AS and imagination

[sphil]

Just had a really interesting conversation with DS1 (6). We've suspected for some time he has AS traits, with dyspraxia being the main 'symptom'. He was asking me why DS2 (5, severe ASD) doen't like playing with toys and I explained that some people with autism find it hard to use their imagination. He thought for a while and then said "But I never pretend". I listed all the games he plays (which to me and others look like extremely involved imaginary games) but he just kept saying 'But that's not pretending, it's real'.
'OK, I said, what about when you and Nanny were playing 'Raven' the other day? You weren't really a warrior were you, you were DS1 pretending to be a warrior'. He got quite agitated at this point (the effort of trying to explain himself I think) and said 'NO - I was really playing Raven'. So I then used the example of David Tennant playing Doctor Who as an example of 'pretend'" and he said (very patiently and slowly as if I really didn't get it) 'Yes, but I'm different from ordinary people'.

Does this sound like Aspergers to you?

[Blossomhill]

Hmm hard to tell. My dd with Aspergers has a fantastic imagination. Hard to tell just by what you have said really. I think you need to look at the whole picture regarding your ds. FWIW AS is very commonly attached to dyspraxia. This here www.autism.org.uk/nas/jsp/polopoly.jsp?d=1245&a=2621 is a great piece of info on AS. HTH

[yurt1]

Worth considering. I think often in AS the problem with imagination is that it's over active, and that there's a lack of understanding of the blurring between reality and fantasy. Quite a few of the adults I know with AS are like that!

The diagnostic criteria for ASD is actually stererotypical patters of behaviour etc rather than 'lack if imagination'. It just gets interpreted like that, somewheat incorrectly imo.

[sphil]

Thanks BH - I hadn't seen that page before. It's so hard to tell with DS1 - he has no problems with change, no need to follow routines, but probably has mild versions of everything else mentioned, with definite difficulties in the motor skills area. But come to think of it, DS2, who's severely autistic, has no problems with change either. I think it must just be a family trait to be adaptable and laid back (comes from DH not from me).

[sphil]

Hi Yurt! We're typing in tandem...
Think I'ming to terms with the fact that DS1 may have AS - have been in serious denial about it for some time. Growing Minds have really helped me with this - our last two phone calls have been as much about DS1 as DS2! The hard thing is knowing what to do about it: to dx or not to dx. GM err on the not atm. He's their archetypal 'quirky' child - and Steven's view is that DS2 having autism might make people view DS1 as more severely affected than he is.
BUT DS1 is making more and more comments which suggest to me that he realises he's different from other kids - and he's also asking me lots of questions about DS2. Not sure if the two are connected.

Do you know lots of adults with AS?

[Saker]

Sphil - in terms of your Ds1 asking lots of questions about Ds2 - I don't think that means anything necessarily. Certainly Ds1 (8) who is most definitely not ASD often asks me if Ds2 does such and such because of his "problems" or asks for an explanation of why Ds2 does what he does (like I know ! ).


Though having said that do you think that the fact that your Ds1 is trying to understand how someone else's mind works is more of an indication that he isn't Aspergers? Perhaps that's too simplistic a view though?

[yurt1]

Steven could have a point there...... If he's not struggling at school then you could hold off a bit. Perhaps introduce him to things like freaks geeks and AS as he gets older.

I do know quite a few adults with AS, but more online than in RL.

[sphil]

He's borderline in so many areas, that's the problem. I've done two online diagnostic questionnaires on him - and in both he came out as just below the minimum score required for a dx. But those things are so subjective anyway - he'd probably score in the AS range if I did them when I was premenstrual .

He does show an interest in why other people behave and think as they do - and when I ask him questions about how characters in books are feeling he seems to find it easy most of the time, though tends towards 'sad', 'scared' or 'happy' rather than anything more sophisticated.

[flyingmum]

He sounds a bit like my chap who always had a fab imagination and sometimes does get reality and fiction a little bit blurred. For example he started sleeping with his window shut when in year 6 and they were doing WW2. He knows that WW2 is over and understood lots about it BUT still shut his window because he was scared of bombs dropping. My DS is very dyspraxic and has ASD or Aspergers - frankley its all very blurred. He is very good on emotions and was nothing like those chaps on the 'brilliant minds' maths programme that was on the other day. He can understand others emotions and can read me like a book!
He's got a lovely personality but is undoubtably 'Quirky' with a capital Q! My chap also has a complex speech and language difficulty (apparantly - I have to believe the SALT - he talks fluently and seems to me to have reasonable comprehension but there are gaps on occasion) and Semantic Pragmatic speech and language - so your conversation with your son might link back to more of a S&L difficulty rather than ASD (lots of shades of grey I think).

I would personally go with a diagnosis. As they grow older and the quirkyness between themselves ad their peers widens and they move into the more stressful environment of secondary then a diagnosis can help professionals such as teachers be a tad more understanding. There is no need to broadcast it to the outside world. If professionals (ie, your son's teachers) already know about his younger brother's more severe difficulties then they are likely to be making links with the 'quirks' anyway but it is a very personal decision and one I fought myself with for years - I never would have written about my son like this until three or four years ago.

Good luck

[Blandmum]

I have also seen a tendency amoung very able children with AS to lack some ability to differentiate what is real and what they think should be real!

So in science they can sometimes get terribly irritated when what really happens isn't as efficient as they way they think it should work! And they sometimes find it quite hard to accept the real explanation of something. This is more of a case in biology (where systems are quite complex) than in physics

[sphil]

This is very interesting. Flyingmum, our sons do sound very much alike. Do I gather that your DS has been diagnosed but with a complex mix of things? DS1 does have some speech difficulties but has improved hugely over the last year. He was assessed a year ago by DS2's private SALT, who found his language abilities to be above his age, sometimes quite a way above. But she admitted that she'd have to see him speaking in a social setting to do a proper assessment. His conversational speech is so much better than it was, but still tends towards the disjointed and cryptic at times. He's easy to teach though - since I explained that people won't follow his conversation if he jumps from topic to topic he now always says 'OK, I'm changing the subject now..." and THEN plunges straight in . I can quite see that the conversation about what's real and not real might come down to semantics.

MB - it is definitely the case that he passionately believes that certain things SHOULD be real!

Having said all this, he is at this moment setting out the living room with various Raven quests constructed out of Lego. And when I said - 'Ah, now THIS is pretending and using your imagination' he gave me a cheeky grin and said
"Well I'm doing it today for the first time - all the other times were real" .

[Niecie]

I have a DS who is very similar with mild AS and dyspraxia. I would say he doesn't make up stories as much as role play things he knows about. So he would pretend to be Raven in the eg from the original post, but he could make up Raven if he didn't already exist. DS2 on the other hand is NT and can make up roles and games that come from many different experiences and none.

As a matter of interest, DS1 has been through the DX process and the clinical psych said that he had traits but didn't warrant the label AS. However, the review team said that he did justify the label even though none of them had ever met him. They thought it was better to have a label. The OT wasn't at the review and I now question whether he should have a label of dyspraxia with AS tendencies because to me that is what he needs. However, we saw the OT yesterday and she kept going on about how the labels don't matter and I shouldn't get so hung up on them.

I just wish we either scrapped labels and went with the original psych who saw him or we had a proper discussion about the labels that I (and DH and others) actually feel are justified. At the moment I don't feel happy about telling DS his dx (he is 7). Maybe a few more years will give clarity. Who knows.

I am not sure that getting a label is necessarily the answer, at least not for us.

[Blandmum]

'MB - it is definitely the case that he passionately believes that certain things SHOULD be real! '

absolutly! I teach a very bright and able young man who is on the spectrum. He can think of any number of 'better ways' that various biological systems should work! and I have the devils own job in convincing him that millions of years of evolution didn't agree with him!

He is a delight to teach. We just have some 'vigorous' discussions on times

[sphil]

Niecie - DS also role plays more than making up - though he does extend the ideas himself iyswim. For example, he's made up a whole fantasy based around the planet Tigeranger, which was destroyed by the evil Doggio, leaving only one survivor: Tigerslayer (DS1's alter ego) who has now taken on human form to fight evil across the universe. It's clearly based on a number of sources - Dr Who, Transformers, Power Rangers et al - but is all his own invention. Your comments on labels are very interesting - and I think we'd be in a similar position if we went down the dx route.

MB - if DS turns out like your student I'll be delighted . Just hope he has teachers like you.

[Blossomhill]

Sphil ~ tbh thinking back once my dd hit 6-7 I felt her AS became more pronounced and we didn't get her a dx until she was 7. Although we had been seeing pros since she was 2.
It's funny I was scared of the dx but looking back now it was the not knowing that was worse.

[yurt1]

sphil- do consider what Steven said as well. He's a wise man, and I have seen something that he described happening. A friend of mine has an eldest dc who is probably at a similar place in the spectrum to your ds2 (they're quite different, but I'd place them together iykwim) and a younger dc. Her eldest spent some time at ms in the same school as her youngest. Her youngest starting having some school problems (not spectrummy, just school issues) & it was firghtening how quickly the school built everything up into 'the child must have AS' (especially considering how slow they've been to move on children who are screamingly spectrumy!). It was very difficult for quite a while, as the apprach was not appropriate and made things worse for a quite a while. In the end her yougest ended up seeing a clinical psych who said something along the lines of 'oh for goodness sake'. The child in question was so UNspectrummy it was frightening that the school could get it so wrong.

I know you've had concerns about your ds1 for a while in terms of what exactly is going on with him, but I do think Steven is right that seen in the context of ds2 people with little experience may have a tendency to over egg it. Which is why I said early on do consider whether a dx would make a huge difference. If its just a case of recognising his difference you can do that yourself in a very positive way. If he's getting in trouble at school because of sequencing problems or something then there may be more point persuing the whole thing.

[Niecie]

Sorry sphil - having seen the OT for the first time in 2 years and still not feeling like we were getting anywhere with getting to the crux of what exactly is different about DS I was probably a bit unfair about it all. Please don't think that you will be left in a similar situation. I think we are like Flyingmum and her DS - there is massive overlap of the Venn diagram and I am not sure where the emphasis should be.

I suppose the important thing is that my DS is getting help but on the other hand I want people to understand DS as they would try to with any other NT child and not just put everything down to a label. For example, his new teacher doesn't feel he concentrates in class and I don't want her to think (which I suspect she might) that he is like that because of AS and not try to engage him so that he does concentrate better. He gets short changed that way.

The other thing about DS's imagination is that he can't make games up but manages to frighten himself by foreseeing all sorts of disasters! For example, he will see a car driving down the road in a film and will keep asking if it is going to go off the road and crash! He has no reason to believe that will happen (and it doesn't) but he can imagine it happening. It is a little bit like living with the Voice of Doom sometimes - always imagining the worst.

[sphil]

This new school are incredibly laid back about him, whereas in his previous school they had him on School Action + for a while. They're just in the process of getting him some OT help with handwriting, but other than that seem to have no major concerns. In fact he's just received a 'gold badge award' for being trustworthy and always trying his best. (He told us he'd been made a 'Badger Warder' ). So I sometimes wonder if it's me over-egging it! I know I have a tendency to over -analyse at times. And I'm sure the context of DS2 makes me do so more.

Unless he starts to struggle I think we'll leave the dx for a while and focus on trying to help his dyspraxia. He's doing trampolining and karate and we're working on handwriting/spelling at home, as well as the OT at school. He doesn't seem to have any self esteem issues and is a sunny natured and cheerful boy. He says he 'hates school' but then in the next breath will tell us he's had a 'fabulous day' and is always happy going in and coming out. I worry about him socially sometimes (another birthday party he's not been invited to this morning and a boy he's invited home who doesn't want to come) but it doesn't seem to bother him at all. He's got a best friend who he sticks to like glue and basically ignores everyone else, although he has a soft spot for a few of the girls. Kids often wave at him and say hello out of school but I usually have to prod him to a) notice and b) wave back.

[sphil]

Niecie - don't worry, yr post didn't make me anxious! I just think the whole labels issue is a very tricky one for those of us with quirky kids. DS1 can be a bit Voice of Doom sometimes (he told me yesterday that he'd fallen over in the playground and it 'ruined my whole day....no, my whole life' but he snaps out of it pretty quickly. I'm reading a brilliant book atm, recommended by Growing Minds (DS2's home programme providers) - it's called 'The Optimistic Child' by Martin Seligman - which is all about ways to counteract pessimistic thinking. GM recommended it because children on the spectrum are sometimes prone to anxiety and depression (not saying this is true of your DS at all btw!). But it has helped me deal with DS1's black and white thinking.

[Saker]

It's really interesting this thread, because I see a lot of Ds2 in it although he would no way be diagnosed as Aspergers as he has learning difficulties as well as the dyspraxia and autistic traits. But he plays in a very similar way - he pretends to be people he sees on television or in books or his taxi driver, but never makes anyone up completely. Likewise he can pretend any object is anything, so he might pretend a stick is a cup of tea - but he finds it really hard to pretend that nothing is something - ie just to drink an imaginary cup of tea. However I asked him last night if he was really Nigel Marven (flavour of the evening) and he said no, he was just pretending. And he always makes me laugh because when he wants me to be a character he always attaches "Mummy" on to the front - so he will say "you be Mummy Bob" or "you be Mummy Buster" .

Anyone the point of this ramble is that the thing that Ds2 has in common with most of your children described on this thread is the dyspraxia, rather than the Aspergers and I wonder if that is at the route of the other problems. DS2 also has no diagnosis but I daresay I could get him an ASD diagnosis if I hunted round a few professionals. I'm not that bothered because he has a place at special school and the help he needs. However I really feel that one of the major causes of his problems with speech, language, communication, play skills and socialisation are his motor, organisation, processing skills. I feel that the effects of being unable to process and organise information and control his body in the way he wants lead to most of his other difficulties. Therefore I would be reluctant to get him a diagnosis of ASD without at least a co-diagnosis of dyspraxia because I feel that it would cause people to address the wrong areas and that any therapy has to strongly take into account his motor and processing problems.

[Niecie]

Thanks for the book recommendation sphil - I think I might hot-foot it over to Amazon to get that one - my one big worry about him is that he will end up depressed as so many AS children do and he is already quite negative about his abilities and in his expectations although overall still a happy boy.

The friends thing you mentioned sounds like my DS as well. He has 3 main friends but seems to have days when he simply chooses not to play with them but he has no problem with this. Its me that worries not him. However, I can see in the future (now who's the Voice of Doom ) that he will end up with no friends at all because he doesn't pay enough attention to the ones he's got and they won't hang around waiting for him to join in.

Certainly lots of children say 'hello' to him and he has to be reminded to say hello back again. He is getting better though but sometimes he just doesn't notice other people. It seems to be a question of training him rather than knowing intuitively what is he should do.

[yurt1]

Ah Saker you've hit on an area of mine. I actually think that ds1 (with his dx of severe autism) actually has massive motor planning problems and that it is this that has resulted in the autism, pr certainly the non-verbalness.

Bit of a soapbox of mine. Quite a bit has been written by adults with autism on this (espeically non verbal ones0 but it barely makes the literature.

Morton Gernsbacher's web[page is worth looking at - along with 'communication is more than speech' (or something like that)- she goes into this subtype.

[Saker]

Yurt

I agree - it frustrates me so much because the professionals mostly seem to really underestimate the effect of the whole motor skills / planning thing. They see it as a separate issue that will get better with a few exercises that are impossible and unrealistic for a child like Ds2.

As a baby Ds2 was very smiley and sociable - many of his first words were people's names. I watched him withdraw from a world that he couldn't cope with. His eye contact can be dodgy for example, but it's nearly always because he is worried he is going to be asked to do something he can't. He might not answer quickly but it's nearly always because he's processing the question, not because he doesn't want to answer. And anyway he probably wonders what the point of answering is when half the world can't understand the answer, because his speech is so unclear.

We saw a neurologist recently who basically told me I should stop fussing about the motor skills - something along the lines that not everybody's child will be a star footballer. I lost it a bit - as if I care about whether he can play football or not - my aspirations amount to a hope that my child might be able to put his shoes on by the time he grown up, or take his t-shirt off, or feed himself with a knife and fork. Sorry still fuming about that as you might tell .

Anyway we have a lovely private OT now who does seem to understand and is really helping Ds2 and even going into school to give them some ideas, so perhaps we can progress. I just wish I had realised all this 4 years okay instead of letting them tell me that his motor skills would probably improve with time.

[Blossomhill]

I just think that after what I went through with my own dd that a label is useful. As the pro said when dxing if your child had anything else such as diabetes, epilepsy etc you would call it what it is. Also it is proved that early intervention and letting the child themselves know exactly what there difficulties are really helps them cope in teenagehood.
I am not for a minute saying your ds has it but some of the little things you are saying like needing to be prodded to acknowledge a hello and the "oh my whole day has been ruined becasue I fell over" type comments are typical things dd would do.
Again it is a very personal thing and you just have to work out what's best for your ds. I remember Mrs F once saying that even though her ds didn't have an AS dx she "treated" him as though he did and it helped massively.

[yurt1]

He sounds very like ds1, Saker. Despite ds1's very severe autism he is incredibly sociable! The way we got him back eating at the table rather than in front of the TV for example was to have guests- he WANTED to eat with them

Growing Minds really did recognise the enormous effect motor planning/dyspraxia and executive function can have, and they have worked on it.....

We're teaching ds1 to type now as I don't think he'll ever overcome the motor difficulties enough to speak, but typing may be an option for him (although he has the added problem of very poor impulse control- again often overlooked). Have a read of Morton Gernsbacher's stuff you may like it.

[Niecie]

Saker and Yurt - that is it - I think dyspraxia makes a child look somewhere on the spectrum and it can be 'disguised' by the autistic spectrum diagnosis. Yes dyspraxia is about motor skills but it affects the way the children interact with the world.

I argued this with DS1's headteacher just after he started school 3 years ago. I said that he fulfilled 14 of the 16 items on the checklist on the Dyspraxia Foundation website and that surely a child who has all that to cope with isn't going to enjoy a sudden change of plan or feel like they fit in with their peers and she just waved the idea away and insisted he had AS (as I say even though the psych who assessed him said that wasn't his biggest problem and he didn't justify the label)

It is a whole jumbled up mess of overlapping symptons and dx's.

at the neurologist who made the football comment. He should know better surely.