Differentiating autism from SPD or attachment issues in adopted children

When I talk to other adoptive moms, especially those who have adopted kids from hard circumstances, I often hear concerns about autism. It’s a familiar concern to me because one of my kids raised a lot of red flags in regards to autism symptoms. When my oldest was about two, I was beginning to have real concerns about his development.  He had a hard time making eye contact at close range.  He was always crashing into things, touching things, invading the space of others, etc.  He couldn’t point to objects yet and his speech was delayed.  Having little knowledge about attachment issues and even less information about SPD, my first concern was autism.  I had him evaluated and we got him into Early Intervention.  This was very helpful for his development.  He had occupational therapy where they addressed his fine motor and sensory issues, and speech therapy too.  I saw major improvement.  But still,  I spent so much time fretting that he had autism.  I was scared for his future and what all of this meant. I was in full grief and panic mode, and that anxiety made it hard for me to see his social strengths that conflicted with an autism diagnosis.

Now that he’s older, I know that my early fears of autism were wrong, although he does have sensory motor issues that accounted for the late pointing and speech.  (Speech is a fine-motor issue . . . who knew?)   But I spent years worrying about it because no one had ever explained to me the connection between adoption and sensory integration, or that sensory issues can lead to late milestones and delays that are not related to cognitive functioning.  Many adopted children have one or more risk factors for sensory dysfunction.  Prenatal drug exposure, early neglect or lack of stimulation, trauma, lack of attachment . . . all of these things effect the way the brain develops, and can lead to sensory processing issues.  These sensory processing issues often mimic other disorders, and can have parents (and even professionals) coming to the wrong conclusions.

In addition to the higher risk for SPD, many adopted children have attachment-related behaviors that can also mimic autism, like poor eye contact. A friend recently linked to this video on understanding symptoms of autism, and I really wish I had seen this 6 years ago when I was fretting about my own child. It illustrates some of the more specific signs of autism, which are much more complex than sensory-seeking or a reluctance to make eye contact.

Adopted children seem to confound the rules when it comes to neurological diagnoses, and what it appears to be may not be the whole story.   If you have an adopted child who is not meeting milestones, be sure to educate yourself on sensory processing disorder and attachment behaviors, and don’t assume that every professional  you see will be familiar with these issues. I’ve seen far too many adoptive parents have doctors suggest an autism eval when the symptoms were simply a combination of sensory and attachment issues, both of which are common in children who have experienced early neglect.