This is Vince and our friend, Chrissy. This photo was taken today, right after we got back from the pediatric office. Vincent had such a fun time there that he promptly dressed up in his doctor costume (a Christmas gift from my mother - thanks Mom) and went to work on her. It was adorable!
Anyway, the evaluation was pretty straight forward. The D-Ped did two types. The first was a history log of my pregnancy with Vince and his behaviors since birth.
Good thing I kept a meticulous baby-book for him, because I needed each month to remind myself of which milestones he hit and when he hit them. I highly recommend keeping up with those books for your children if at all possible. I always thought his would be a keepsake memento. It's actually been more of an archived medical history given what I've now learned about milestone achievement and their connection to autism and sensory disorders.
But I digress.
After the history, she did a current snapshot of Vincent's behavior through conversation. She asked me questions, I answered. She took notes the entire time and was sure to ask for clarification on anything she was unsure of.
The entire time we were having this discussion, there was another D-Ped in the room simply observing Vincent. They had a train table set up and the 2nd D-Ped was there strictly to observe Vincent and his behavior as I spoke to the first doctor, as I interacted with him, as the other doctor interacted with Vince, and as he was left to his own devices. I thought that was great. Two doctors for the price of one, and each could focus on a separate task instead of one trying to observe Vince while getting a family history down.
Anyway, once the D-Ped was done asking questions of me, she had me fill out a GARS-3. For those unfamiliar, GARS stands for "Gilliam Autism Rating Scale" with "3" being for the 3rd edition.
As I filled out the scale, the doctor turned her attention to Vincent. She did a brief physical exam, and then she spent some time "playing" with him. She wanted him to draw certain things, point to certain things, or do certain things as she tested various capabilities. At this point, the second D-Ped interjected because she was so excited by Vincent's drawing of me. When asked to draw a picture of a person, Vincent kept drawing various scribbles. It dawned on me that the word "person" was not part of his vocabulary, and when I suggested they use a different word, he was able to follow through with the request to "draw Mommy."
Vincent kept looking at me and then adding features to his stick figure (glasses, earrings, my ponytail, etc). The silent D-Ped couldn't resist commenting on how detailed his drawing ended up being. I was delighted she took such joy from his art. I was even more delighted that she acknowledged how intelligent he was - something I sometimes fear people neglect to realize when they're busy looking for labels.
The original D-Ped finished her assessment of Vince a few minutes after I'd finished the GARS. It only took her a few moments to add up the data and place him into percentile rankings. This standardized scoring method is useful in predicting Autism. It doesn't, however, diagnose it. Rather, it establishes a baseline of probability and possible severity level based on 6 areas: Restricted / Repetitive Behaviors, Social Interaction, Social Communication, Emotional Responses, Cognitive Style and Maladaptive Speech.
For Vincent, his percentile ranged him as "Autism is Likely" with "Level 2" severity (out of 3) which would require "Substantial Support."
However, as the D-Ped pointed out, he "failed" the DSM-V criteria for Autism completely.
How is this?
Well, the DSM-V (read: Psychologists' Bible) notes that for Autism to be diagnosed, three persistent deficits MUST be present: Socio-emotional reciprocity, non-verbal communicative behaviors for social interaction, and developing, maintaining and understanding relationships.
Now, in addition to those top three criteria, there are things like repetitive patterns of behavior, inflexibility and fixated interests that are also added to the list, but in all Autism diagnoses, the three I mentioned in the preceding paragraph MUST be present. Since they were not, she explained Autism could not be a diagnosis. I asked about Asperger's Syndrome. It's not technically an Autism disorder anymore, but given it is still spectrum, I wanted her feelings on that, too.
She explained that Vincent didn't measure up to that diagnosis, either. The closest she could come up with was Sensory Modulation Dysfunction which, again, is another way of saying Sensory Processing Disorder. It was exactly what I had anticipated based on my own research and findings.
She did mention he exhibited signs of being hyperactive, but this is not surprising. She explained that many children with SMD / SPD can either be hyper- or hypo- active depending on where they fall on the scale. Vince, being easily over-stimulated and constantly craving a stream of tactile sensation, was obviously going to be on the hyperactive side of things.
Point is, all of his "Autism symptoms" were strictly related to his sensory issues. Since the two do overlap at times, it's easy to understand his GARS ranking. However, since the D-Ped was able to add her own analysis and evaluation through the DSM-V, I was able to walk out of the office with a diagnosis that would finally take Autism off the table for Vincent's child study team.
I felt like I'd finally be able to tell the surgeon I needed kidney surgery vs. a stomach surgery. The CST will FINALLY have the D-Ped report they've been hounding me to get since Vince was in Early Intervention from 18 months of age. I can finally prove to them that he is not so easily labelled.
He won't be so easily placed into their bucket of special needs children to up their state funding.
Not my child. I will never let him be a statistic or a financial victory for those people. I know how the system works and I absolutely refuse to let it take advantage of him like that.
So two hours after walking through the doors, I walked out victorious. My son was confirmed as having Sensory Modulation Disorder (or SPD) and the current course of therapy that John and I currently have him on is exactly what was prescribed.
Vindication is glorious. I finally, finally feel like we are going to get somewhere with his education now. There is no excuse not to proceed now that they've got everything they demanded of us. I find it delicious that the diagnosis they were so SURE we'd get today not only falls short of their expectation... it falls completely in line with mine.
Parents know best.
And praise God for allowing things to line up so perfectly for this today.
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