Confused about Asperger's

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I am new to this forum. I am NT (hope that is OK - this seems to be mostly people WITH Asperger's posting) but I have been reading many of the posts here to understand Asperger's b/c my almost 6 year old may have it. He has had 3 evals. One diagnosed HFA or Asperger's (thought he seemed like Asperger's but he did have a speech delay which "rules out" Asperger's apparently). This doctor did no formal testing, just observation and interviewing me. Two more evals (both all day testing) turned up with dx of ADHD. Both noted a sensory component (sensory seeking) and he has since also received a dx of SPD.

When I post to parents' groups about Asperger's it seems to me that so many children are being diagnosed with it and it seems that virtually "nothing" rules it out. In other words, I have been told that many Aspies are social and make great eye contact, that many have rich imaginative play, that many don't stim, etc. Ok, so any child who doesn't quite fit in can be dx with Asperger's???

I guess I am wondering...what DOES rule it out? What is common to all people with Asperger's? Anything?
My son definitely has some Aspie traits. He is delayed in social skills, but does seem to understand them. Just doesn't use them well or forgets to use them. His social communication is immature - he has a slow processing speed and often does not answer or answers in a way that doesn't make much sense or says something silly to cover up that he doesn't understand. He does a lot of jumping and crashing (stimming?). His play is more about gross body movement than imagination. He never plays with toys like Legos, cars, action figures, etc but is more likely to be running around with a play sword or jumping on the trampoline. Definitely NOT a rich imagination. But not particularly obsessive about anything. He does have things he likes a lot: Spongebob, roller coasters, video games, any rough kind of game. He loves to have "races" to see who wins, anything tht involves running, jumping, etc. Doesn't have a huge repertoire of play. But he doesn't talk about one thing a lot, doesn't collect things or have to have things in a certain order, etc.

One thing that definitely does not fit is the whole thing about being rigid, needing routine, etc. My son is often "clueless", seems out of it, it seems like you could take him anywhere and he wouldn't care. He doesn't care about sameness, routine, wearing certain clothes, doing things a certain way, etc. at all. I would describe him as easy going, but very active, unregulated and "quirky".

I am wondering what some of you with Asperger's were like as children? I am not so concerned about what the diagnosis is (after all he is who he is no matter what dx he is given) but I would like to get a handle on the correct dx so we can decide how to best help him. Maybe he has both ADHD and AS?
Thanks for any input.

If a kid exhibited all those things they wouldn't be AS, more than likely. But a child who makes great eye contact and is very social can still be socially clueless. It just means they are extroverted. You don't have to fit ALL the symptoms.

I am great with eye contact and very forward socially when confronted with people. However I am from vaguely to completely clueless socially, I don't recognize faces from just 5 minutes ago, I treat most folks formally even if I know them well (that means I recognize their voices) and never assume someone likes me, or remembers me either. People don't usually take much of this and I am almost oblivious when they stop saying hi to m. Sometimes, years later, wondering what ever happened to old 'so and so.'

So Asperger's is all over the place, the only thing we all have in common is being autistic

The PDDs are syndronal, that is there is no one identifying behavior, but rather a cluster of behaviors from within particular ranges of potential behavior.

The way to understand this is to reverse your thinking from “what makes something Autistic” to ask what makes something non Autistic.

Non Autistic children who do not have some other condition, experience normal development, which again exits as a range rather a checkpoint list. It’s very difficult to comprehensively describe this range because of the huge variety of “normalacy”. It’s easier then to extract particular aspects of normal development and describe their absence. “Normalacy” is a state as much as “Autistic” but it’s so ever present and varied that it is easier to build “mental conceptions” of non normal and label and describe them than to describe every possible state of “normalacy”.

But the problem is that just as “normalacy” is a state that comes in (for practical purposes) barely limited forms, so to does the state of Autistic people vary. We are not normal people plus and minus the limited defined effects of autism. We are autistic people with development potential and limitations no less varied within our group than those who experience the many varied states of “normal development”. If you can imagine trying to describe “a normally developing human child” so as to be specific enough to “diagnose” someone as “normal” while including every such person and excluding every non such person, you can imagine that even though “normally developing persons” are very real and common, describing them as a group is not easy.

This is why the criteria for PDDs are difficult to work with. Everyone with a PDD is a human who is experiencing a non typical developmental trajectory and is characterized by non typical developmental triggers, needs, potentiality and limitations, that effect development in particular areas, and describing all the possible manifestations of humans with developmental differences in these areas, is a very difficult task indeed. No less difficult than comprehensively describing all the possible manifestations of human “normalacy”.

I don’t know if this helps but I had many of the symptoms of your son at his age but they gradually turned into the other Aspie symptoms as I became a teenager. If I had to name one symptom that I have always had it would be a profound sense of loneliness. The difference in my behavior was how I attempted to alleviate the loneliness. As a young child it was in one way and as a teenager or adult it was in another way, hence the difference of the symptoms. First off my theory is that there is more than one type of Asperger's. Having said that my theory is that the type of Asperger’s that I have is due to the facets of my mind being too close to each other. I can elaborate on that if you like but I’m not sure if you are all that interested in my unprofessional theories.

It might help if you watched your child interacting with other kids. What does he do when he talks to them? Not just one kid but, say, ten or fifteen. You compare him to the other children. If he seems just like them in many ways chances are he isn't AS or HFA. You are supposed to be able to tell or else there wouldn't be a disorder. People use what's in the DSM as a guide. Does he have repetitive behaviours the other kids don't?
Does he seem unhappy when socializing with them for some reason? (you might think of it as immaturity...does he seem to act more immature than his peers?) When he is around them does he stay to himself more than interact with them? Does he argue with them(even after being corrected by others and told to stop bickering)? Do they bully him or tease him? What is their opinion of him when asked?
What about his behaviour with you and at home? Does he do what he's told on a regular basis? Is he stubborn? Does he have a repetitive behaviour that you can't get him to stop doing even though he's been told not to do it on a daily basis (like flicking light switches on and off)? Does he have a constant need to move around even when told to sit still, or does he cry and "throw a fit" when told to sit still, does he overract to simple instructions?
What about his sleep patterns? Does he get sleepy when the sun goes down and is ready to wake up when it rises or does he spend half the night (or longer) wandering around the house or other things (like drawing pictures or watching television)?
You talk to other parents, compare the behaviours of your children and if the other parents are saying "mine never does that" or, "that's unusual" it might mean something's up.

It sounds very frustrating that you keep getting different diagnoses. Doctors are very weary of over-diagnosing mental disorders, especially ones deemed "fad" diagnoses (for example A.D.D and now Aspergers). I had one evaluation that said I had A.D.D; another said that I had Aspergers (both diagnosed as an adolescent by Psychiatrists). Recently I went to see a neurologist (to try going back on A.D.D medication) who said he thought I was misdiagnosed both times, because I just "didn't have the typical story for someone with either of those disorders". However he did not hesitate to prescribe meds for me, as he said that I "had all the symptoms". I really do think some doctors think that if you know one kid with Autism, A.D.H.D etc., you know them all! I think many are just plain misinformed.

From what i understand, all people with Aspergers share social difficulties and obsessive/repetitive thinking patterns to a significant degree, but they can be manifested in many different ways from person to person... Which makes things difficult to pinpoint. One might make great eye contact, but not know how to use the appropriate facial expressions to go along with it. Another might seem really friendly and interested in approaching people, but not know how to keep a friendship or even conversation going for any length of time. So people might not have one symptoms, but have others that make their autistic features apparent.

Does he fit the criteria (available here). If he doesn't, it's quite simple: he doesn't have Aspergers.

If you actually bother to read the criteria (this is addressed to all posters now, not the OP), you'll see that someone can be great at body language and eye contact while still fitting the criteria.

Wow! It's very odd that you just posted this yesterday as i have been trying to find someone in the past few days that carry the same type of symptoms as my son who is 7 years old. I took him to a specialist a few days ago who said she is even a little confused as to whether he has As or just a severe type of ADHD. Your son and mine sound ALOT alike. It is so hard to differentiate because the symptoms vary so much from person to person. My son goes like this: 1. above average memory
2. above average vocabulary
3. pragmatic speech (always something off the wall)
4. attention deficit problems (held him back in kindergarten)
5. socially immature (his friends seem to grow out of him)
On the flip side though, he seems to have alot of traits that do not fit the Asperger's profile.

1.Very outgoing, great eye contact
2.he is coordinated and pretty athletic
3. no sensitivity to light, sound or touch
4. definately not routine oriented
5. He is empathetic, whether or not he understands his own feelings i'm not sure if anybody really knows at age 7.

I am confused, like you, at whether or not they consider T.V. watching something that they really "focus" on. When my son is watching T.V. there is NO talking to him. You could say his name ten times and he will not acknowledge you. He can recite MANY movies but i guess if you've watched them enough, anyone can! He's very good at video games but i guess my thought is what kid doesn't like T.V. and video games? I had even considered putting my son into TV and commercials because he is so outgoing. I feel the same way as you. I am very confused!

the stuff you describe sounds a lot like my son, who's dx'd NLD. he hit puberty last year though and recently some very AS symptoms have popped out that weren't there before, like stimming (or I didn't recognize his spinning on one foot as stimming anyway, but now he's rocking, too). he dislikes people his own age and wants to spend time with adults who treat him as intellectual equal. he's social, but socially awkward and he reaches a point where he has to disconnect or he'll melt down. he's starting to recognize his own sensory overload symptoms and that he doesn't understand what people mean from their expressions. I think he is AS, actually. I'm trying to get additional assessments for him.