Edit (AUGUST 1, 2017): Simple spelling fixes.


The Diagnosis

"He's... well... very hesitant around others." They all peered at the boy playing on the ground only a short distance away. He was meticulously examining a wooden block he took from the bucket next to him. He placed it gently and neatly on the carpeted floor, along with several others, creating a square foundation. The boy sat there and pondered for a moment. He examined the foundation he created one last time before finally reaching back into the bucket and removing more of the same wooden blocks for construction.

"He rarely interacts with the other kids at his school. I've talked with the teacher multiple times to try and figure this out, but nothing has come of it."

The doctor nodded in acknowledgment as he continued to watch the child. "And when he does interact with other children, how is he?" the doctor turned and faced the mother.

"Awkward, in a sense." the mother informed, "He isn't very good at picking up social cues, and he has trouble carrying on conversation. Most of the time he just won't reply to them."

"And this obviously pushes the kids away from him?" the doctor asked. "Yes. They get bored, or what have you, and leave him alone." the mother said, "I feel as though he's starting to learn this, and he isn't talking back out of purpose rather than social deficiency."

"Children can be very smart like that," the doctor explained, "We may tend to think of them as low intelligence, but they can learn and understand patterns just as we adults can. If they find out a way to consistently get what they want, they'll do it."

"I'm afraid that's going to hurt him in the future." the mother explained, "There will come a time when he has to interact with others, like during partner work in school."

"How is he when he interacts with you?" the doctor asked, "Is he more social or less?"

"He's very good with both of us," the mother replied, "But more so with dad."

"What's the difference between how he interacts with you and him?" the doctor said looking at both the mother and father.

"He usually clings on to dad more than I." the mother said. "Yea. We usually spend a lot of time together in a garage building things." the father spoke for the first time.

"So, would you say, your son spends more time with you than his mother?" the doctor asked. "Yea, I would agree with that." the mother and father both mutually agreed.

"Interesting..." the doctor pondered, "Usually it's the other way around; Children would attach to their mother."

"I guess we're just a unique family like that..." the mother smiled. The doctor chuckled before turning back at the boy on the carpeted floor. At this point he was able to construct a simple pyramid out of the wooden blocks. He made sure that all the cubes were properly aligned and that the structure was firm and robust. The boy continued to look upon his creation and smiled. He then carefully started to take each cube from the pyramid and back into the bucket.

"Does he always play with those wooden blocks?" the doctor asked, turning yet again to the parents. "Yes. That's basically the only thing he plays with anymore." the mother said.

"We actually made that block set," the father spoke up, "It was just a simple weekend project. I bought a piece of timber around eight feet long from the local hardware store. It was already in the shape of a two by two inch square, so all we had to do was make equal cuts to make the cubes. I spent the next day sanding them down making them smooth for him to use."

"We?" the doctor asked, "Did your son help you with the project?"

"Yea. It was the both of us in the garage. He helped me mark the measurements and I did the cutting." the father explained.

"Do you work as a carpenter?"

"No, actually. I'm a Net-Researcher at Scilab. I just work with wood as a little side hobby of mine."

"Well, it seems you may have hooked your son, here, into woodworking." the doctor smiled, "May a have a few words with your son?"

"Absolutely!" the mother affirmed. The doctor got up from his seat and sat cross-legged next to the boy.

"Hi, Lan." the doctor said, "What are you building?" Lan seemed to ignore the doctor as he continued placing down yet another foundation of wooden blocks, this time in a more rectangular shape. The doctor waited a few moments, hoping for a reply, but did not receive one.

"Can I help you build, Lan?" the doctor asked, "We could build a big tower! It would look so cool!" Sadly the doctor's attempts of persuasion failed, leaving only silence on his ears. The doctor pondered for a moment. It would appear that Lan really has learned to keep quiet in order to be left alone.

"Lan, sweetie," the mother called, "Let the doctor help build with you."

"No." Lan replied. "Why not?" the doctor asked, pretending to be a little hurt.

"You don't know how to build..." Lan replied. The doctor smiled to himself. Now that he managed to get a reply from Lan, hopefully he will be able to start a conversation.

"Can you teach me how to build?" the doctor asked. But, unfortunately, Lan didn't respond.

"What do you like to build, Lan?" the doctor asked. He thought that Lan was going to remain silent, again, but then he spoke up.

"Buildings..." the doctor smiled and chuckled at Lan's response,"What do the kids at school like to build?"

"I don't know..."

"Do you not build with them?"

"No."

"Why not?"

Lan remained silent.

"Why do you not like building with the other kids?" the doctor pushed the question.

Lan remained silent.

"Do the other kids not know how to build?" the doctor asked, remembering what Lan just told him.

"No."

"Does your dad know how to build?"

"Yea."

"Did he teach you how to build?"

"Yea."

"Do you like building with your dad?"

"Yea."

"What do you guys build together?"

Lan remained silent.

"Didn't you guys build these wooden blocks?"

"Yea."

"So what other things do you guys build?"

Lan remained silent.

"What do you like to build at school?"

"Buildings."

"You really like building buildings, huh?"

"Yea."

"Do you only build buildings when at school?"

"Yea."

"You don't play with any other toy?"

"No."

"What do the other kids play with at school?"

"I don't know."

"Do any of the other kids try to play with you?"

Lan remained silent.

"Do you like the other kids in your class?"

Lan remained silent.

"Do you like school?"

"Yea."

"Why is that?"

Lan remained silent.

"Do you get good grades in school?"

"Yea."

The doctor turned back to the parents, "Does he do well in all his classes?"

"Yes. He's been getting A's consistently the past years." the mother testified, "The teacher even told me that he's pretty proficient in Math and Science."

"Very good." the doctor replied, looking back towards the child, "Lan, do you like Math?"

"Yea."

"What do you do in your Math class?"

Lan remained silent.

"Do you add and subtract numbers?"

"Yea."

"Is it fun adding and subtracting numbers?"

"Yea."

"Do you add and subtract numbers when you build things with dad?"

"Yea."

"What kind of numbers do you add and subtract?"

Lan remained silent.

"I guess I'll leave you playing with your blocks." the doctor said before slowly standing up. "Okay." Lan replied, continuing to build the rectangular shape that he started when the doctor started talking with him.

The doctor moved back and sat down in his original seat before starting to talk with the parents again. "Social deficiency does seem to be the main concern.

"Lack of eye contact or any type of visual acknowledgment, very short replies, not very responsive, appears to be absorbed in his own world." the doctor said, "But, despite this, I believe Lan has a very high functioning case."

"What does that mean?" the mother asked.

"Well, you see, we created a spectrum to help diagnose children who may have these social deficiencies." the doctor explained, "The more you lean to one side, the higher functioning you are. This refers to speech and social skills. The lower you are, the more you may struggle with developing these skills than others with a higher functioning case. I would place Lan in the high functioning category.

"I believe some of the issues I presented earlier, such as lack of eye contact, does stem from his high functioning case, but I believe the short replies comes from him learning to not speak to others if he wants to be left alone."

"Is there any medicine he can take to help him with this?" the mother asked.

"For his high functioning case, no. This would be something that is with him for the rest of his life," the doctor continued, "But, as long as you keep encouraging him to socialize eventually these symptoms will become marginalized, usually by adulthood. I host therapy sessions for people who are on the spectrum to try and help them develop the social skills they need, and it's been shown to work. But for a case like Lan's, as long as you keep encouraging him and making him get involved socially as he grows up, his social deficiency should become very minute."

"And what's the best way to do this? Getting him involved in sports or clubs?" the mother asked.

"Absolutely. Definitely encourage him to socialize whenever he can." the doctor said, "Try setting up play dates with other kids he might get along with, or go visit other family members. These can help improve his social skills immensely."

"Doctor, I thank you very much for the help you gave us." the mother smiled, "I means so much to us."

"It was an absolute pleasure!" The doctor replied, "Take this pamphlet, here. It contains more information about this for your convenience." The parents received the pamphlet and stood up and walked to the door.

"Come on, Lan!" the mother said, "We're leaving now." Lan looked up from his blocks at his mother. He quickly put all the blocks back into the bucket and carried it over to his mom and dad.

"Goodbye, Lan! It was nice talking with you!" the doctor smiled as Lan walked by. He became flustered and tried hiding behind his mother's leg.

"Lan, don't be rude." the mother said, "What do you say back?"

"Goodbye..." Lan mumbled, barely being audible for the adults to hear, causing them all to chuckle.

"If you guys have any more questions or concerns, feel absolutely free to call the office or schedule another appointment." the doctor reassured.

"We owe you big time, doctor." the father replied.

"You don't owe me anything..." the doctor said, "Well... maybe the bill..." The adults started to laugh as they started walking out the door, Lan at their feet with his bucket of blocks banging against each other. He stayed very close to his parents as to make sure he didn't lose them as they walked through hallways and down stair cases until they finally entered the man lobby of the building.

The doctor then truly made his final farewell;

"Mr. and Mrs. Hikari, it was a pleasure meeting with you both. I know Lan is going to turn out well; I just know it!"