Autism and Sleep

Sleep can be difficult for any young child, but when you are dealing with sensory sensitivities, schedule changes and and communication barriers it can be down-right agonizing.

Julia Walsh from Good Night Sleep Site NC has some tips for us on her blog: Click HERE

Why do I support Autism Awareness?

April is Autism Awareness Month, and April 2nd is Autism Awareneness Day where everyone is supposed to wear blue to show support.

Why do I promote Autism Awareness?  

Obviously as a parent of a child with Autism I want to show support for what he is dealing with.  I want to share with the world the “road map” that I have learned to navigate.  As a parent, it is my job to prepare my child for the world, but I also feel a need to prepare the world for my child.  Those who are close to him need to know what his triggers are and how his mind works, and also how wonderfully bright and funny he is.  

So I raise awareness for my son so that he can have the most amazing life possible and be comfortable in his world.

But it’s more than awareness and support… its understanding and acceptance.  That is the end goal of wearing blue and sharing Autism Awareness Ribbons.

Many times since my son’s diagnosis I have found myself thinking of an elementary school classmate of mine.  His name was Trevor and it was obvious to us all (even at a young age) that Trevor was different.  He cried (and by that I mean he screamed at the top of his lungs) for hours after his grandmother dropped him off at school each day.  It became an expected event.  “Oh, that’s just Trevor”.   I remember thinking how he talked weird and ran funny.  No one would play with him, or maybe he didn’t want to play.  And on many occasions, we would hear Trevor being spanked all the way down the hall.  His behaviors were not to be tolerated.  I suppose the thought was that discipline was the only way to “fix” him.  I sit here now with tears rolling down my face and I want to reach out to that Trevor.  That scared little boy who was so misunderstood.  He was crying for help, but no one was listening.  I don’t know that he had Autism, back then I guess it wasn’t something many people talked about.  And I don’t know what ever happened to Trevor.  I try to think that he became a well-functioning adult despite his rough childhood, but the reality is he never got the help he needed. 

I want to raise AWARENESS of Autism so that people know the symptoms.

I want to SUPPORT those who have Autism or are affected by it.

I want to spread UNDERSTANDING so that children who can’t express themselves can be understood.

I want to spread ACCEPTANCE so that we may eliminate the stigma and children, like Trevor, can learn that it’s OK to be different.

These are a few of my favorite things...

As 2013 comes to an end, I can't help but think of where we were a year ago and how much progress JC has made since then.  I wanted to give tribute to the supports that have made such a difference in our lives and in his development.  Below are a few of my favorite things from 2013:

1)  Fish Oil Supplements:  We use Nordic Naturals Strawberry flavored.   Liguid filled gel caps make it easy to puncture the capsule and pour into juice or other beverage.  I try to maintain a daily regimen, but if I slack off and he is having a rough day or two, difference that I see in my child within 24 hours of taking these supplements is amazing.

2) ELECARE Formula:  Although very expensive, this formula has allowed JC to grow and thrive.  it is n amino acid based formula that is already broken down and only requires the body to absorb it , not digest it.  For a child like JC who has many food allergies and  a history of digestive issues, this formula has been a must have.

3)  Occupational Therapy:  I just cant say enough about the impact that OT has had on JC's development.  When I think of where he was before starting OT, and where he is now... its astounding!  For those who many not know how OT is used for children with sensory issues (including Autism), here is a great video that descriges sensory integration therapy.

4) Speech Therapy:  Just as with OT, Speech therapy has made such a difference in JC's development.    And not just the verbal use of words.  It has been much more than htat.  JC's therapist understood his challenges beyond speech.  She knew that although he could say many words, those words escaped him when he became frustrated or upset.  She also knew that he did not always form a connection between a word and an object.  She introduced us to visual schedules and social stories and those have made a HUGE difference in his frustration level and my understanding of him.

5) Visual Schedules & Social Stories: to read about these see my previous post

6)  Social activities like
Kindermusik:  If you aren't familiar with Kindermusik, it is a program for young children that focuses on music and movement to improve early brain development.  It is a "mommy and me" class layout for children JC's age and it helps to introduce the concepts of social interactions while maintaining the comfort of familiarity and fun.  Here is a video of JC enjoying a Kindermusik class:

And Preschool:  Finding the right preschool for a child with special needs can be challenging.  I choose JC's preschool based on small class size and access to a large gym for lots of physical activity.  It has been a wonderful experience for him and his teachers have gone out of their way to try to understand him and his needs.

7) Headphones:  One of the challenges for someone with sensory integration issues is discriminating among all of the different sensations they experience at any given time. Imagine being in a crowd and hearing everyone's conversation instead of being able to focus on the person with whom you are speaking. Headphones have been a huge help for keeping JC focused and reducing overstimulation.

8) Calming techniques:  JC is a snuggler and often he relies on me to help calm him.  But rocking, swinging and deep pressure also work well.  A Weighted Blanket from Sensory Goods has become a calming tool because of the deep pressure that it provides.  During the first night of use, JC slept without waking for several hours (which is uncommon for him).

9)  Sensory  Play:  Tons of everyday items can be used for sensory experiences.  Playdough, sand, bubbles, bird seed, coffee beans just to name a few.  In this same category, I like to put  Movement toys like the swing and trampoline:

These have been integrated into our home and used on a regular basis to help regulate JC's sensory input.  What I mean by this is sometimes, when JC is overstimulated, swinging will calm him.  And sometimes when he is under stimulated, jumping can help find that happy medium again.  With a sensory-sensitive child, too much or too little stimulation can lead to tantrums and meltdowns.

I also love the T-seat we got from Sensory Goods!  This is a great for children with low tone and trunk strength.  It requires them to balance while sitting and strengthens those core muscles.

10) iPad apps: Here are my favorites (most of which have "Lite" versions available for free)
INJINI  Includes several different activities to improve cognitive development

Anything from Wonderkind:  These are interactive "Seek n Find" scenes ... LOVE THESE!

My Playhome:  This is probably JC's favorite.  It is an interaxtive house with various people and you can make them interaxt with their environment.  For example, the mom can eat a bowl of xereal and the chidl can listen to music.  Very imigination friendly but also promotes appropriate social understanding.

Endless Reader:  Excellent sight word app!

Touch n Say: This is an incredibly simple app that features several brightly colored faces saying words, singing songs or making funny sounds.  So why do I love it so much?  Because it touches on all the basics: colores, letters, numbers and best of all... feelings!

Autism: Cured or Misdiagnosed?

As JC continues to make great progress I am often asked "do you think he will be cured?" or "well maybe he was misdiagnosed". Here are my thoughts on those possibilities:

Let me start by saying that I am not a believer that Autism can be cured, because after all it is not a disease.  It is, in the simplest terms, a difference in the way the brain functions and processes information. There is no "cure" for that, nor is one needed. The aspects of autism that we as a society seek to "cure" are the symptoms of this brain functioning difference.

What do I mean by "symptoms"?

Sensory issues impede and can severely limit everyday life, so we try to desensitize the body to various stimuli.  The stereotypical repetitive movements (flapping, rocking, jumping) all come from a need for sensory input and an attempt to regulate the body in some way.
Trouble with communication and speech results from various components of the brains operation. For example, some may not be able to process speech and emotions at the same time.  Others may not be able to speak at all because the process to formulate an idea or response, process the appropriate way to express that idea or response, and then plan the motor movements needed to say the words is a very un-natural process that requires so many steps, each of which produces an opportunity for error and break-down. In many cases, a child is non-verbal not because they have nothing to say but more because they simply can't say it with words.    
Rigidity and inflexibility can result from an overwhelming sense that the world is unsafe. Imagine if everything you touched, heard, smelled or saw was scary and painful. You would want to have as much predictability in your life as possible to reduce the unexpected and thereby limit the assault on your body.  Requiring a strict routine or method of doing something becomes a coping mechanism so that the child can function on a daily basis.
Social issues arise from a variety of reasons as well.  Maybe because of sensory issues a child doesn't like to have others in "his space". Or maybe the effort to communicate is so in-natural that a child would simply prefer not communicate with others.  Or perhaps the unpredictability of social situations makes the child uncomfortable thus leading to a need to control and be inflexible in play. This inflexibility and need for control can cause difficulties in social  situations because the child doesn't understand or seek to understand others emotions or desires.  In many cases I think they are simply trying to preserve their own sense of comfort rather than avoiding acknowledging others.

These are just snapshots of certain circumstances, specific to what I have seen with my own son.  As we understand the reasons behind the behaviors, we can better understand how to deal with these "symptoms".  In our situation with JC, we have focused on early intervention therapies that seek to deal with the root cause of the behaviors, therefore eliminating the need for the behaviors.  As a reminder, JC entered sensory integration therapy at 16 months old, speech therapy began at 23 months old, and he was diagnosed with ASD (Autism Spectrum Disorder) at 30 months old.  Throughout that entire timeframe, we were focusing on these behaviors very early, even though we didn't know they were related to autism. We began implementing strategies to overcome challenges and tried to provide him with appropriate coping mechanisms.  But I think the biggest success of our endeavors has been that we gained a better understanding of him, of how his brain functions, and of WHY he reacts or behaves a certain way. It is only with that realization that we have been able to help him overcome the challenges that have made his life so difficult.

Does Progress = Cure?

I often talk to people and I will share how well JC is progressing.  His speech has made marked improvements even just over the past months. His rigidity and inflexibility have subsided somewhat as we are more able to understand his "triggers" and help him navigate through the world.  He is showing great improvement in social skills as he learns to share and take turns. He has even made great strides in emotional awareness and I have been brought to tears more than once over this accomplishment.  Just the other day, I scolded him for doing something and he looked at my face, saw that I was upset, thought about it for a second and then said, "sorry mommy". That was such a huge moment!  It showed that he understood the expectations, knew that he failed to follow them, acknowledged that it had an affect on me, and then accepted the responsibility by saying he was sorry. This seems like such a trivial thing to those who haven't dealt with autism first-hand, but let me tell you it was like "first words" all over again!

As you can see, JC has made enormous leaps in the development and progress.  The child who once screamed rather than communicating, refused anything outside his "norm" and made us all walk on egg shells for fear we would "trigger" a meltdown has become a very happy and somewhat well-adjusted little boy.  Much of this progress has taken place over the past 6 months. Of course, there is a lot of normal developmental progress that goes into the time between 2.5 and 3.5.  But I don't think it is a coincidence that the progress peaked after his diagnosis with autism. Why? Any diagnosis is just a label but it is with that label that you begin to understand.    It validated the challenges and encouraged the progress. Knowing that there was a reason for a certain behavior gave me a place to start and from there, we were able to "re-build".  Studies show that early and intensive interventions can make all the difference in children with Autism. Their brains are still developing and it's the best time to "re-wire" those connections.  After JC was diagnosed, I spoke with the neuropsychologist who did his evaluation.  I asked if JC could "outgrow" autism.  After all, I knew he was high functioning, I knew he was very smart, and I knew we had already made such great progress.  His response was this: "autism isn't something one grows out of.  But a child can develop coping mechanisms and learn to better navigate the world so that the signs of autism aren't as noticeable or debilitating.  JC has a very good chance of being one of those children who, learns to function and manage his Autism."  That became my goal: For JC to develop coping mechanisms and an ability to self-regulate so that his issues wouldn't interfere with daily life as much as they had at one time.

So do I believe JC was misdiagnosed?  No, I have always known that his brain works differently. Autism is a spectrum of symptoms and severity. JC started on the milder end of that spectrum so every little bit of progress leads to a more manageable life.  It doesn't mean things will ever come naturally to him, but he can learn to adapt.

Imagine walking through a maze with obstacles at every turn. That's what life was like for him (and us) before the diagnosis. Having an evaluation and a diagnosis was like giving us a map to the maze. We knew there were going to be obstacles, but we learning to navigate through them and in some cases avoid them altogether.  There are days when we have new challenges or things regress a bit, so we pull out that map again (maybe we go back to basics with visual schedules or social stories).  But having that understanding provides a comfort that we did not have before his diagnosis.  Some day we will be so accustomed to traveling through the maze that we will be able to do it without a map. And one day, JC will be able to navigate the maze on his own.

So do I think JC will ever be "cured"?  As I said before, I don't think Autism can be "cured" nor does it need to be. As I see it, some children can "develop through" autism, and JC is showing great progress in doing just that!

Here is a video of Daryll Hannah speaking about her life with Autism.  What a powerful testimony of what it was like for those with Autism years ago.  Her mother was told to institutionalize her!  And now she functions very well as an adult.  As she describes, she still struggles but has gained the ability to overcome much of it.  THAT is my goal for JC!

That's What it FEELS Like to be a Special Needs Mom

I often hear parents of special needs children saying that others just don't "get it". They feel judged by outsiders who think their child is a “wild-child” or just needs discipline.  I try to remember back before I was a special needs parent.  How quick I was to pass judgment and say “well, if that was my child…” as if I had all the answers.  

I remember when JC was a bit younger, he was having an especially difficult day.  We were involved in a parent group activity I felt so horrible that my child was acting this way.  I was so worried about what all of the other moms thought and how I must look like a horrible mother.  No one knew of JC’s diagnosis or history.  So to them, he looked out of control – and I looked like I had no control.  But one mother said to me, “I have been so impressed by how you interact with your son.”  I almost cried.  How wonderful of her to notice, and then share that with me!  From that day on, I no longer worried about what it looked like from the outside.  Because for every one person who may think negatively, there are 5 others who may realize that I am doing the best I can.  And it doesn’t really matter anyway does it?    Aren’t we supposed to be oblivious to what others think of us?  Aren’t’ we supposed to know that we are strong and have our child’s best interests at heart no matter what anyone else thinks?  I hope you are having better luck with that than I am.  

We are our own worst critics as mothers (all mothers, not just special needs moms).  We second guess ourselves, feel an overwhelming amount of guilt over things that we realistically cannot control, and hold ourselves to expectations that are unattainable.  So it’s no wonder we feel judged by outsiders because maybe we project our own feelings onto others.  

Bottom line, being a mom is hard.  As the mother of a special needs child, our struggles may be different than someone else’s but when you look deep enough the feelings are very similar. 

So I wanted to put together examples of what it feels like to be the mother of a special needs child.  Examples that all moms can relate to and maybe when we all realize we are more similar than we thought, we can all judge each other(and ourselves) a little less.  

What does it FEEL like to be the mother of a child with special needs?

Think about...

That feeling when your child is sick, but you can't do anything to make it better. You feel helpless and all you can do is hold them.

That's what it feels like when my child has a meltdown because of the slightest frustration or variation in his expectations, and I can't do anything to fix it. I feel helpless and wish I could do something to make it better. 

That feeling of heartbreak when your child didn't make the football team, or cheerleading squad, or basketball team.

That's what it feels like when I see my child struggling to self-regulate, rebound from frustration or deal with social situations. My heart breaks for him, but I can't turn the situation into a life lesson about trying hard and "better luck next time". It's a constant struggle, and the only lesson seems to be that slow and steady progress will take time.

That feeling when you have been working for  hours to help with a project of studying for a test, and the longer you try to help, the more frustrated everyone becomes.

That's what it feels like when I try to teach my child how to play a game and the rules are so abstract that he refuses to participate in any way other than his own. Or when he becomes set on doing things a certain way, and as much as I try explaining that it doesn't work that way... He continues to insist. 

That feeling you get after the unending fight to get your kids to eat their veggies.  The frustration, the "just one bite", the "no dessert until you eat!"

That’s what it feels like every day.  Imagine your child refusing to eat ANYTHING.

That feeling when your child starts a new school. You are anxious about how they will fit it, hopeful it will be a good fit, and worried that it won't be.

That’s what it feels like almost every day as we enter any situation. Even a common experience can feel new depending on the mood, level of stimulation, subtle changes in environment rile expectations... or any other factor. 

That feeling when you have had such a long day and you can't stand the argument over whether or not they can watch TV before bed because all you want to do is have peace and quiet.

That's what it feels like when you see us in the grocery store or restaurant and I allow my child  to watch the ipad or eat cookies out of the bag because I have fought him all day over far more important issues like wearing clothes, and at this point I just want to finish the shopping trip or restaurant meal without a meltdown. 

That feeling when your child lashes out at another or jerks a toy away and screams. There is an expectation that 2 year olds don't want to share. We spend time teaching them appropriate social habits, and they learn them through experience and through watching others. 

That’s what it feels like on a regular basis because my child struggles to understand those social rules. "Teaching" means not only telling him and redirecting his behavior, but also using social stories, video modeling and a whole lot of hovering. The end result may eventually be the same.  He will learn what behavior is appropriate and what is not.  But the path that we take is long and winding. 

That feeling when your child cries for you after you leave then at kindergarten for the first time.

That’s what it feels like when my child is so attached go me that he will not allow anyone else to care for him.  I love having such a close connection, but for him it is a security issue. I "get him". I have always been there with him. I know how to make rough situations easier. I am the only one who can calm him after a meltdown or tantrum. It drains me to the core, but I am the only one he wants in those situations. 

That feeling of embarrassment after your child knocks over a display in the grocery store or spills his drink at a restaurant.

That’s what it feels like anytime we go out.  Loud screams, running around (unless buckled in a cart), climbing over chairs and under tables in a restaurant. We don't go out much unless it is a place with a playground. 

That feeling of exhaustion when your baby is a newborn and is up several times a night and then needs your constant attention during the day too. 

That’s what it feels like, even three years later.

That feeling when you are the first of your friends to get married or have a baby.  Everyone else is still living the single life. You don't fit in anymore. Your lives are so different.  You lose touch.

That’s what it feels like as the parent of a special needs child.  You have no time for play dates because of all the therapy sessions.  In fact, you look forward to therapy sessions to have someone to talk to that understands what you are going through. And even if you had time to schedule play dates, you know your child isn't that great at play dates so it isn't a fun experience for either of you. So you relinquish yourself to hanging out at home and are so thankful for the other special needs parents you find along the way. 

That feeling of defeat when your child is given an antibiotic or steroids that hype them up so much that they are bouncing off the walls.  And all you can do is count down the days until the medication is over.

That’s what it feels like every day for a child who has sensory issues.  They play hard and crash hard. Any it never wears off. 

But now think about…

That feeling you get when your child takes his first steps, says his first words or smiles at you for the first time. That amazing feeling that all the sleepless nights are worth it and you can't imagine life without that sweet face.  The pride you feel when your child wins a competition or advances to a new level of something after trying so hard. 

THAT’S WHAT IT FEELS LIKE even after the smallest accomplishment, because I know how far he has come.  The most simple request to “help me” brings tears to my eyes because he is FINALLY using language to ask for what he wants.  The act of saying “I’m sorry” after a tantrum or meltdown has such huge implications that I can’t even describe how proud I was at that moment.  THAT is what every day feels like as a mother of a special needs child.  

Reflections of a Mother

This is well worth the read: http://www.autismsupportnetwork.com/news/he-struggles-hes-my-hero

What a touching, honest and heartfelt depiction of this child and his mother's love. JC has high functioning Autism.  His struggles pale in the light if so many. I can relate to this mother's explanation of good days and bad days. Days when JC says new words, eats new foods, plays without screaming, asks for help. Those are days when my heart beams with pride and amazement at how for he has come. And then the days of tears because he can't get his shoes on but won't allow me to help, or screams because someone touched or moved his toy, or the constant attempts to elicit a response of some sort when it feels like I am taking to myself and all he is doing is babbling or screaming.  The bad days make me so thankful for the good days.  And I love every bit of him. I'm thankful that the bad days aren't worse, I enjoy the good days and I thank God for every day. 

I have never told anyone this, but before we had my older son, my husband and I were having fertility issues. We had tried for 2 years to have a child. We had finally decided to do in vitro fertilization. During that time I asked God to please bless us with a child. Even if he needed a special home for an angwl with special needs, I would love any child and be the best mother possible.  We became pregnant the month before we were to start in vitro fertilization. We had a beautiful and healthy baby boy. He is now 7 and he lights up my world. But God remembered my promise, and also blessed up with JC 5 years later.  And I am trying to live up to my promise to be the best mother that he deserves. 

JC's Autism Spectrum

What is Autism?

For almost 2 decades, the Diagnostic and Statistics Manual of Mental Disorders ( DSM-IV),  defined Autism ( Autism Spectrum Disorder) as a variety of disorders known as Pervasive Developmental Disorders.  These are disorders which manifest in developmental delays  in multiple areas of basic functioning skills, usually socialization and communication.  The reason it is called a "spectrum disorder" is because no 2 children are alike in their symptoms.  It is often said that if you know one child with Autism, you know ONE child with Autism.  These delays can range from mild to severe and the symptoms themselves can vary from child to child.  For example, some children are communicative but lack the understanding of social cues and interactions.  This is often the case in children with an Asperger's diagnosis. Other children may be non-verbal and and/or seem to have little interest in social interaction at all, as can be the case with classic autism (the stereotypical Autism that people think of).  And many are in the middle, like JC.   The dichotomy of high vs low functioning Autism is misleading.  Someone may be "high-functioning" cognitively, but may be non-verbal and have low-functioning social skills.  This variety is why Autism is considered a Spectrum Disorder.

The New DSM 5:

Recently a new Diagnostic and Statistics Manual of Mental Disorders ( DSM-5) was released (click here to read more). It altered the description and diagnostic criteria for Autism Spectrum Disorder. Now, There are no subcategories within the Autism spectrum diagnosis (for example Asperger's and PDD-NOS were removed from the DSM-5).  The necessary criterion to diagnose Autism also changed.  In the DSM-IV, there were 3 categories from which symptoms must be present. These categories focused on problems with social interaction, problems with communication, and restricted repetitive and stereotyped patterns of behavior, interests and activities.  With the new diagnostic criteria have been rearranged into two areas: 1) social communication/interaction, and 2) restricted and repetitive behaviors.

Here are the diagnostic criteria from the new DSM-5:

1) All of the following symptoms describing persistent deficits in social communication/interaction across contexts, not accounted for by general developmental delays, must be met:

• A) Problems reciprocating social or emotional interaction, including difficulty establishing or maintaining back-and-forth conversations and interactions, inability to initiate an interaction, and problems with shared attention or sharing of emotions and interests with others.

JC has significant difficulties in social situations where HIS expectations are not being met.  If he is playing HIS game, HIS way, by HIS rules, things are fun and he enjoys social interaction. However, if someone varies from that "scripted" view of how things should go, his anxiety level increased and he is no longer able to function in that environment.
Joint attention is a struggle as well.  He often leads me to an object of interest rather than trying to communicate that interest to me.
For some children, these social issues do not manifest until school age when the demands of social situations become to much for then to handle.

• B) Severe problems maintaining relationships — ranges from lack of interest in other people to difficulties in pretend play and engaging in age-appropriate social activities, and problems adjusting to different social expectations.

JC often prefers to pay by himself, but will play with others when initiated by them. He usually prefers specific toys (cars) or random household objects like bowls and candles.
He has difficulty understanding the necessary social rules in various situations and often doesn't generalize from place to place (for example, he doesn't speak much at preschool, while he does at home).

• C) Nonverbal communication problems such as abnormal eye contact, posture, facial expressions, tone of voice and gestures, as well as an inability to understand these.

JC limited eye contact. This actually surprised me when the doctor mentioned it because I always thought he had adequate eye contact. However, it varies from person to person and he doesn't rely on it as a method of communication. He looks to see, not to relate. His eye contact is fleeting and he doesn't use it to establish "joint attention" (pointing and looking to see if I know what he is looking at).
He also has difficulty mimicking gestures.  He often uses his own version of gestures rather than the actual gesture (for example, he does thumbs up with his index finger extended rather than his thumb; he uses his thumb and index finger to show the number 2 rather than his two fingers; he requests you to follow him by patting his chest, rather than making a sweeping motion with his hand.). These examples are not significant in and of themselves, but they show that when it comes to mimicking, he doesn't view things like gestures from the perspective of the person giving the gestures.


2) Two of the four symptoms related to restricted and repetitive behavior need to be present:

• A) Stereotyped or repetitive speech, motor movements or use of objects.

JC toe-walks, and sometimes flaps his hands in excitement.
He also plays with cars by lying down on his stomach and pushing the in front of his face to see the wheels turn.
He also perseverates in speech (if he says something I have to repeat I back to him exactly as he says it or he will continue to say it)

• B) Excessive adherence to routines, ritualized patters of verbal or nonverbal behavior, or excessive resistance to change.

JC has a very rigid view of the world. He runs "scripts" in his head in any given situation, and if things vary from that "script" he becomes anxious. For example, if we go through downtown and don't turn onto the street to go to school, he becomes upset.
We use visual schedules and social stories to facilitate changes to his expected scripts. I could really talk about this one more, but I have other blog posts devoted to this.

• C) Highly restricted interests that are abnormal in intensity or focus.

This is really the only symptom that I don't see JC having. Some children may be obsessed with trains, others may know everything there is to know about dinosaurs, and some may have an interest in letters and words and can recite passages from books at 18 months old. It can also arise in obsessively repeating an activity with such intense focus that trying to stop that activity causes frustration.

Although he doesn't have these types obsessions, he does have abnormal intensity and focus related to fears and anxiety. We cannot drain the bath water after a bath because he panics and screams. Wind blowing leaves around the yard causes panic attacks as well.

• D) Hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment.

Well, this one needs no explanation. Sensory processing disorder is where we started after all.

3) Symptoms must be present in early childhood but may not become fully manifest until social demands exceed capacities. Symptoms need to be functionally impairing and not better described by another DSM-5 diagnosis.
Obviously JCs symptoms are present in early childhood.
The only other diagnosis that could partially explain his symptoms is a new diagnosis termed Social / Communication Disorder. However, it doesn't take into account sensory issues and rigid behaviors.


Another main difference is the introduction of severity levels. Previously, terms like high-functioning or low functioning were used to describe the severity of symptoms. But these can be misleading because someone who is low functioning on a communication scale may be very high functioning cognitively. The new levels will enable the medical community to describe the level of supports needed based the level severity of symptoms.
Level 1: "Requiring Support"
Level 2: "Requiring Substantial Support"
Level 3: "Requiring Very Substantial Support"


JC's Autism

JC struggles with communication, speech, sensory issues and social interaction. However, he shows more affect than classic autism. In other words, he is interactive, affectionate, attempts to communicate, WANTS to be involved and social. But he doesn't understand the reciprocity needed for proper socialization.  Rather than relying on communication to effectively express his needs or desires, he often seems to assume that others should understand innately what is inside of his mind.
But, JC doesn't fit the "Autism mold" (if there is such a thing), likely because he has been receiving therapy since he was 16 months old.  Although we didn't know at that point that JC was Autistic, we did know he had sensory issues and began therapy and early intervention followed by speech therapy at 2. Even his neuropsychologist mentioned that he had never seen a child receive such early and intensive intervention.  I have no doubt that if he had not received this early therapy, his level of functioning would be much lower than it is and I am so thankful for the wonderful therapists that have made such a difference in his life already!  We have been able to circumvent many issues because of the early therapies and early understanding of his sensory issues especially.  And when you look at each of these issues and symptoms, any one may not affect daily life, but as a group - they impede his development and interfere with daily activities.  Below is a visual that I created to show JC's Spectrum of Autism.  Those items in Red, orange and yellow are the most difficult and have the most impact on daily life.  The others aren't as impeding, but are still prominent enough to be a part of his diagnosis.

He is doing very well, even compared to a few months ago. His speech has exploded and we are making progress in the other areas as well.  The therapies are working to provide him with coping mechanisms as well as helping me to understand "what makes him tic".  My hope is that by the time is is school-aged, he will have made such great strides that he will no longer meet the criterion for Autism.  That does not mean that he will "outgrow" Autism.  It simply means that he will learn to cope, manage and overcome his symptoms.  That is why these years of development are so crucial.

JC is one of those children who was not diagnosed because of the obvious symptoms, and were even told by a developmental psychologist that he couldn't be Autistic because he was social (JC looked at him when he walked in the room and made eye contact a few times).  He likely have fallen through the cracks or perhaps been diagnosed later due to the increase in severity of symptoms as school demands increased.  When JC's social interactions became increasingly troublesome,  I  researched enough to know that the issues he was having were synonymous with autism, even if it wasn't the "classic" non-interactive type. After all, it is a spectrum disorder.

When I found the neuropsychologist that diagnosed JC, I knew right away that I had found the right doctor. He listened to my concerns, never dismissed JC's struggles, and provided an in depth evaluation. That's all I wanted.  I didn't care if he said he had polka dotted monkey disorder... As long as he had taken the time to evaluate and listen. When we received the diagnosis, I agreed with everything he said. He even picked up on things that I hadn't noticed like limited eye contact and joint attention (more explanation later). But he did point out that JC doesn't fit the classic autism diagnosis because he "shows more affect" than expected with classic autism, but he still was on the Autism Spectrum.

For these reasons, I am actually happy about the changes to the DSM criterion. I feel that the new standards better describe the struggles that JC faces, especially the sensory issues (which weren't included at all before).  Although he still scored on the spectrum before, the new criterion portray a clearer picture of his diagnosis.


No matter what the criterion or severity levels... The important thing to remember is that no 2 children are the same. Every Autistic Child's Autism is as different as every non-Autistic child's neurotypicalism. No 2 children are alike... Period.