Autisim and what to look for

[GM270]

Hello,

My 3 1/2 year old son seems like a normal child to me, but some friends of mine are convinced he has Asperger's and have suggested that I get him evaluated and treated.

These are some of the things cited as autistic traits in him:

-He repeats things he's seen on TV.  Now, I would understand that that'd be pretty weird, but he always uses it in context - an example would be this interchange "Daddy, we have to get the new Mickey Mouse movie, it's available now on DVD".  Or, sometimes "We have to get the new  movie, coming soon to BluRay."

OK, sure, that's not something you hear out of every 3.5 year old, but seriously, is rote repetition of a commercial *that* off the charts?  Especially when he's asking for a new movie?

Another thing:  He only eats certain things.  Like chicken nuggets, french fries, and several fruits and vegetables.  I say "picky eater", others say "strange and autistic behavior".

Another: He has a HUGE amount of energy.  If he sees something he likes, he'll run around, dance in place, sing about it, etc.  That's definitely more energetic than other kids I've seen, and looks a little odd sometimes, but is that really an indicator?

He communicates well, pretend plays very well and has a vivid imagination.  He has emotional awareness, and will ask you if you're all right if you look sad or angry.  He'll look you in the eye, tell you he loves you and give you a hug.  He's got most of the same behavioral issues I've seen in other three year olds (i.e. doesn't listen, throws tantrums when put in "time out", etc.)  He has a good vocabulary, knows colors, shapes, numbers, etc. and retains new language easily.  He loves to imitate and get involved with others (he especially likes to "help" me cook...)

The only things that seem a little "different" about him is his energy level, and the fact that he only pays attention to what he *wants* to.  This is what concerns me a bit - I'd love to send him to preschool, but I don't think there's any way on earth he'd ever sit still for a storytime, or engage in a craft or activity just because someone told him to, or keep at it after he decided he's had enough.

If *anything*, I'd say it sounds like ADHD, if there's a diagnosis other than "he's three years old".

What should I look for in his behavior?  Does any of this sound indicative of a problem?

I'm apprehensive about getting an eval done professionally, because I really don't want to get him "coded" over a minor issue and have that follow him around forever.

Thanks for any insight!

[LondonKat]

thanks so much for the great tips. We played with flour yesterday and my son really enjoyed - and towards the end he started coping some lines in the flour which is great.

There is a 2 years gap between my boys and definatelly a challenge. My younger one is 16 months now and follows older brother everywhere and wants to play but older brother has a difficulty in sharing sometimes as well as both receptive and expressive language.

I am quite pleased with my sons assessment to date, considering we only got referred end of Sept earl Oct this year wehave now seen all specialists concerned in social and communication diificulties and the consultant that originally referred him visited him in nursery last week and was so pleased to see so much progress and this is what matters to me, a label is for the doctors and perhaps a positive thing so that he gets some help in education; for us is finding a way to help him overcome the anxiety, tantums, speech and language barrier and I will not rest until I have tried everything...

I will be in touch if I need anything further, but once again thanks so much for the valuable tips.
,

[specialmom]

First, I want to say what a great mom you are as well.  You seem to be so in tune with your son and are working hard to figure out his needs.  It takes so much extra patience but the end result is so worth it.  And you are like me, you are juggling a younger sibling along with it.  How far apart are yours?  Anyway, bravo to you for doing such a great job with your kid!

I see that you live in the UK . . . your system is so different than ours for things like this.  You all seem to have longer waits for services which probably is frustrating (albeit, we pay for it).  But after the New Year, you will have a team addressing the issues it sounds like, so that will be helpful.  

With speech----  does he mainly have trouble with articulation or is the whole group of language areas (expressive and receptive too?)  My son had some issues with articulation.  This was attributed to his sensory integration actually as his motor planning is off so organizing and carrying out the motor ability for speech took some time.  I went online and researched different ways to help.  We did monster faces/wacky faces and froze them.  We did tongue exercises where we stuck his tongue out to all corners of his mouth, ran his tongue along his lower lip, did tongue push ups, etc.  I got this cd called "speechercise" that is all mouth movements and making sounds to music and in a fun way.  I would talk slowly and have him look at my mouth to say words.  He was saying words and making short sentences though and I don't know where your son is with that.  Hopefully speech therapy will start soon----  it really is amazing what they can do with that.  Kids respond really well to it.

Yes, I give him what he craves because the need is part of making his sensory system feel just right.  I would give your son lots of baths if he loves water play so much too.  A bin with beans in it would be loved by him as well, I bet.  That is a good winter activity.  But put an old sheet down underneath the bin so that beans don't go flying and remind him to keep the bins in the bin.  You could get a large bin and fill it enough so he can actually get in it.  Or you could get a smaller one and he will probably put his hands in it like crazy.  You can hide small things in it and he can pick them out with his hands at first and then get a pair of kids tongs and he can find them with the tongs.  I'd get him doing playdoh and putty for hand strength (comes into play later).  You'll have no trouble with that as he isn't tactile defensive.  Shaving cream, flour, pudding, etc. are all good for using the finger on a cookie sheet to make shapes.

Making shapes is early writing.  Circles are easiest and then triangles.  My son did start occupational therapy at 4---  so he was a little older.  But they worked on this every visit right from the begining.  Maybe because he had some fine motor concerns and really avoided all things writing related (coloring for example).  One activity that he liked was they would sit at a chalkbourd (you could do a dry erase bourd as well) and the ot would draw the shape and then he would use a damp cotton ball and go back over the lines.  This gives the feel of writing.  Always let him erase things (heavy work for the wrist) and writing upright at an easle or something taped to a wall is good.  We colored pictures that way a lot.  It helps with future writing and works on all those core muscles they need to use.  I only bring all of this up as occupational therapy addresses a lot of practical things a child needs-----  and pretty quickly, learning to write is a big factor.  So they work on it early.  "Handwriting without Tears" is an awesome program.  All of this is ahead of where you are at.

Okay, the not so gentle way of showing love . . . tough one.  First of all----  one thing that is very true is that hitting and the like is not autistic behavior in my opinion.  That is little kid behavior and expectations can still be set for not hitting.  Keep it short, simple and firm "no hitting".  There is a book called "hands are not for hitting" that has a simple message kids get.  They also have many social stories as the autistic world calls them.  My son likes these too-----  they are simple, have pictures to represent a desired behavior or prohibited behavior and repeat it over and over.  You can also make your own.   I gather that you are talking about he wants to be affectionate and it comes out as a slap.  But I'd still go the route of "no hitting".  Then I would stop everything and say "we give soft high fives" and then do it very soft.  If he does it too hard, I'd say.  "soft" and do it again soft and keep doing that until it is done softly and then go crazy with praise.  I'd exagerate your emotions and talk about what they are so he can learn to recognize it.  Reading facial expressions is something that is hard (one of the reasons social cues are often missed in sensory or autism)----  so helping him practice it will help.  You could make a game out of it and cut out pictures out of a magazine and show them to him and have him tell you the emotion.  I'd keep it simple  ----  sad, mad, happy, silly, sleeping, etc.  My son actually did this in a social skills class.  I'd also make sure  your son gets the slaps and input to his hands in other ways.  Let him hit a pillow or hammer a cobblestone toy or play wack a mole or whatever.  

You mention something about his mouth and putting a blankie in it.  Oral stuff is really big for sensory.  At 4/5 my son got really oral---  chewing on shirt sleeves and putting stuff in his mouth.  We give him appropriate things to chew now (like specically made chewies, straws or coffee stirrers, etc.).  We also do lots of mouth stuff-----  he chews gum every day on the way to school.  He chews gum if he is super upset as it is calming.  He drinks thick liquid through a straw with applesauce being almost daily.  He blows bubbles, etc.  All are soothing to the nervous system.

There is an excellent cd program called "Sensory Songs".  I got it on ebay and LOVE it.  It is basically an ot session and gave me so many cool ideas of games and things to do.  Or we just do the cd with all of its activities to music.  Very helpful.

You are noticing things coming and going-----  that is typical of sensory integration.  It can change over time ----  things can go away and then come back or be gone forever.  My son's hands can bug him.  He did this finger rolling thing at 3 and 4 and I would ask him why and he would say they itch in between his fingers.  Hm.  It went away.  He's been ill and guess what, a year and a half later-----  he started doing it last night.  (being sick makes sensory go crazy.)  Anyway, so you have to keep hopping to stay up with sensory.  The next phase for you might be the meltdown phase.  This happened more and more as his fight or flight response intensified at 4.  We have lots of strategies for that so when you need them, let me know.  

Anyway, my son really is doing so well.  I hope that all of the things you are doing for your boy help him too.  Keep up the good work and anything else you'd like help with, let me know!!

[LondonKat]

you are a really special mum. I realised long time ago evn before I startedoticing the quirks with my son that physical activity calmed him down a lot and he was a better child after a run in the park, jumping around, swinging and sliding in the playground... He is mainly speech delayed and we are awaiting for the multidiscipliary team diagnosis sometimes in the New Year but since I have not heard anyone mentioning the SID I am sure he will be diagnosed as being on the spectrum. He has a great eye contact, responds to name 9 out of 10, has good pretend play but of course struggles on the social side - not being withdrawn when kids are aroud, he would get really happy and excited, tries to join in but being speech delayed he doesnt get very far.

Back on the sensory side - by reading your post I have learnt I have been doing many things wrong. My son is also sensry seeking an instead of letting him get his share of joy I had been preventing this worring it may grow into an odd behaviour.

Visual - he likes looking at bright lights, we went from a staring phase when he was ounger toust looking now and he grew out of it on his own.

Audio - likeslud noise, first he was scared of it but now cant wait to put the hoover, hairdryer, food mixer on. Only briefly now but used to forever or until I stop him when he was younger.

Touch - not many problems with materials tuching his body, he has just disliked some new clothes or shoes (difficult to work out which). HE has  habit of changing from clothes he wears out into his pijamas as soon as we enter the house. He loves WATER, I am sure he gave in in pottty training just so that he can wash his hands afterwards. H can spend as long as you et him on the tap and of coure bath tme being his favourite which is the opposte of when he was a baby - he hated baths. And he sleps with taggies blanetsince he was 1 but more like playig with it rathe than to soothe himself. When hs younger broher was born and was crying he would get the blankie and put i in his mouth :-)

He used to spin in circles for few months at around 18 monts however I was preventing this so he stopped.

Fine motor - he doesnt write yet althogh duing the assessment OT said to eourage lines and circle drawing in foam, flour etc.

He is not a picy eater at all so we enjoy a healthy mediteranean diet, but I do supplement him with Omga 3 and 6 and we have chosen as a family to drink Soya milk i Uk but switch to fresh cows milk when visiting fmily (husband's family live on a farm) but havent noticed any difference.

Also as I mentioned he doesnt know how to show emotions so when you expet a pat or a hug r a kiss you may get a slap on the face so my younger one i wary of him and poor guy doesnt understand why older brother is sometimes nice and sometimes hit him.

I hope I have given you an overview of the issues and I am hoping to get some tips on how to make his life and our life easier and a happier environment. Thanks again!

[specialmom]

Hello.  I do feel truly blessed to have found such a wonderful occupational therapy center for my son.  They really specialize in sensory disorder with kids and know how to handle them.  They've taken every issue we had and we work on a plan for it from meltdowns, angry outbursts, making and keeping friends, fine motor issues with handwriting, sensory seeking that gets my boy in trouble, tactile defensiveness, etc.  After the holidays, we are going to work on some of his issues with food.  He is picky and certain things like meat he may chew, says it tastes good but then spits it out.  Whether it is texture or motor planning issues-----  I don't know. But his ot says she can help with it . . . looking forward to that!

Anyway, sensory can be such a mixed bag of things for each kid.  My son is a sensory seeker big time.  So my theory with him is to give him as much of that as I can to fulfil the need.  For example, my kid gets a glazed look in his eye as he wants to "crash" into something.  He wants his whole body to bump something kind of hard.  So if I did nothing for him to get this input into his nervous system----  he'd bump into kids at school, bump into desks at school, throw himself up against something in an unsafe way, etc.  So I find safe outlets for it.  Here are some examples of what I do---  we have a park by us that is all sand.  We live in the midwestern United States and it gets quite cold for us here----  but winter spring summer or fall----  we go to this park with our sports equipment.  Fall and Winter are actually best because no one else is there.  We take a football for example and he will throw it and run and "dive" onto the sand for it.  Then he rolls and dives and rolls and dives over and over again.  We do the same with soccer balls, frisbees, etc.  If I see a hill----   I say-----  roll down it.  And they do it if it is 80 degrees or 10.  (I say they because I have two boys----  my sensory kid who is almost 6 and his little brother that is 4).  We have another playground that we go to that has this really thick rubber mulch and tons of it.  It is really cushy.  We go there and he jumps off all the equipment onto this mulch.  He will swing really high and then jump into the sand or mulch too.  That big impact upon landing and then  he rolls.  I mean, he looks a little wacky doing it-----  but who cares.  It is feeding his nervous system.  We make "crash" pads in which it is like a big pile of pillows up against the couch (using couch pillows too)----  he runs into them.  Or we put the mini trampoline by it and he jumps into it.  Sometimes we pile all the piles deep on the floor and he crawls through them (we call it "rat" or mouse game).  I set up obstacle courses and try to get him to jump, crawl on all fours, do push ups.  We've been doing this since he was 4.  When I spot something that is good for his sensory system ----  I say "okay, time for an olympic challenge".  And he does it.  He at almost 6 knows that these things help his "engine".  He will do it as he has felt the difference it can make first hand.

When he was young and resisted certain fine motor things---- tongs, scissors, writing----- I did the hand over hand method to teach him.  I physically show him how using my hand on his.  Then he got the feeling of it and the message of how to do something got to his brain (my belief).  He ended up catching onto things pretty quick that way.  I had his teachers in preschool doing that after a while.   So instead of going up to a station in his preschool----  picking up tongs, looking at them with no idea what to do and then just dropping them back on the table and moving on-----  his teacher would come up when he was there and say, "let me show you how to do this" and do hand over hand to show him.  (we were blessed with kind and wonderful teachers too).  He had trouble with riding a tricycle.  So I put him on it and moved his legs for him at first.  The little light went off and he started doing it himself right away.  Now motor planning isn't too bad anymore with my boy.  His fine motor is a little off still-----  but not too bad.  We do putty games and playdoh and finger play to strengthen them.

There are all kinds of writing tricks if you are at that point yet, let me know.  We started with that at 4.  

My son had tactile issues.  We did lots of brushing in the begining and joint compressions-----  have you heard of this.  It worked fantastic.  There was one issue in particular that was terrible.  My son freaked out over hand washing like it was killing him.  This went away after 6 weeks and hasn't returned.  That in itself is a miracle.  But they do little things that get them used to sensation.  This week they mixed shaving cream with sand and beans beans (yuck) and called it dirty snow.  He had his hands in it for about 2 minutes before he said "i'm done".  He's written his name in pudding (practiced drawing circles at 3ish and 4).  

/They do all kinds of swinging games with him that he craves and loves.  Let me know if you'd like ideas on that.

I guess, if you tell me any of your child's actual sensory issues----- maybe I could think better what we do that would specifically help you.  I will say though that I watch my son and if he is craving something-----  I get it to him.  He likes to spin-----  we get to a tire swing, roll down hills or dance "which is spinning for my son".  With others, we use verbal quues (oh, i'm tired --- how do you spell that?).  Robat arms to take a step back.  Softer to be gentle.  My son gets that.  He's realized that he does things a little too rough.  Since his brother is 15 months younger, he's always known that he can't hurt him as we are tough on that.  But we will give him a play hammer and pegs into a bourd for him to hit really hard.  So we just provide it elsewhere.  We talk about our stop button-----  that is the button we use before we do something we shouldn't.  I work on getting that pause before they act.  Impulse control is hard to teach----  but that has worked best for us.  Getting that couple of seconds of thought before they do something.  But keep your verbal prompts really simple and consistent----  "softer" or "gentle" is all we have to say.  Like I said, I have no less than a million (lol) things we do------  so I'm happy if you need any more ideas.  Let me end on this note-----  my boy played on a jungle gym for an hour and then we swam for an hour and a half and then we went for a walk on Sunday for about 45 minutes.  The next day at occupational therapy----  his ot said he was so incredibly calm.  His system was "just right".  So the key for us is to have that physical play as part of our world.  It makes him calm afterwards into the next day (or two).  Good luck!

[LondonKat]

thanks for sharing your story about your son. I would be grateful if you can share some of the techniques you have learnt from the OT as not all of us are blessed with a good one and everything seems to be a trial and error so would be good to rad what you do at home with him (or have done to get him improve). I have read in other posts about lots of active activities wich seem to be also working for my 3 and a half year old son still undergoing diagnosis) but what else? I have noticed lots of sensory issues and he is seeking light, laud sounds and is also not getle sometimes when we play, the high five as you said, especially sometimes when in play with younger brother. What excersizes do you do to get him be more gentle?


Thanks so much for sharing. I am very pleased your son is doing so well today.

[specialmom]

In my opinion, your child does not sound autistic at all.  You describe normal play with a child and pretend play is really key.  You describe a child that interacts normally it sounds.  Repeating something from tv once in a while but using regular conversation is not autistic, in my opinion.

However, there are other things that could be going on.  My son has a developmental delay called sensory integration disorder.  He is a mixed bag of things when it comes to that.  I would describe him as in constant motion.  He met all his motor milestones on time or early----  he went from walking to running in about a minute at 9 to 10 months.  He spins, climbs, jumps, bumps into things, plays very intensly.  He is sometimes "on a mission" with his activity.  All of this is because his nervous system doesn't function properly and he is trying to get input into it.  He's sensory seeking.  When he gives a high five----  it is really hard, for example.  When he went to preschool at 3, that is when an amazing and wonderful teacher noticed some things about him.  (I didn't think it was so amazing and wonderful at the time, but have learned what a blessing it was overall).  He wandered a lot.  He dumped bins of toys.  He didn't sit well with the group for circle time.  He had some difficulty interacting with peers.  He didn't complete the tasks and things the class was doing (and we are talking all FUN stuff here like painting and coloring).  He had meltdowns at school.  He just seemed very uncomfortable there.  So we had him evaluated.  It was inconclusive at 3.  By 4 there was no doubt something was going on as he really struggled in preschool.  He was evaluated again and this time sensory integration was the issue.  He was evaluated by an occupational therapist and now does occupational therapy once a week.  It is amazing how great he is doing.  You would never know that his nervous system is dysfunctional.  (by the way, sensory integration disorder and add/adhd are both developmental delays of the nervous system and look very similar in terms of behavior-----  but it is handled completely differently).  

My son is an extremely picky eater as well.  It is sensory related.  Certain textures are not to his liking as well as chewing is a very motor related task that motor planning has to be working perfectly for.  Eating issues are common with sensory.  

Anyway, my son is almost 6 and is really doing very well in kindergarten.  You'd not be able to pick him out of a crowd most likely.  (not he case before we knew what was going on and addressing it.)  I have a huge list of things you could try at home of which all of them I bet he would enjoy.  Let me know if you'd like some ideas.  So many activities have a direct calming affect on my boy.  Good luck!!!!  Follow your heart when it comes to advocating for your child.