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3 yr old with anxiety ....autism??
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3 yr old with anxiety ....autism??

Hello,

I have a 3 year old daughter who enrolled in preschool this year. At
home she is bright, active, loving, affectionate and very talkative. I
was sure she would love preschool. At her 6 week conference her
teacher told me she had never heard dd speak. I went to observe
her and was horrified by what I saw. Dd was hunched over, looked
down, never spoke, lagged behind in line and never made eye contact. I
felt sick to my stomach. I stayed the whole day and she was a bit
better when she realized I was there. The SECOND we stepped through
the door to the car she face changed, her posture straightened and she
began talking away.

I had the early childhood school district come and watch her at
school. I also brought dd to their offices twice. She does not
like strangers and will not speak to them. She did talk with them
while I was present. They also came to our home and sat and watched
her play. She was not comfortable be did interact with me and her
brother.

They told me that they think she is a very highly function autistic!
I was shocked because the characteristics they listed where they ones
she does under stress at school but no where else. She has
imagination, is affectionate, no ticks, no rituals, no fixations, love surprises, nothing except the
inability to interact in preschool and with people she doesn't know.

Can anyone please advise me on this? I am taking her to see our Ped Dr
next week.

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by Penny2kids


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Penny2kids
Member since Dec 2008  



, 1 hour ago
I should add a few things. She has had a long history of anxiety separation. SHe screamed in church nursery until she was 2 1/2. SHe went through 6 months where is  was fine. Now is gets very scared when she walks in the door but is very excited to go beforehand. She now stopped talking in church nursery.

She will somethings repeat a word or question. If it's a word it's something new and it's like she trying to memorize it. If it's a question she will parrot it back such as "what did you do in school today?" or "do you have to go potty?" In both cases it's more like aviodance.

Yesterday we got a new box of straws. She had asked for a glass of juice and then asked for a straw. I asked her what color she wanted and she repeated the question back but was staring at the straws. I had to ask her twice more before she made a choice.

Also she uses pronouns correctly 80% of the time but with often say "mommy come down stairs and play with you". When asking for things she always uses "I want" correctly. SHe doesn't mix up he/she.

The district has gotten me so paranoid and worked up I may soon need anxiety meds!
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she's only 3 years old... well, can you remove her from preschool?  Maybe she doesn't like the teacher or the other kids?  Maybe she's not ready for the preschool?  Isn't 3 too early to stick them on medication?  Or do you mean for yourself?    

Repeating phrases is indicative of autism.  The term is called echolalia.  It is also indicative of other speech issues.  I would not trust a diagnosis from the school system and personally would go find a developmental pediatrician or child psychiatrist or someone not in the school system to assess my child.  We took our daughter to a developmental pediatrician.  It was  a 5 month wait to get in to one of the tops in the area, but it was well worth it.  

You daughter may just have some sort of social anxiety disorder.  Or she may have something else going on, but you really need to have a trained professional assess your daughter.  

I guess the big things are... is she behind in any developmental areas that you would want to get her help in?  Such as if she has language delays (common for autism) she might qualify for speech therapy or to go to a developmental preschool through the public school system where there is a speech therapist and other therapists to work with children.  Does she have any sensory issues that she would need an occupational therapist to work with her on?    I guess if she qualified for developmental preschool even with having social communication issues, the teachers at a public developmental preschool are trained to teach the kids to interact with each other.  ANyways, ask the school system lots of questions... a diagnosis of autism is not all that bad.  Maybe the diagnosis is not accurate from the school system but hey, if they want to give her free public therapy and aid... well, I am not sure if they're assessment is wrong if getting the label of autism off would be a hard thing or not.  

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As far as the echolalia goes she will repeats a question after me. I know if I ask her something like “do you need to go potty?” It’s mostly avoidance. Sometimes she just says the last word. Sometimes she will pick out an interesting new word and will use in a sentence later on. She also repeats more commonly if she is stressed like at preschool or a situation she is uncomfortable with. She has bad separation anxiety.

I have never heard her parrot something out of context. She does not repeat shows, radio, or over heard conversations.

My father is Norwegian and he uses some Norwegian words around her. She knows a few but they are only spoken in his presence. So she understands certain words have meaning to certain people and not to others.

She is not delayed.
She does not have sensory issues.
She spoke slightlly later than most of her peer but not all. She was within the normal range though.

I know this is cynical of me but the district has to find something work in order to enroll her. They cannot dx her but they can lable her for their proposes.
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SOrry you are having frustration with the school system.  Labels are frustrating.  Even if your child is autistic, every child with autism is different from others who have it.  My daughter is very social, for example, but she does have immense problems with language and social cueing along with the sensory issues and some ritualistic behavior.  However, she is kind of advanced with having friends for her age.  Her preschool teacher says she's definitely fits in along their definition of autistic spectrum, but she is social.  So it's confusing.  But then there's another boy in her class who is 1 year older who has classical autism who doesn't interact at all with anyone.  He has less sensory problems and is better at language but he can't interact at all, except it seems he does like to chat with my daughter especially at times they aren't supposed to like circle time reading.  

I guess what is important is that the teachers acknowledge the individual needs of our children.  If your daughter needs some language/speech therapy, maybe having a temporary diagnosis of autism is okay if it means she gets services through the public school system for free.  Therapy adds up... we're  having one therapist continue to come to the house and she's cheap at $50 an hour if you pay privately without insurance.  Problem with having a label, though, is that sometimes it's hard to remove.  Sure, free therapy is wonderful... but I guess you have to weight does your daughter need help right now versus getting a more accurate diagnosis later on.  School systems are supposed to provide service for kids without a diagnosis, but I think in reality, they have to label our kids with something.  

Good luck.  SOrry again that you are going through frustrating times.
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I know it is a very difficult time for you, but if you ask your daughters paediatrician for a referal to a multi disciplinary team (Speech and Language Therapist, Clinical Psycologist, Occupational Therapist etc), who have experience of autism and aspergers then they will be able to assess to see if she is on the spectrum completely, or whether she has some aspects of autism but not in all the areas required for a full diagnosis.
Echolalia is a different way of acquiring speech.  My son (although he uses phrases and words from people and TV), does sound very articulate.  He uses the words appropriately, but I know where it has come from and a specialist SALT will be able to test her 'understanding' of what she is saying or what is being said to her.  That is usually when it becomes more apparent.  Let me explain it another way.  When you learn a new language there is a time when you 'say the correct word or phrase, but you don't have a complete word for word understanding to translate it.  That is how I presume echolalia is.  They 'know' the just of the word/phrase and they use it appropriately.  Some children don't, but higher functioning ones do.  
Your daughter also immediately repeats some questions or words from questions straight back at you.  
My son has also had his cognitive abilities assessed and they are higher than average for some abilities but his level of receptive language and semantics is severely affected.  So he needs his school work to be made simple enough for him to understand, but challenging enough to keep him interested.
My husband is Greek, so my children also speak another language.  
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One of the frustrations of the district is they have not explained anything well. They did do a test to check vocabulary and understanding. They did not explain why or what they were looking for. I said that she may not talk much because of her anxiety. They said they could assess her anyhow. Their result was the high end of average.

Her preschool teacher said she understands directions but would freeze if the other kids watching. She follows along in church nursery. I haven't questioned her comprehension before. She can follow instructions I give her. She understands concepts like under, over and behind which can sometimes be tricky when you're on the spectrum.

I think I need to see some professional they you both have suggested. The district has a psychologist but she has never talked to my daughter one on one. Their "team" is really hit and miss in areas.

Also I forgot to mention this but ADD runs in my husbands family. Not the hyper run around kind. It's mental. My husband has a hard time concentrating and jumps around in a conversation which can be quite annoying at times!
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I think having assessments and getting some answers will help make things clearer in your mind.  Professionals are not perfect.  You know your daughter the best.  Try to read up a bit about any conditions you think may affect her.  If she is echolalic she may well have some auditory processing difficulties as they tend to go hand in hand.  There are so many kinds that you need the time and professionals to help you tease out what, if anything, she struggles with.  For example my son can hear a DVD and immediately rote learn all the dialogue.  But he doesn't necessarily understand what all that dialogue means.  He cannot stand environments like churches because of the acoustics and he hates to hear group singing, although he likes to hear one person sing and he goes to drum club!  So there are many auditory difficulties out there incuding CAPD, delayed auditory processing, difficulties with auditory memory, anxiety around sudden unpredictable noise etc etc.  And that is just one sense!  Every child is different and is affected to different degrees and in different ways.
As your husband has ADD, she may find it hard to concentrate the more 'busy' her environment becomes and the more distractions there are around her.  She may be much better in one to one situations in smaller groups.
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Yeah, I know about ADD.  I have the mental kind too.  Was diagnosed in college and then a doc rediagnosed me last year because she sort of noticed that I couldn't talk in a straight line and couldn't answer questions with like one word or a short phrase.  Ha ha ha... um, oh wait I guess not too funny... um, anyways, yeah, ADD has some overlapping symptoms to autistic spectrum.  Also have been told that people with ADD can have sensory issues that people on the autistic spectrum can have.  Aren't human brains so intrinsically interesting?  

Oh, I guess well, the thing I wanted to add was that I have problems functioning in party type environments.  I never went to preschool because there just wasn't one in my town that my parents could afford back in the early 70s and my mom didn't work so she did all the paint and reading and all that with us herself.  I learned to read at age 3, so I don't think preschool would have benefitted me educationally.  Maybe socially perhaps, though I didn't seem to benefit from elementary school socially because nobody liked me there so I'm sure preschool would have been just starting all that frustration a few years earlier.  Um, right... so I liked school if it was orderly and quiet.  I hate parties to this day.  Maybe your daughter has some issues with processing stuff while outside her regular environment?  Maybe she is having problems processing the teachers as well if there are other kids interacting at the same time?  I don't know... she's probably just this really bright kid with some issues socializing... If you really need her to go to preschool, maybe a developmental preschool that will teach her and work with her in a smaller group... but if the teachers are bad and you don't trust them... well, would putting her in an environment that you don't trust be a good thing?  I don't know.  Man, life is so difficult. ANd stressful.  TOo bad there isn't that easy button that Staples used to advertise.  I'd push it all day long.  
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I think you really have to become a bit of a detective and always ask 'why' is my child doing this/that.  But you also have to not compare their reaction to yours, as their perception is probably completely different to yours.  But if you try to analyse what could cause a person to behave like that.  Then you can start testing out your possible answers.  An example of 'not listening' to what your child is telling you is this.  The other day I had to take the kids in the car.  As soon as we got into the car my son says 'what is that awful smell, open the windows'.  I answered by saying 'the car doesn't smell and I'm not opening the windows because it is cold'.  30 seconds later he vomited all over himself and the car.  Now I KNOW that he is hyper sensitive to smell, so why didn't I just listen to him and believe him rather than compare his response to my perception of the environment.  Just because I couldn't smell anything doesn't mean he can't. QED.
As you say 888mom, it could be quantity of sound sources or quantity of visual distractions that are overwhelming the child causing them to be unable to gather her thoughts to speak.  Or it could be a social thing whereby she doesn't quite know who to speak to and how to do it.  Or it might be that the environment is 'hostile from some kind of sensory way', causing the child to be stressed and over anxious and therefore not wanting to communicate.  There really is such a long list of 'possibilities', but as the child is verbal, I think it would be very useful to start asking her questions.  I know she is young, so it might be better not to ask 'why' questions, but you could ask 'Do you speak at nursery?', 'Is it hard to speak at nursery'.  'Do noises bother you at nursery', etc, kind of like 20 questions.  And believe what her answers are.
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The other thing I wanted to add is that I have an auditory processing problem whereby if I am in a noisy room eg. party/classroom with kids talking etc I cannot get my ears to home in on any one conversation.  It is called 'cocktail party syndrome', and it is part of CAPD.  My brother also has it.  For example for all my life I could never understand how people can talk to eachother at parties, pubs, nightclubs etc.  It is as if my ears have a will of their own and they listen to whatever they want to, so I pick up odd words and environmental/background noise as my hearing appears to skip around the room listening to a word here and a sentense there.  The person next to me, trying to talk to me, I cannot even hear and I have to really strain to try to listen to what they are saying.  But I can't do it, so I tend to 'remove myself' from people who try to talk to me in those situations because I can't do it.  Someone watching me might think I avoid social interaction, but I don't in other environments.  This is an example of what it is like.  Imagine yourself in a room of people speaking a foreign language that you don't understand.  How long would you sit with that group of people not being able to understand anything before you got up and tried to find something else to occupy yourself with, even if that is with your own thoughts?  That isn't an exact match for what I experience, but I think you'll get the jist that nobody can stay in an environment that they cannot access, and their behaviour in one environment is not necessarily how they always behave, but just a reaction to that specific environment.  Therefore if a child is reacting extremely differently in different environments there is a reason behind it as it is not a 'typical' response.
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