What steps do I need to take to get my son diagnosed?

Question

My son is going to be 15 yrs old. He has been struggling with many symptom of Mild Autism. I think he might have Aspergers Syndrome. He has been attending a Learning Center after he started Middle School. The public school system had an IEP meeting and referred him to a Learning School with children with disabilities. I was more scared of the NE environment but he seemed to like the smaller environment. When he began Middle School in the Public school; his anxiety and stress level increased a lot. He would have emotional break downs at school. In Elementary he got use to being around the same faces every year and most of his class mates knew he was different. He went through different testing but they would always say "His academic's was good so they couldn't put him into Special education". Some how my son made it through Elementary. It was a struggle because the Doctors didn't know what to do about him. He has never been tested for Autism or Aspergers Syndrome. I have been learning

Answer 1

talk to his pediatrician and teacher.  you will need a referral to a school pyschologist.

Answer 2

I agree call a psychologist or physician for an outside evaluation.  Also, WRITE a letter to the school or department of special education or your district requesting a full-evaluation, including an autism screening.  They have 90 days to complete i per the school system.

Answer 3

It sounds like you have reasonable cause to suspect AS, so good for you for wanting it checked out. Talking to your school district is fine for services, but as I'm sure you know they can't diagnose.

We've had our best luck seeing neuropsychologists who are experienced with AS. Some parents also pursue multi-disciplinary evaluations that may be done at children's hospitals. We have known one psychiatrist who did a more limited evaluation, but the neuropsychs seem like the most comprehensive providers.

Parents are a great resource for finding good evaluators. If your school has a parent group relating to special ed issues (around here it's called a SpEd PAC -- Parents Advisory Committee), they may maintain a list of providers that other parents have found to be good. You could also try a web search for a local autism or Asperger's support society. They may either maintain a similar list, or have a parent support group where you could get suggestions.

Whoever you work with, I suggest making sure that they can do a comprehensive battery of tests. My kids have always been tested on cognitive skills and academic achievement, but also on speech and language, including pragmatic language and verbal reasoning; memory and cognitive organization; "theory of mind"; social skill development; and executive function. Providers often administer a standard measure of Asperger's (like the Australian Scale) as well. (Incidentally, not to slight another respondent, but I've never heard of "doing a DSM-IV."  DSM-IV is the manual where the diagnoses are found, and perhaps it's used to assess eligibility for educational services in her area. But I don't believe there's any such diagnostic psychological test, which is what you seem to need.)

Multi-system evaluations can be costly, and some providers don't take insurance, so you'll probably want to check that out up front. Good luck.

Answer 4

Depending on what state you are in, you should start with getting a referral from your insurance.  However, a lot of insurances will not cover autism assessments and/or treatment.  A neuro-psychiatrist is best (don't let that title scare you).  A board-certified child psychiatrist is second best.  A psychologist is okay, depending on what protocol he/she uses.  A lot of school districts here in California are trying to reject diagnoses that are not from doctors on their "approved" list.  In fact, there is an Autism Blue Ribbon Committee which had a recommendation that only diagnoses from regional centers or doctors approved by regional centers should be accepted.  Although I won't bore you with the political details, this is very, very wrong.  It would be like the government denying treatment for cancer until an "approved" physician diagnosed you.  Anyhow, whatever type of mental health professional you choose, you should insist on a DSM-IV be done.  You may also wish for an ADOS to be done and I highly recommend an ABLLS.  However, since your son is so high-functioning, I would imagine a DSM-IV would be sufficient.  You must request the school district assess IN ALL AREAS OF SUSPECTED DISABILITY.  Oftentimes, school districts perform cookie-cutter initial assessments...mostly of academics.  In addition to academic testing, you son should have a Theory of Mind assessment, pragmatics speech assessment, social skills assessment, occupational therapy and sensory integration assessment and an executive functioning assessment.  These are areas I have never seen a school district volunteer to assess.  Most school districts operate on a "don't ask, don't tell" unspoken policy.

Here is a DSM-IV that is in a Word format.  You can insert your own text for each item in which it pertains to your son, print it out and take it to the mental health professional you choose.  Also included is a Tilte 5 Section 3030 of the California Education Code.  This is an excellent tool if you live in California.  You can find the tools here:  http://www.valleysnafu.com/SAMPLE%20DSM....

You should also request the assessments I recommended by using this type of sample letter:  

Sample Letter 2: Requesting an Initial Evaluation

Today's Date (include month, day, and year)

Your Name

Street Address

City, State, Zip Code

Daytime telephone number

Name of Principal or Special Education Administrator

Name of School

Street Address

City, State, Zip Code

Dear (Principal's or Administrator's name),

I am writing to request that my son/daughter, (child's name), be evaluated for special education services. I am worried that (child's name) is not doing well in school and believe he/she may need special services in order to learn. (Child's name) is in the ( _ ) grade at (name of school). (Teacher's name) is his/her teacher.

Specifically, I am worried because (child's name) does/does not (give a few direct examples of your child's problems at school).

We have tried the following to help (child's name): (If you or the school have done anything extra to help your child, briefly state it here).

I understand that I have to give written permission in order for (child's name) to be evaluated. Before the evaluation begins, I have some questions about the process that I need to have answered (list any questions you may have). I would be happy to talk with you about (child's name). You can send me information or call me during the day at (daytime telephone number). Thank you for your prompt attention to my request.

Sincerely,

Your name

cc: your child's principal (if letter is addressed to an administrator)

your child's teacher(s)

--------------------------------------...

Note: If your child has been identified as having a disability by professionals outside the school system, add the following sentence to the end of the first paragraph above.

(Child's name) has been identified as having (name of disability) by (name of professional). Enclosed is a copy of the report(s) I have received that explains (child's name) condition.

Fell free to contact me if you have any questions.

Answer 5

You need to find a developmental pediatrician, developmental neurologist, or pediatric neurologist for a medical diagnosis.

A regular pyschologist probably isn'gt the best way to go about it

Answer 6

The steps will take strong shoes but will help you assist your son as his adolesent years bring new concerns.  Will he be able to be independent and live alone some day?  Will he develop life skills by the time he is age 18.  

Teachers and school personnel are not allowed to make a diagnosis.  They may make observations of autistic like behaviors and document them for your DR.   I would pursue testing with a well recommended psychyatrist for an evaluation and diagnosis.  Certain diagnosed disorders provide subsidies for the child such as  SSI , med. services, even   Vocational tutoring, job training, to tutors in college depending on family need and student ability.  

Several secreening instruments have been developed to quickly gather information about a child's social and communicative development within medical settings. Among them are the Checklist of Autism in Toddlers (CHAT), the modified Checklist for Autism in Toddlers (M-CHAT), the Screening Tool for Autism in Two-Year-Olds (STAT), and the Social Communication Questionnaire (SCQ) (for children 4 years of age and older).

Some screening instruments rely solely on parent responses to a questionnaire, and some rely on a combination of parent report and observation. Key items on these instruments that appear to differentiate children with autism from other groups before the age of 2 include pointing and pretend play. Screening instruments do not provide individual diagnosis but serve to assess the need for referral for possible diagnosis of ASD. These screening methods may not identify children with mild ASD, such as those with high-functioning autism or Asperger syndrome.

During the last few years, screening instruments have been devised to screen for Asperger syndrome and higher functioning autism. The Autism Spectrum Screening Questionnaire (ASSQ), the Australian Scale for Asperger's Syndrome, and the most recent, the Childhood Asperger Syndrome Test (CAST), are some of the instruments that are reliable for identification of school-age children with Asperger syndrome or higher functioning autism. These tools concentrate on social and behavioral impairments in children without significant language delay.

If, following the screening process or during a routine "well child" check-up, your child's doctor sees any of the possible indicators of ASD, further evaluation is indicated.

Answer 7

First of all, I want to congratulate you for being a concerned and self-informed parent. It appears that you have taken some positive steps to learn more about your child's difficulties and to advocate for his success. This is one of the most important things you can do to help your son. I agree with other answers that if you are looking for a diagnosis, your quickest and easiest route would be to find a psychologist familiar with autistic spectrum disorders and have an evaluation. You could also request assistance with this from your school. I would like to caution that special education is not necessarily a fix for your child. Your school might have been correct saying he does not require an IEP, if he is able to function effectively without special education services. However, school functioning can include behavioral issues and socialization skills. It might be more reasonable to look for 504 accommodations if your son does have Asperger's, as this can provide accommodations and modifications at school without labeling your child. By this I mean things such as testing accommodations like small group or extra time, as well as some for behavior problems or social skills deficits. It can also provide some protection if your child has behavior problems at school. From your description it sounds likely that he does have an autistic spectrum disorder. Many schools and psychologists have become more informed about autism spectrum disorders over the last several years, due to the increase in diagnosed instances of autism ( Between 1 in 150- 1 in 164 are diagnosed with an autistic spectrum disorder, according to CDC figures). There is a website I have visited that is by and for "aspies" ( as individuals with Asperger's often refer to themselves) it is called wrongplanet.com. This might be a place where your son could find some social support in a nonthreatening manner with others who would be understanding of his difficulties. As far as medical insurance, I don't know if a diagnosis would help in that area, but if you want more confirmation, than I would pursue it for your piece of mind. I just wanted to add that special education does not "fix" disabilities, it is meant to allow people with disabilities be successful at school. It sounds like your son has some good, skills and abilities as it is. I wish you both well.

Answer 8

Take your son to a psychologist for a full psychological evaluation. He should get a diagnosis once the evaluation is completed.