Wednesday, February 19, 2014

The Autism Assessment

So I know that everyone has been wondering: "What is going on with my crazy kids??". So tonight, I wanted to share a bit of what Logan has been up to these past few months.

On an almost daily basis, I look at my little guy in disbelief that he will be turning 4 in less than 3 months.  He has matured so much in the past year.  At times, when I watch videos of tantrums taken (for therapists) just a year ago, I can't believe how different he was.  Or that we lived to tell. 

He's still a challenging little guy.  But the two hour long tantrums?  They're a thing of the past.  We still have our fair share of tantrums.  Logan still struggles with regulating his emotions.  He goes from 0 to 100 in the blink of an eye.  I am somewhat concerned that he will one day actually be kicking holes through my walls instead of just kicking them.  But the frequency and intensity of his tantrums has decreased significantly ever since we put him on Ritalin.  Anyone who tells you that it is inhumane to medicate your kids so young, let me tell you, it was inhumane of us to not give him, and our family, the ability to get away from so much constant stress.  Medication is not the right answer for every child, but it certainly has been part of the answer for our family.

Logan still does Physiotherapy once a month and both Occupational and Behavioural Therapy every second week.  It has led to lots of changes.  Too many to number.  He is much more willing to try new things and is less terrified by movement.  At my husband's Christmas party this year, he even tried a few climbing apparatuses, which would have been unheard of in the past.  Not a big deal for most kids.  But a very, very big deal for Logan. 

He's been doing wonderfully at Mon Gym and his coordination is improving.  In fact, as I sat at the Petit Gym this past weekend, watching a younger child who I suspect to have SPD have a post-class meltdown, I couldn't help but be in disbelief that that was us just one short year ago.

And he is essentially having no problems at daycare.  I write this almost exactly a year to the date on which he was kicked out of daycare, for being unmanageable.  Although he used to have to be seated with an empty seat on each side of him he is now able to be in the middle of the group without issue.  His teachers tell me that he functions just like the others.  I think part of it is the fantastic job his educators have been doing with him and how well they have adapted things to meet his needs.

I realize too in reading this same post above, that this was also when the suspicion of autism was first brought up by his therapists.  We got the final results of his autism assessment the day before Christmas holidays started.  I've slowly adjusted to accepting the results, which I found hard to digest at first. 

Logan failed both of the tests used to assess autism at his age, the ADI and the ADOS.  In other words, he scored as being autistic on both tests.  In our feedback session, the psychologist who assessed him told us that at that point, she was convinced that he had both ADHD and Autism.  However, further to observation of him at the daycare, she became convinced that he is not on the Autism Spectrum.  Although his social communication and language skills appeared to be similar to those of an autistic child in one-on-one interactions during the assessment session, she felt he was much too social with his classmates for autism to be the true cause of his difficulties.  She told me that her clinical gut tells her that his autistic-like symptoms are being caused by "very severe ADHD plus, plus, plus" (evident to her even with him on Ritalin!!), a motor coordination disorder, probably auditory processing disorder and significant anxiety. 

What I took away from this is that although Logan may be functioning much like an autistic child in many settings, he does not qualify for any of the therapy that he would qualify for had he been diagnosed with autism.  Which just left me feeling kind of pissed off. 

Our system here in Quebec is set up to provide services based on diagnosis.  If you do not meet a pre-determined set of criteria, you don't get access to services.  If you can't check every little checkbox... you're out.  Pay for everything yourself.  Doesn't matter that your kid needs as much therapy as a child with autism (never mind your other kid too).  If we can't call it autism, or some other recognizable and acceptable label... too bad.  Yep, I was pissed.

I've since come to terms with it all.  I mean, in all reality, even autistic kids out here don't get a heck of a lot in terms of public services.  And thank goodness for that.  Or I think I would probably still be pissed at the world.  Thankfully, I've always believed that a label is only that, and doesn't at all determine a child's skills or weaknesses.  So whatever you call it, our Logan and all of his developmental challenges are what they are, no matter what label you do or do not put on it. 

Despite not believing his difficulties to be due to autism, the psychologist definitely recognized and acknowledged the extent of his difficulties and, consequently, our challenges as a family.  For instance, she mentioned to us that, in her entire career, she has never seen a child with such significant difficulty self-regulating (i.e. keeping your body at an ideal level of stimulation, being able to respond appropriately to situations, etc.).  So our concerns were definitely heard.

Further to her assessment, she referred us to see a doctor who specializes in ADHD to see if we can look at adjusting his medication.  Firstly, to get him on something longer lasting.  His Ritalin has worn off by the time he gets home from daycare, so we really only get the benefit of it during the day.  Evenings can still be very challenging.  Secondly, she wants to look at whether or not he can be put on something for his anxiety.  Our appointment is tomorrow and I CAN'T WAIT!  I'm trying not to hold my breathe though.  Most of these types of meds aren't prescribed until 6 and he's super tiny for his age and not putting on weight well.  So they may not be able to give him anything just quite yet.  But I'm hopeful at the possibility that we can maybe get a little more of this in our lives:


Colleen said...

My littlest, Fiona just saw me reading your post and said, "aw that boy is cute!" Hope your appointment went well today. Amazed and in awe of all you have been through and all you do. Have personally and professionally witnessed the positive rebalancing that can come from medication. If it wasn't needed, it wouldn't work!

Food for Thought Linds said...

Aw, Colleen, that is the cutest thing ever! And thanks for the encouragement. Interestingly enough, I was at a conference on ADHD recently with a specialist from the US and he was saying that response to intervention actually doesn't confirm diagnosis for ADHD. He said that it helps anyone concentrate, which we would see if we tried one. Found that very interesting, as I had always thought otherwise too.