Q: How young can Asperger syndrome be diagnosed in a child?
A: I would normally wait until a child is at least five years old before having confidence in the diagnosis of Asperger’s syndrome. Nevertheless, the characteristics can be identified in children as young as two. However, there are risks of the child having a false positive diagnosis, that is, having the characteristics of Asperger’s syndrome when young but actually may be a late developer in terms of social abilities. Thus, when the child is five years old the clinical picture is much clearer and we have a greater opportunity to assess the characteristics associated with Asperger’s syndrome.
When a young child, say between the ages of three and four years, is considered as having the characteristics of Asperger’s syndrome then they may well benefit from strategies to improve social understanding, cognitive development, interests and the art of conversation, while the eventual diagnosis is pending.
Q: With so many more children being diagnosed with autism spectrum disorders, what are the signs and symptoms parents of babies and toddlers should be watching for.
A: We are starting to develop a range of strategies to identify the characteristics of Asperger's in infants. This can range from aspects such as social relatedness to parents and peers, but also aspects such as sensory sensitivity and unusual profile of language and cognitive skills, and difficulties with emotion, expression and management.
We do not have a specific test at this stage with regard to diagnosing the characteristics in infants and toddlers, but in the next few years there will be a range of questionnaires, schedules and assessment procedures that can be used for very young children.
Q: How do parents advocate for their child when their doctor is not listening to their concerns — prior to diagnosis or after an initial diagnoses?
A: My personal opinion is that when a parent is concerned about a child’s development then there is clearly something they are identifying that needs to be examined by a specialist, they are usually right, especially mothers. However, the parent may not be able to precisely describe the characteristics that cause their concern and, in a child’s brief interaction with the doctor, these characteristics may not be apparent. If the doctor is not listening then it may be appropriate to change doctors.
Tony Attwood is a clinical psychologist and an international authority on Asperger's syndrome. His book, Asperger's Syndrome: A Guide for Parents and Professionals, provides detailed information on diagnosis, problems of social relations, sensory issues, motor control and other typical issues which face people with Asperger's.