Assessing the Skills of Your Child with ASD and ADHD

How prepared is your child for school?
What is the best classroom for next semester?

Dr. Udell's Fish Tank

Dr. Udell’s Fish Tank

As the school year comes to a close, and plans are being made for appropriate placement next fall, these are the questions that parents of ASD and ADHD kids have to face. IEPs are generated to provide documentable services, and professional assistance is sought to understand choices that will best address your child’s situation.

The Examination
In order to help families evaluate these difficult choices, various points-of-view come into play. There is the school the child goes to, the one he is going to go to, the one that you want him or her to go to, the administrators, teachers, and all of the other professionals who interface with each child. At The Child Development Center, we have found that, by observing the actions of our children, the reactions of their parents, and the interactions with the staff as patients enter our playroom and gravitate toward the tropical fish tank, many of the skills that are under consideration may be appropriately assessed.

“Hi, did you see we’ve got baby fishies in the tank?” I ask. If mom or dad immediately interrupts, to prompt the child to listen to the doctor, there is a reason. Sometimes a parent will say, “Look at the doctor. What is his name?” Often, they will repeat my question – several times. It is the rare parent who, if the child doesn’t attend, let’s time pass to see what their child will do.
Symptom – The child doesn’t pay attention.

“Do you see the biggest fish?” Does the child look at me? At the tank? At the TV? “Do you see the rainbow fish?” “Do you see the treasure?”
Symptom – The child won’t focus.

“Where is the red fish… we have one red fish.” The child looks at the train table.
Symptom – The child is easily distractible.

If they point to the orange carp, that’s ok, but there are two of them.
“How many fish?” If they start to count, that is BIG.
Symptom – The child is really smart, and even though it LOOKS as if he isn’t listening, he actually does.

The Diagnosis
And, it’s not just the aquarium, of course. Many activities that take place in our playroom provide a framework about your child’s abilities and challenges. For many young children who do not seem to pay attention, can’t seem to focus and appear easily distracted, the diagnosis is immaturity, not attention deficit or hyperactivity. Stimulant medications and anti-anxiety drugs may not help the situation, and often make behaviors worse.

Making A Plan
Parents prefer their child to be with verbal, non-disruptive classmates. Often, special educational environments do not seem to fit their children’s needs. Here’s the bottom line for many of our recovering ASD patients: in the best of all worlds, each child would spend some time in a neuro-typical classroom for socialization, with pullouts for required therapies and academic challenges, and a shadow to redirect. Resource allocation will determine the combination that best fits each family’s situation.

Be realistic about what accomplishments you really want to see in the next school year. For the youngest patients, speech acquisition and play are the most important skills. Five and six year-olds need to get along with others and pay attention to the teacher; or at least, appear to pay attention. In elementary school, it is not in the child’s best interest to force too many academic challenges that affect self-esteem and create anxiety.

Therapies and homework need to be balanced with outdoor activities (golfing, swimming, martial arts, etc.). Do not force multi-player sports such as soccer, because of difficulty with eye contact. Importantly, find a way to limit video games and television stimming.

Conclusion
The world of autism evaluations includes tests such as the Autism Diagnostic Observation Schedule (ADOS), Psycho-educational Profile Exams (PEP), Modified Checklist for Autism in Toddlers (M-CHAT), the Clinical Global Impressions Scale (CGI) and many others.

Then, there is my fish tank.

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Brian D. Udell MD
6974 Griffin Road
Davie
FL 33314
Office phone – 954-873-8413
Fax – 954-792-2424

Email bdumd@childdev.org
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