School district eval for ASD question

[mcribster]

Hi. What do you mean repetitive movement? Is it tics or things like spinning? Involuntary or stim? It sounds like there is no question he needs a full evaluation. Have you considered a dev pedi or is that who you saw that brushed you off? I'm glad they are serious about having a good plan in place.
My son has PDD-NOS- socializing with peers was a biggie for him. He's somewhere between Aspergers and NT now as we work on his medical issues. Having him in an intergrated classroom really helped with the peer socialization and he's doing great w/ that now.

[mrsbuttinski]

It's hard to say.

I'm a little confused by the term "repetitive movement". Repetitive Movement Disorder is an umbrella term for a condition that arises from overuse performing a specific task- something like carpal tunnel syndrome or tennis elbow. Do you mean Stereotypic Movement Disorder? It's sort of like a close but no cigar catch-all for those who have might have stims or tics. How long has this behavior been present. Stims are usually obvious from toddlerhood, onset of tics is closer to school age. Compulsive behavior related to OCD can arise at any age but is more common after puberty; boys with OCD tend to have earlier onset than girls.

psychcentral.com/disorders/stereotypic-movement-disorder-symptoms/

Some school districts do not dx ASD. They might identify related delays and deficits and offer services and accommodations around them. Other districts will offer an "educational dx" of ASD. Unless they turf a child to a dev pedi or clinical psych, they can't offer anything but an educational dx.

While it's great to share any diagnostic reports you have obtained privately with the school's team, read them first. If an MD has R/O ASD emphatically, you might not want to share that because it could be purposed to paint you as the worried well.

How old was your son when he was evaluated? Where was the eval done and by what sort of team?

In your situation, I would write a short document titled Parents' Concerns and include a bulleted list of issues you see that could be autistic behaviors. If his preschool teachers report that he's aloof or can't socialize appropriately include it. You could also ask about him being observed in school.

[princesslily]

You seem to have everything you need. I would also suggest you prepare a paper on what milestones were met at what age.

For us, when we met with our social worker first we were asked information on his birth and meeting milestones, like sitting up, crawling, walking, speaking, were the big ones. Next, we were asked (on a rating scale) his skill sets. How often does he/she wipe themselves on the toilet, how often does he/she brush his teeth on their own, etc etc.

When you say you were blown off at the children's hospital, what happened exactly? Did a dev pediatrician see him and deny a Dx of ASD? Did they provide another DX?

Sometimes when a repetitive movement occurs, there are symptoms that can overlap (ADHD and ASD specifically). Did they do any testing to parse out the DX? Or did they delay a medical evaluation to a future date?

[mrsbuttinski]

Apr 2, 2015 9:40:12 GMT -5 allwaswell said:

Apr 2, 2015 6:42:08 GMT -5 mrsbuttinski said:

The paperwork I have from the developmental pediatrician we saw says he was diagnosed with "Repetitive Movement-Primary 307.3 and Sensory Integration Disorder 782.0." I don't know what the numbers mean.  He has a stim, spinning. He's done it probably since age 2 or 3. He's 5 now.  He's always called it "dancing," but he spins in a circle without getting dizzy.  He usually puts on music to spin to. He tends to do it at night generally, and his preschool teachers said they've never seen him do it at school. 

The numbers are DSM-5 diagnosis codes. the official title associated with 307.3 is Stereotypic Movement Disorder so it's really weird that the clinician called it something else entirely. It's even weirder, IMHO, that this was listed as a primary presenting dx; I would have expected SPD even though it isn't "official"in the DSM. I could even see how this particular behavior- spinning- could be a function of SPD entirely. 

The social worker I spoke with mentioned that their team (if they felt it was necessary) would do a more complete eval for an educational diagnoses of ASD.

That's great.  

He was 4 years 7 months at the time of the eval last August.  He just turned 5 in January. It was really just meeting with a developmental pediatrician at a children's hospital. The meeting was about an hour long and she mostly just asked us questions and talked with him.  I had filled out a bunch of info and scales prior to the meeting as well. 

Under these circumstances, I'd be inclined to withhold the dev pedi's report. It doesn't sound very thorough. Does her report include any scales or tests? Sometimes these can be tough to recognize because they feel like answering questions/giving a history. You can't R/O ASD on something like eye contact with an adult. I'd expect to see something like ADOS, ADI, CARS, GARS, along with BASC and Vineland. 


Thanks for the info mrsbuttinski! I will do this and mention the observation offer as well. His preschool teachers have already told me they would welcome me or anyone else to come and observe him anytime. 

Ask about it. Some districts will send evaluators to private schools for evals. 


I know no one can tell me whether I'm doing things right, but do you think this is the right step? Should I pursue getting him evaluated by a team at a different children's hospital? I guess I started with the school district because I wanted some kind of plan in place before he starts kindergarten, and I know I'll be on a long wait list to see a developmental pediatrician/team from a hospital. He has been very successful in his private preschool, but we're talking about a class size of 12 and two teachers. It's going to be very different with a public school kindergarten. 

DS did really well in preschool. It wasn't until he started at a very structured and academic full day kindie that things went to shit here. 

It makes sense to go through the district in advance of starting school. You could get on a waiting list for the best dev pedi in your metropolitan area in the meantime. If it takes a year, things may be clearer one way or the other then.