My youngest son was diagnosed with an Anxiety Disorder.
The doctor told me that though he did have features of autism, he felt that the underlining cause for all of his symptoms was anxiety. He clarified that this is something our son was born with and not something caused by his older brother’s rages. He said it was wired in him from birth and will continue to be a struggle for his entire life.
He also concluded that he does not have ADHD, which is something that the first neuropsychologist diagnosed him with. He explained that all of his inattentiveness and impulsiveness is due to his high level of anxiety he’s constantly experiencing. He said that my son’s anxiety is so high that it affects all aspects of his life, which would explain his sensory issues, his social issues, his rigidness and his trouble with transitions. He explained that his anxiety keeps his body so wound tight that it doesn’t take much to set him off, it can be a room of kids talking or a change in toothpaste.
When I clarified some of his behaviors the doctor said that it was sounding more like OCD, but he didn’t think it was necessary to give him that diagnosis since it’s also an anxiety disorder. Instead, he warned me to keep an eye on this as he gets older.
He told me that the problems we’re facing today will change as he gets older. At this age we may have trouble with him staying in the classroom, but as he gets older, he may refuse to date or even leave the house.
When I asked him how his restrictive interest in the game mindcraft (refusing to play with any other toys), his long monologs about mindcraft and his echoing of statements fit into the diagnosis of anxiety, he only said that he didn’t observe these behaviors during the evaluation and if it was autism he would’ve seen it then.
When I asked him about his monotone voice, the doctor acknowledged that he too picked up on that, but dismissed it.
When I asked him about how he has no filter and will tell teachers they are boring or other parents that he doesn’t like their kids, how he doesn’t easily engage in back and forth conversation, or how he walks the playground talking to himself instead of playing with other kids, the doctor admitted that our son has odd behaviors that can affect him socially and that as he grows these may become more apparent. He said that we may need to assess him again in 2 years to see if he has learning deficiencies in social skills. He referred to the newly created Social Communications Disorder, which according to John Elder Robison of Psychology Today:
Social Communication Disorder is described (in my opinion) as a sort of “autism lite,” where the person has some features of autism but not enough to meet the diagnostic standard under the new definition.Robison points out the concern many critics have about this new label:
Here in America, it’s time to open a discussion about Social Communication Disorder and where it belongs. If it’s part of the autism spectrum or “autism lite” we need to make a decision about what services will support people with the new diagnosis. Otherwise we risk doing that population a great disservice – giving them a diagnosis that leaves them nowhere, with no indicated services or therapy.So basically, this is just another label, but at this time it doesn’t offer much support.
In the meantime, the doctor told me that a certain amount of oddness is accepted because he’s still young. Unfortunately, his classmates don’t agree.
He then recommended a book called, Helping the Child Who Doesn’t Fit in. Here’s how the book is described:
Remember the kids who just didn’t fit in? Maybe they stood too close, or talked too loud. Whatever the reason, we called them hurtful names, and they never understood why. Now, clinical psychologists Duke and Nowicki call these children “dyssemic,” and offer some ideas of how to help them.
Dyssemic children cannot readily comprehend nonverbal messages, much as dyslexics do not correctly process the written word. Yet nonverbal communication plays a vital role in our communication with others, and children who misunderstand or misuse it may face painful social rejection. In HELPING THE CHILD WHO DOESN'T FIT IN, Duke and Nowicki show parents and teachers how to assess the extent of a child’s problem, as well as how to help the dyssemic child.Our doctor also mentioned that the medication our son was currently taking, Prozac, is a mood stabilizer (this was news to me) and that even though he wasn’t diagnosing him with a mood disorder, it would be helpful if he ever developed one as he got older.
He then recommended regular therapy. He told me it will be a fine balancing act in creating an environment that’s predictable enough that it allows him to function, but also doesn’t become so rigid that it just reinforces his anxieties, something he said we’ll definitely need help with.
He also said that I should get occupational therapy through the school to help him cope with his anxieties while there. But unfortunately, my school has already denied him getting OT because he doesn’t have an IEP, something they denied because he isn’t 2 years behind. My plan was if he was diagnosed with autism I could go back for an IEP, but now I don’t know what I’ll do to help him there.
At the end of the appointment I asked the doctor which DSM guide he was using for his assessment, and he said, “I’m using the new DSM-5 and support it completely, I could go on for at least 5 hours about why I prefer it to the previous version.”
So what do I think of all this?
I have mixed feelings. I accept that he has an anxiety disorder, this came at no surprise since we already knew he had this. But so does 75% of children with Aspergers. What surprised me was that all of his struggles were based on anxiety and not Aspergers, especially since he had what our Neurologist described in December as “textbook autism spectrum disorder.”
Do I wonder if this outcome is because of the new DSM released this month and the fact that Aspergers Disorder as a diagnosis was removed? I would be lying if I said I didn’t.
It’s also possible that the old DSM was faulty and that kid’s like my son should’ve never been diagnosed with Aspergers in the first place.
I will always wonder, but that doesn’t change reality.
The reality is that he has anxiety. We’re already treating this with medication. We’ve been advised to get him therapy to help him cope with his challenges and teach him social communication skills so he can fit into society.
If he was diagnosed with Aspergers, I don’t know if it would be any different, except we would have more support and services available.
Either way, my husband said it best, “At this point it doesn’t matter what they call him, in the end it’s up to us to help him, and that’s just what we plan to do.