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Advice needed- borderline assessment result for teen

AmyK84

Hi there 

My son is almost 14 years old and yesterday had his autism assessment, results of which gave him an overall score of 8 in most areas which the clinical psychologist said is not enough to issue a diagnosis as it's borderline.

He said that my son scored clear signs of autism for the area of restricted repetitive behaviours but that with only a little prompting could have a reciprocal conversation so lower traits in that area. Also that based on the broad picture including both mine and the school's views my son is able to socialise (which is true) and that he believes my son's social difficulties are more likely social anxiety.

(His difficulties in this area are overthinking on what others might think of him in his friendship group, out on the street in front of strangers. He has always refused to have the blinds open in the living room as fears people will look in on him. Refuses to have a conversation with me/family when out in public and always seems high alert, becomes overstimulated in busy places etc)

My son has never shown signs such as stimming, avoiding eye contact or any of the more seemingly 'obvious traits' but here is a brief overview of him:

He functions properly with a set routine and since he was maybe 4 or 5 was fixated on ensuring he had three meals a day (in context e.g. if we got up late at the weekend and had brunch and then dinner in eve he couldn't cope well with this and became dysregulated. Still does now at almost 14!)

Needs to have a logical reason given for absolutely every decision made in terms of parental guidance/behaviour/discipline before he can process the request/issue 

Has fixations that change maybe every season. Has been in the past space, rubix cubes, golf and currently Nandos! Prime example of a meltdown linked to current fixation- had promised him nandos at the end of the Easter hols. Scheduled to go with sis and a few others- and arrived after 8pm and they were at capacity with a huge wait. Immediate frustration from son- questions flew by the dozen to me - you promised/how/why/let's drive to another nandos as I MUST have it. Went to zizzi and he was emotionally dysregulated then went inwardly frustrated. Refused to talk or order. Refused a pizza. Obsessively checked both the time and uber to see the cut off time for ordering home delivery. Eventually agreed to pizza but STILL ordered nandos back home even though he wasn't even hungry. During the assessment feedback I asked the CP to tell me if that behaviour is neuro-typical then, because I would be surprised if it was. He said 'no-thats an autistic trait'. They mentioned autistic traits a number of times but said he didn't score high enough across all three areas.

Only in recent years has understood sarcasm but is uncomfortable with it. Only functions well with literal talk and finds inference very hard.

Many other traits but these being the main.

The CP said that the school's feedback was that he has more traits of ADHD as he can become easily distracted and also distracts others mostly with noises and social media qoutes. This I believe are his tics becoming now verbal, as he said he doesn't realise he's doing it but then gets sanctions for it.

The CP advised me to 'park autism for now' and explore ADHD and social anxiety. Neither of which I'm convinced of as much as I am with autism.

My son felt very deflated from the whole experience and said he now further doesn't understand his differences. 

When I've looked into scoring it appears that his overall score would have prompted an Aspergers diagnosis some years ago, which has obviously all changed.

I feel I should have advocated for him in insisting on being in the room with him as he had asked me. Because some of the answers he gave were minimal, vague and I feel I could have supported him in reminding him of other things he does.

This was a private assessment as I was lucky enough for a family member to support with the fee. 

Any advice, pointers and ideas for next steps will be so greatly appreciated and thanks to those of you who have taken the time to read this.

Amy

Parents

  • This is sounding a bit like an old school assessor to me. Autistic people can be perfectly capable of reciprocal conversation. In a 1:1 situation I would generally manage this pretty well. It becomes more difficult if the discussion is about a difference of opinion, I would very much struggle with this. Or if it's more than 1 other person. Then I don't know when to take my turn speaking etc. 

    Similarly with social difficulties. Autism isn't an incapability to socialise. There may just be difficulties with it. Some individuals are overly social and don't notice when people want to stop. It's called a spectrum for a reason. Boys may also mask (it isn't just girls) and often the masking comes hand in hand with social anxiety and the over thinking what people think.

    You certainly are describing traits in line with autism.

    It is interesting that you mention ADHD as well. When you mentioned special interests changing frequently it immediately made me think ADHD. But also ADHD and autism are conflicting and often mask each other which could explain the borderline result. 

    I'm sorry your son has felt it was an unpleasant experience and he feels like he further doesn't understand himself. That must be difficult for him.

    I wonder if you can request to speak to someone about the process and discuss these different areas and the reasons for it. You've spent a lot of money on the assessment so I feel you should be entitled to question it.

Reply

  • This is sounding a bit like an old school assessor to me. Autistic people can be perfectly capable of reciprocal conversation. In a 1:1 situation I would generally manage this pretty well. It becomes more difficult if the discussion is about a difference of opinion, I would very much struggle with this. Or if it's more than 1 other person. Then I don't know when to take my turn speaking etc. 

    Similarly with social difficulties. Autism isn't an incapability to socialise. There may just be difficulties with it. Some individuals are overly social and don't notice when people want to stop. It's called a spectrum for a reason. Boys may also mask (it isn't just girls) and often the masking comes hand in hand with social anxiety and the over thinking what people think.

    You certainly are describing traits in line with autism.

    It is interesting that you mention ADHD as well. When you mentioned special interests changing frequently it immediately made me think ADHD. But also ADHD and autism are conflicting and often mask each other which could explain the borderline result. 

    I'm sorry your son has felt it was an unpleasant experience and he feels like he further doesn't understand himself. That must be difficult for him.

    I wonder if you can request to speak to someone about the process and discuss these different areas and the reasons for it. You've spent a lot of money on the assessment so I feel you should be entitled to question it.

Children
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