Psychiatrist Findings

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Hi Just exploring again, I received my son's report from the local services, He has received a dx for Aspergers privately.

I am just going to write a little of what his findings are and maybe your insight might be able to allow me to understand what it means.

I also found that the client presented with quite significant Aspergers syndrome like traits. During a separate assessment by speech and language a communicative impairment was found that, she felt, was indicative of a possible underlying diagnosis of ASD. When I reviewed the client Aspergers symptoms systematically, however I could, in particular, not find any evidence to suggest he has any specific, all else excluding, repetitive interests. Whilst he scored high on most other Aspergers trait, I feel that this particular symptom is so specific to people with ASD that I could not give him a diagnosis of Aspergers Syndrome as one, on the other hand, cannot disregard all the other symptoms that are specific to this diagnostic category, I felt a diagnosis of PDD NOS is more appropriate.

In line with the clearly Asperger like traits that he present with, he also suffers with the atypical OCD like symptoms that so many clients with ASD presents with.

My son repeats phrases over and over repetitively, he constantly twisting his hand, and does complex whole-body movements not as often as the hand twisting. He did have an interest in dinosaurs knew all there names but will only show interest now if he see them. He gets obsessed with new things he engages in and needs to do them constantly but they are short lived he gets bored and moves on to the next thing. He needs to sit on the same chair gets very distressed about this, and has to have his food separated doesn't like one food touching the other. Doesn't like to share his possession no one can touch them or move anything in his room, but doesn't understand why he is not allow to use others possessions. At the moment he has a great interest in the world war 2 and talks about it a lot.

Would these be seen as repetitive interests. I am interested in your opinion, I get confused with the findings maybe I am not understanding the criteria. Explanations as simple as you can. Thank you

We only have a school diagnosis and I worried about the repetitive interest issue too as my son doesn't focus on certain topics as is what most people think of with AS. While he likes legos and certain things, he has never been obssessive about topics or certain activites.

At that time, he was very worried about being first though. Walking into the school before his sibs, turning in schoolwork first, etc.. They listed these behaviours under this category.

Now, he is more worried about people touching his desk and chair, or if he walks next to someone going or coming to school, he will focus on our feet and walk in step with the person next to him. However if he is distracted, he won' think to do any these things, so it seems more an OCD thing, but they used it for his Aspie classification.

My son would also have those issues at school there is so much I can list, but because it the norm for him I am at times not sure. He has to finish exams first regardless of how well he performs once he finishes before everyone else.

I am hoping people can explain repetitive interest as in how they or there child behaves to see if I can identify with it. As some of the behaviours my son presents with I might see them as normal and maybe they are to to with the above. Thanks for your post.

My son was diagnosed at age 6 with Aspergers. He is now 11. When he was younger, the only thing he would talk about was space. He loved learning about all the planets, moons, stars, etc. We would walk around the house and find household objects arranged like the solar system. When he met someone new, he would start every conversation with "did you know..." and start explaining some fact he'd learned. Every book he read had to be about space. He was very agitated until he learned how to draw a planet with the rings around it.

Eventually, his love space lead to other interests, most of them related to science. Every day when we walked to preschool, we had to talk about plate tectonics. When he was 7, we had the summer of the periodic table.

His topics of interest became all consuming. Everything new that we discussed had to be related to space in some way, or he dismissed it. I think that's the type of behavior they were discussing in the diagnosis.

I hope this helps!

MrWizardsMom I understand the specific interest but not everyone dx with AS has this trait is that correct.

My son, now 17, was diagnosed with mild Asperger syndrome last summer. The psychologist who diagnosed him felt that he fits the "special interest" thing even though his interests are fairly short-lived. While brief in duration, they're intense while they last -- son will research everything there is to know about a certain subject -- and are fairly idiosyncratic (that is, not common for his age group). Some focused interests have been chili peppers, mushroom cultivation, aquarium fish, The Beatles. Unlike many with AS special interests, our son is easily able to stop talking/obsessing about a particular subject when asked to.

My son's psychologist feels that in his case the special interests are an asset -- he's developed phenomenal research skills! She does definitely believe that these interests fit Aspergers.

Hope this helps.

Did she give a dx of Aspergers or PPD-NOS in the end? In a couple of years it won't matter anyway, because the catatagories of autism, Aspergers, and PPD-NOS (plus a few others) will be merged into a single category called Austism Spectrum Disorder (ASD) in the DSM-V in 2013.

There seems to be some variation on how different psychologists interpret this criteria. Yours seems to think that "encompassing" means "all else excluding", where my son's psychologist felt that riding the elevator 10 times during the break and preferring to watch the skyrail instead of the animals at the zoo was sufficient.



This exactly describes my 5yo son. His special interests generally last 2-3 weeks, and tend to be centered around re-enacting some sort of project he sees on a PBS cartoon. Once it was performing a magic show at a friend's birthday party, another time it was creating an art show, another time it was creating his own newspaper and delivering it to the neighbors. I drew the line at seetting up an alternative-energy go-cart race!

I think zette makes really useful points. It strikes me as a mostly academic distinction, with little practical bearing, and there isn't consistency in how it is understood.

My son has no obvious repetitive interests and yet is considered solidly AS by those who are familiar with AS (his only diagnosis is through the school).

It sounds like the psychiatrist is being pretty literal in his or her interpretation of that criterium (ironic, huh?). It would seem that since your son doesn't obsessively line up Thomas the Train toys every day all the time and hasn't done this every day since he was 2 then he doesn't meet the reptitive interest category for this particular doc. As zette and others say, even though the criteria seem to be quite specific there is still a lot of room for interpretation. I think some medicos are more hung up on literal interpretation and others see the "spectrum" part of ASD more.
My son also does not have just one repetitive interest that has stuck around for very long. He does know more about certain subjects than you average 5 yo and his behavior in this regard was enough for the school system to say he met the repetitive interest criterium.

i think your evaluator is wrong in how they are interpreting the diagnostic criteria, thus leading them to believe your son has to have repetitive interests. that is not a requirement of any form of autism. the section they are referring to is about behavior, interests, and activities, not just interests. this is that section:

Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

- encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity of focus
- apparently inflexible adherence to specific, nonfunctional routines or rituals
- stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
- persistent preoccupation with parts of objects


he fits the criteria if he has any ONE of those things. so yes, he fits if he has repetitive hand twisting motions, or whole body motions. even if he has NO special interests, he can still fit the criteria if he fits one of the other three in that category.

it frightens me how often i hear about professionals who dont actually know the diagnostic criteria, even more so when they are put in such positions of power in regards to autistics getting the help they need. out of the 5 psychologists ive met in the past 18 months, 2 gave the wrong diagnoses and 1 refused to give a diagnosis of asd at all. and we are talking about classic auties who are almost textbook examples of the criteria, not borderline cases at all.

my 5 yo autie doesnt have long lasting special interests yet, however he does go through phases of obsessiveness over certain things. my SO has bursts of obsessiveness over new video games or tv shows, and has a few long lasting interests such as skepticism and atheism. my 15 yo aspie doesnt really have intense interests, but he does really like certain things, like an author whose book he is currently reading for about the 3rd time in 6 months.

My older son with classic autism has the hand flapping thing. (He opens his mouth wide, flaps his hands, and hops up and down when very excited.) However, he does not meet the other three criteria.

My younger son (AS and OCD) meets the other three criteria but has no repetitive motor movements.

My older son received several different diagnoses, which is not unusual--severe expressive/receptive speech disorder from a speech pathologist when he was 3; static encephalopathy manifesting as selective mutism, speech delay, and anxiety; autism; sensory integration disorder; and PDD. I think that the important thing is to identify each issue that the child has and figure out how to treat it.

My dd has only one of these, as well: the "apparently inflexible adherence to specific, nonfunctional routines or rituals," or what we've been calling "rigidities." (I don't know if that is really the right term.) She does not have areas of interest, and reduces the intensity of any interest when her traits are most apparent. It seems to me that Asperger's kids with higher general IQ or abilities have stronger interests than those who are average or slightly below, but that might just be my impression based on the kids I know. Her diagnosis was clearly an autism spectrum disorder, the psych said the results were consistent with Asperger's. In terms of cognition I find she is closer to mid- or high-functioning, and in terms of social skills / life skills she is pretty high.

It was the results of the 15 WISC-IV tests that I found most helpful for developing her special education plan. That and just telling the teachers what seems to work and what doesn't.

J.