have had an AS diagnosis for quite some time at this point, and I will be honest, there has always been a measure of noncompliance, and certainly meltdowns. The difference is that when a school gives you a mood disorder or ODD or any of those things, I think they feel like they can just push harder until they break the kid and he behaves or they can send him to alt schooling or kick him out.

Those things as a stand alone diagnosis with no acknowledgement of AU/AS tendencies??? I shudder to think how a school would treat the child in that case. They do not have to account for pragmatic/communication issues, sensory issues, transitions or any of the things that could actually be improved to make things better. It is just "do what I say or {consequence} " Still not doing what I say? -- {stronger consequence} and so on.

I would guess the main thing they would do would be to push zero tolerance for non-compliance. That is where they were heading with my son with an AU diagnosis and just the beginning of an implication (but no testing or diagnosis) for ODD or anything else.