More to This Case Puzzler? Ken Anderson’s April 2016 article, “There Was Something Going On With This Child, But What?”, includes a chart summarizing the differences among “anxiety shutdown,” “ASD meltdown” and “behavioral tantrums.” I am concerned the chart is attempting to make black-and-white an extremely gray issue. Today we talk about the growing body ... Inbox
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Inbox  |   June 01, 2016
More to This Case Puzzler?
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Special Populations / Autism Spectrum / Language Disorders / Social Communication & Pragmatics Disorders / Attention, Memory & Executive Functions / Inbox
Inbox   |   June 01, 2016
More to This Case Puzzler?
The ASHA Leader, June 2016, Vol. 21, 4. doi:10.1044/leader.IN.21062016.4
The ASHA Leader, June 2016, Vol. 21, 4. doi:10.1044/leader.IN.21062016.4
Ken Anderson’s April 2016 article, “There Was Something Going On With This Child, But What?”, includes a chart summarizing the differences among “anxiety shutdown,” “ASD meltdown” and “behavioral tantrums.” I am concerned the chart is attempting to make black-and-white an extremely gray issue.
Today we talk about the growing body of evidence that people with autism spectrum disorders have social pragmatic issues. Even though we lack a lot of research to fully understand ASD and the three levels of severity—as described in the DSM-5—and how to provide treatment for these levels, mounds of recently published articles talk about how most people with ASD have compelling anxiety and many have behavioral tantrums.
As a speech-language pathologist who has been trained with mental health professionals as well as who trains a lot of mental health professionals, I have learned that anxiety, behavior problems and social competencies very often co-mingle in our students. A brief, three-column chart to distinguish among these overlapping issues does not promote increased professional understanding.
The many clues provided in this article about the boy suggest the author should rule out social communication disorder, ADHD and executive function challenges, or perhaps reconsider ASD. The most bullied children in our schools are the ones who don’t stand out to professionals in a big way. Social-pragmatic challenges exist beyond the boundaries of ASD.
Michelle Garcia Winner, San Jose, California

Thank you for calling attention to the subtleties, complexities and potential overlap to consider when diagnosing autism spectrum disorder, social communication disorder, ADHD, executive function challenges and anxiety disorder in children.

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June 2016
Volume 21, Issue 6