He still had to go into work in the morning, but he was home by 10, since we met with Dr. Driskell at 11 to go over the results of the autism screening in June. As I said before, I really didn't know what to expect for this visit--last time, I was able to prepare myself by reading up on it from Internet sources, but since this was a follow-up, it was harder to be prepared.
Because of the atmosphere in the office as kid-friendly, we went ahead and took both Emerald and Gabriel, though as it turns out, we didn't even need Gabriel there. It probably would have gone easier if we had found someone to watch them, but I really don't think it went that badly. They were not overly rambunctious or over-enthusiastic; they were just toddlers. Unfortunately for Michael, both children were so excited to be somewhere with Daddy that they were crawling all over him and he missed a good portion of what was being said.
Luckily, we got a 8 page packet of everything she went over, and I of course took notes over what was discussed.
First, she listed what procedures were used and what tests were administered--the CBCL 1.5-5, the ADOS, ASRS, GARS, Vineland-II, and the clinical interview for child with Michael, Tammy, and me. We went over and verified why Gabriel was referred for a psychological evaluation, and discussed his background information--how my pregnancy with him went, birth statistics, home life, daycare history...things of that nature. She told us her assessment results and clinical impressions--she actually got a very accurate judgment on Gabriel from the brief amount of time spent with him, which surprised me a bit, since Gabriel is hard to get a read on.
Tammy, Cassie, Michael, and I all filled out the CBCL (Child Behavior Checklist) for a total of three scores on that front; this is to ensure that perhaps I am not seeing or claiming things that are not actually there. Because of the combined testing results, here is basically what we learned:
Gabriel's Daily Living Skills and Motor Skills are still delayed, but not severely--that surprised me because Gabriel is so strong and such a good climber, but he lost points for some fine motor skills things that he cannot do (like pointing).
His Communication and Socialization both fall below the 1st percentile, which means that 99% of children his age are communicating and socializing better than he is currently. This indicates an Autism disorder. Because he is not delayed severely across the board, it decreases the likelihood of mental retardation.
Gabriel demonstrates many Stereotypical Behaviors, such as:
Frequently avoid establishing eye contact
Staring at hands or other objects
Licking or eating inedible objects
Whirling or turning in circles
Making high-pitched sounds
Rapid lunging or darting movements
Walks on tiptoes
and Flaps hands in excitement
(among others). His lack of social skills was a note of concern as well, such as not imitating other people, withdrawing or remaining aloof on group situations, is not affectionate (except with a select few), and shows no recognition that a person is present.
We got a detailed recap of the clinical observations--what they did, and what it meant; how "typical" children would have responded, and how Gabriel responded. There was a summary and diagnostic impressions section that kind of recapped everything that we had read, but the overview was: Gabriel is showing a lot of signs of being autistic, and according to all standards usable for this age, he is most likely on the spectrum. As of this testing, he is leaning toward "moderate to severe", but some how I doubt that--Gabriel is very intelligent and has a wonderful temperament; I think he is just clever enough to try and see what he can get away with not doing for as long as he can.
We also need to monitor his attention and hyperactivity in the future--his energy level is high right now, but he is 2 so it is not concerning. But many autistic kids have ADHD as well which impairs their ability to focus and learn; because of how high-spirited Gabriel is now, we don't want to dismiss it in the future as being "just Gabe".
Finally came the Recommendations--basically, continue what we are doing with ECI and therapies, the pictures, social stories...things of that sort. She is more concerned about Gabriel's "staring episodes" because the EEG would have only been conclusive if he had an episode while hooked up to the electrodes, which he didn't--he slept. Anyways, she thinks we should possibly take him back to Dr. Brown (the neurologist) and have a more extensive screening to rule out seizure activity. Autism sometimes presents with seizures, and they could do serious brain damage if we allow them to continue unheeded. Michael and I think it is just Gabriel drifting off into his own world and being so lost in his own thoughts that he doesn't know what is going on around him; but it may be worth looking into further.
One of the most daunting tasks presented to us is getting Gabriel into his own bed. Since he was little, he has slept in the big bed with Mommy and Daddy--he sleeps very fitfully and needs constant validation throughout the night that we are still there, as well as to maintain the high level of water he insists upon in his life. That boy does NOT like to be dehydrated.
We got a list of books that may be helpful, resources that were available here in town, and were directed to encourage Gabriel to socialize and engage but to never force him if he wants to remain on the periphery; just really praise him for getting engaged when he does.
All in all, just a lot of information to process and wade through so that we can keep on keepin' on (as my old physic's teacher, Mr. Burnett, used to say). What we learned is not earth-shattering, just an affirmation that we need to keep working with Gabe until he is caught up =)
~Andie~
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