ParentConfidante Blog

Changing the Diagnostic Criteria for Autism and Asperger Syndrome

The American Psychiatric Association is reassessing the diagnostic criteria for autistic and the proposed changes, as described in the NY Times article of Jan. 20,2012, may exclude many people who are now diagnosed as having Autism, Asperger Syndrome or Pervasive Developmental Disorder-Not Otherwise Specified (P.D.D.-N.O.S).  These diagnoses would be consolidated under one category - Autism Spectrum  Disorder - eliminating the Asperger's and PDD-NOS categories.  While the new criteria will have little impact on the diagnosis of youngsters who are "classically autistic" - those who have severe limitations in their cognitive and social functioning- there may well be an impact on those youngsters who are cognitively able but have a social disability.

Parents are understandably concerned given that mandated services (IEP) are often dependent on a diagnosis.  It will be important to see how the changes  will ultimately affect the delivery of services, but the attempt to clarify diagnosis is an important and needed undertaking. In the past, there has been a good deal of confusion especially regarding the identification of Asperger Syndrome - does every child who prefers to play alone have Asperger's and are deficits in social intreraction the main determinant?  In fact, there are other determining factors for a classification of Asperger Syndrome and many children who fall within this group need continued support.

There was some concern when it was first divulged that there would be a consolidation in criteria with Asperger's eliminated, because Asperger Syndrome, properly diagnosed, is distinct from classical autism and descriptive.  It will be important, in the tightening up of this diagnostic category, that those who need services continue to receive them.  While these youngsters are cognitively able, their narrow interests, perseverative behavior, and social incapacity makes it very difficult from them to succeed without support.

 

 

Best Early Intervention Helps Manhattan Preschooler into Mainstream Private School

I was very happy today to get this email from a former client.

Toby,

I just want to let you know that <child's name> made dramatic improvement this year and actually made it into <mainstream Upper East Side NYC private school>!!!  Can you believe it?  We can't and as you can imagine we are overjoyed!

The audiologist and the speech therapist you recommended made all the difference, especially after <NYC preschool director> sent us on that wild ride.  You would not believe how <child's name> is now totally in the mix in class.  He even gets invited to playdates.  What a difference we've seen this school year.

Thank you again.

Why to NYC Toddlers Need Therapy?

A recent article in the Wall Street Journal focused on the growing practice of providing mental health professionals to preschool and child care centers.  These counselors help children who are having behavior or social issues.  They work with the youngsters, teachers and sometimes parents to help children find more acceptable ways of expressing their feelings - such as saying what they are feeling instead of hitting.  They help children socialize and manage other anxiety feelings.  These services are especially needed in communities where there is an emphasis on academic achievement like NYC private schools.

The mental health intervention comes amid growing concern that young children are exhibiting more behavioral and social problems than in the past and increasing numbers of children are being "expelled" from preschool.  There are various explanations for this trend from too much and too early large group care, to increased anxieties in familor increased academic pressure on young children.

While all of these issues enter in, I think that a major factor is the pressure on children to develop reading and math skills before they're ready to grapple with those concepts. Increased behavior problems may well be an unintended consequence of the trend to make the preschool curriculum (which used to be learning through play) explicitly academic.

I'm a great believer in mental health services and social skills developed now will last a life time, but it may be past time to take a good look at what we expect of our youngsters in preschool these days.  I would guess that there are fewer behavior problems in those preschool settings that are play centered as compared to those that are more academically based.

I'll be writing more on this issue which has long been of concern and interest to me.  As an educational consultant (toby@parentconfidante.com) I'm often asked if children need special services, what can be done to help them focus, what can be done to help them learn better.  I make referrals to the most trusted professionals but sometimes it's also important to take a good look at what is beiing expected of these little kids.