自閉症孩子經過訓練，情況仍會繼續退化嗎？有人可以解答嗎？

sjmama

我的兒子兩歲前的發展，除了語言發展進展較慢外，其他都正常。18個月開始去國際學校的playgroup。由於我們以為是因為用了雙語的緣故，故後來家裡轉用兒子掌握得較好的英文，也看到他的進展。但到了兩歲半，他的語言還只是單詞，雖然他知道許多單詞。而且開始覺得他有過動的情況，注意力很短。但他跟其他人一直有目光接觸(雖然有時會迴避)，也能用有限的辭彙表示自己的需要。最初還以為他是ADHD/ ADD。

他三歲十個月開始OT, 四歲開始語言治療(英文)，四歲三個月時，政府的兒童發展評估中心說他是autistic spectrum disorder, 估計

mamee

你個問題, 可能要Dr.T先答到, 不如你pm問下Dr.T.

mamee

sjmama

Reply from Dr. T:

It's not uncommon to see this "trend" in kids with learning difficulties (in general terms). It's not that he is regressing but things (in your child's case, language use) are getting much more difficult. My guess is he fails to understand abstract questions and has difficulties expressing himself even if he knows the answer.

But my major concern is what language the educational psychologist used during the assessment? Also the test that the psychologist uses might also play a part in your child's poor result. I don't think your kid will get decent result if HK Wechsler is used given that he is educated in English since very young. Stanford-Binet might be a bit abstract for him but at least he can get near normal result in non-verbal parts. It might be worthwhile to check this in details rather than just focusing on the final results.

BTW, personally I'll not (dare not) diagnose a child as autistic only after seeing him for one or two hours.

Dr. T

pamam

I think your son's condition is very similar to mine. He was assessed last year at the age of 5, they said his speech level and motor skill are like a 3 yrs old. Since then, he has been doing PT and OT, no speech therapy or other training were provided by the govt. They said he has asperger features.(Another private edy psy said my son is asperger indeed).

Since then, my son has improved a lot but I know he's still way behind from other normal kids. His speech and social skill are still very weak. One of the nurse told me that I have to prepare myself as my son may be labelled as low IQ, because one of the main  components of the test is speech.

Well, my son is due for another assessment soon, my hushand is reluctant to go as we know the result will certainly be bad. But you know what, don't let all these number and labelling to upset you,  we know our son better than anybody, if you have doubts in their assessment, go private for another assessment and advices.

Is your son in mainstream school now? How does he do there?   

sjmama

Dear Dr. T,
Thank you so much for your prompt response.

In fact, the Edu Psy is a foreigner (a quite famous one in this area). The whole assessment was done in English. He also mentioned that my son's main problem is his language delay. But the result of speech skill done by the Edu Psy is even lower than the one done by ST one year ago, though they used the same test.

My son is attending 2 ST sessions every weeks. He is going to be 6yr soon. Is there any possibility that his situation can be improved?

sjmama

Thank you pamam.
Your sharing do help to release my despress.

In fact, the edu Psy is a private one. Our previous experience in Gov't assessment centre was not good, so we sought a private one this time.

My son is in a normal Int'l kindergarten. He has no problem to fit-in the class schedule now, though sometimes teachers are not sure how much he learns from the classroom. He is good in reading but very weak in expressive language. We know his limitations. In fact, we thought he may be able to go to a mainstream int'l primary school. However, the Edu Psy's report suggests he should go to the special edu school.

We're not sure where he should go. Worrying that if we put him in a wrong place may further hinder his development, we can only pray and seek for advices.

Dr.T

1. There're only a handful of "qweilo" psychologist in HK and it's not difficult to achieve  "famous" status...

2. Certainly yes but the school environment and whether or not they can offer daily support are both important. Yet it'll depend on how large the gap between your child and his peers when deciding where to place him. Integration is often, though not always, better than educating kids with any kind of learning problem seperately if sufficient remedial support can be provided.

sjmama 寫道:
1. In fact, the Edu Psy is a foreigner (a quite famous one in this area). ... But the result of speech skill done by the Edu Psy is even lower than the one done by ST one year ago, though they used the same test.

2. My son is attending 2 ST sessions every weeks. He is going to be 6yr soon. Is there any possibility that his situation can be improved?

sjmama

Thank you very much Dr. T!
We'll carefully consider everything before we make any decision.

稚言治語

Hi, sjmama,

I am a speech therapist with a postgrad. diploma in psychology and has worked with clinical psychologist for six years.

As far as I know, the ability revealed in "verbal IQ scores" of an IQ test is pretty much different from the "language scores" assessed by speech therapists.  The former refers to the cognitive ability using language as the media, while the latter refers to the language comprehension and expression abilities.

Thus, having a lower age-score in the verbal IQ then in the language assessment doesn't necessarily mean that there is a regression in the ability.  They are measuring differect aspects.

sjmama

Thank you very much 稚言治語!

What I learnt from the Edu Psy's report is that he used the TELD-III  to assess my son's language skill, the same tool was used by the ST one year ago.

For his IQ, the Edu Psy used WPPSI-III.

Do you have any comments on these tools?

Would Dr. T please also provide your comments?

Siu_Ming

Here comes sjmama's husband.  Hi, I am Siu_Ming.
Thank you for all your replies.  I don't think we can't just do straight comparison between the recent edu psy's report with those done by the STs.  The STs are doing measurement of our son's progress from time to time, ie. they are comparing and making reference to our son himself while the recent edu psy is putting him to a larger reference group (based on the empirical intruments, experiences and interpretations) to indicate his place in that context.  A straight comparison of these two sets of data wouldn't help much except producing a heartbreaking impression.  There were also other factors such as loosing getting tired and loosing focus during the assessment session. Remember he was there after one whole morning of school.  He managed to be in the edu psy's room all on his own before a stranger to complete this and that for one and a half hour.  Just this cooperative attitude and performance are worth commending.  Stay positive and hopeful.  He is making progress.
I mentioned this to my wife sjmama already but just also want to add a few words here to enrich the discussion.

Siu_Ming

Pamam,
It's the first time I hear about asperger kids have language delay as by definition these kids are okay with their speech generally.  Indeed, our kid is rather chatty at home and talks and asks many silly things but he always invite us into his silly world, say by asking us to say silly things or to take turn to say such things.

HayBMum

sjmama,

From the experience of other mum, they recruit a shadow teacher for their son to attend the class (but you need to check whether the school accept this arrangement.  Some school will insist to use their own teacher as shadow teacher).  I think this is no harm to try if you can afford it.  At least to give a chance / alternative for your son to try.  If eventually you find this arrangement is not effective, then turn to special school.  As far as I know, it is easy to get a place in special school.

pamam

Hi Siu Ming and SJmama,

The govt assessment centre said my son has Asperger features but it's too early to label him. But the private edu psy's assessment is more comprehensive because not only he took the 1.5 hrs test, he also  observed my son at his kinder and talked to his teachers before his conclusion of my son being Asperger.

My son is also very chatty, he didn't talk too much before 3 years old(just single words and made noise), but after 3, he could talk non-stop if we don't stop him. He would keep asking people silly questions repeatedly. He asks questions even if he's already know the answer.

He is quite smart in certain things but not so good in some areas. I think his IQ is at least average, but using the edu psy's standard, the result may be somewhat different. The result can be affected by many factors, like our son's mood that day as well as the edu psy's feeling that day. I have learnt not to be too let down by all those results.

Want to share this with you. 2 months ago, I was due to meet my son's teacher to discuss his problem at school. I took a taxi, feeling down of course. You know each time I go, they would tell me my son is behind, can't concentrate, he may need to go to special school etc etc.  That driver tried to cracked some jokes with me. I was not in a mood but he kept trying. Then I told him my son's got some learning problem in school. Rightaway, he asked me if my son got ASD, I was surprised and admitted it. He then told me his story, his family was not educated, but don't know why, his youngest son got into DBS and then CU, his whole family was so proud of this son because he was the only one in their family who would be a graduate. But just before the graduation, his son died of a car accident. That day was his wife's birthday. He was heart- broken but now he got over it as he believes in God.
He was kind enough to give me a tape about Christianity.

I have no religion belief, but I am touched by the driver. I got his message, comparing with losing a child, our son's problems is nothing. Let's try our best to help our son and enjoy every minutes spending with them.

HelenMrs.Lau

個TAXI司機真係好好人，我都替他難過 :cry:  :cry:  :cry:

Dr.T

I'll be away for a week. Will get back to you later. Take care.

sjmama 寫道:
...Would Dr. T please also provide your comments?

sjmama

Thank you very much Dr. T!


Dear pamam,

Thank you so much for your sharing. I am really touched by the story.

Being a Christian for many years and better educated than the driver, I feel shame that I do not have as strong faith as him.

As a mother, the most heart-breaking is to know children have in-born problems. I can't help to blame myself as if I have done anything wrong in my pregnancy. We do try to face all the problems and do our best to help our son. But it's really sad to know his “regression”.

In fact, the Edu Psy also visited my son's kindergarten and talked to his teachers. But it seems his conclusion is mainly based on the assessment done in his clinic. We certainly can find other specialists to do the assessment again or just find a normal school for him to integrate (if there is any). However, the most important is that in which school my son will benefit the most. What worries me is that if we put him in a wrong place, his development will be further hindered.

sjmama

We talked to many people within these two weeks about our son's situation. In fact, even our son's teachers in the kindergarten and training centre, as well as ST, don't think he is Mentally Retarded, though we all know his limitations.

Some people also alerted us that if the Edu Psy used the standard of North America, than it was likely our son received lower scores. It is because although our son can only speak English, his English is not as native as those kids in North America.

We visited a special school yesterday and found that our son shouldn't go there. Even the principal of the school suggested that if we would like our son to have more integration with normal students, than we shouldn't send him there. Instead he should go to other schools, where there are more opportunities of integration.

Therefore, we will try to apply other schools. Hope there is one will admit him.

pamam

SJmama

did you visit Sarah Roe?

We know our sons are not md despite their low iq score, a test is just a test, they are inflexible, we should trust our instinct, at least we should fight for a chance to let them go to normal school, if it doesn't work out then we'll try other resort.

I strongly believe your son would do well because he got a good parents, don't lose hope, do what you believe is right for your son!  

  

sjmama

Dear pamam,
Thank you for your encouragement!
Pls check pm.