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When it is autism and when it is not?

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My daughter Molly is 5 3/4 years old. She is Selectively Mute, she also suffers from 'sensory overload', i.e she does not cope well with crowded places, loud noises etc. She also seems to lack empathy, i.e she lacks socio-emotional reciprocity. She does not have restricted patterns of interest, nor any particular rituals, nor any self stimulating behaviour. She was diagnosed with Aspergers Syndrome in Dec 2003. Please would you confirm when it is autism and when it is not. I believe, (albeit perhaps incorrectly), that there is some overlap, particularly with the sensory issues. Please could you clarify this. We are carrying out numerous desensitization strategies at school with the help of a fabulous teacher, and we have increased Molly's Prozac from 7.5 mg to 10 mg after 3 months.

She is happy to communicate non-verbally at school but will not speak thus far and never has in the school environment. Is there anything else we should be doing ? Also, can serotonin really fix the sensory problems? Thank you for being there to give your professional opinion. Here in Sydney, Australia, there is little in the way of understanding or expertise about SM, unless you can recommend anyone. Thanks again. I look forward very much to your reply.

Answer 1

You can HAVE an autism spectrum disorder and SM...but SM is not the primary diagnosis...the autism spectrum disorder is the primary diagnosis.

Clinicial experience dictates that Sensory Integration Dysfunction (DSI) is a precipitating factor into the development of SM...as are speech/language, social/communication impairments. It is often impossible to determine exactly WHY a child developed SM...other than to say it is a combination of many factors.

Communication Anxiety Therapy often words well with children with Aspergers...as long as the child is involved in other types of therapy for Aspergers. Ie, social skill groups, OT for DSI, etc.

All therapies must work together....Helping build social comfort is KEY...although we know it is often difficult for children with Aspergers to relate to others...and understand social cues. This is hallmark for Aspergers...As a result, anxiety is created or exacerbated just from the discomfort of social interaction and awkwardness. Many with Aspergers KNOW they cannot relate well and it is frustrating.

SSRI's often do help alleviate some sensory overload symptoms. This is usually evident at very low dosages of SSRI treatment. NO NEED for higher dosages...which only leads to side effects.

So, recommendations are to work with a clinician who can help progress your child communicatively from nonverbal to verbal and at the same time coordinate Communication Anxiety Therapy with additional supportive services to help your child with issues related to Aspergers Syndrome.

Dr. Elisa Shipon-Blum

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