Aa
My 25 month old daughter
My daughter is 25 months old and is displaying some very strange behaviors we've noticed it progressing more as she gets older. She bites herself so hard she bleeds and its as though she feels nothing. She doesn't like to interact with other children and she has horrible seperation anxiety. Sometimes when your talking to her its like shes not even there she doesn't hear anything you say to her. When she goes off into her own world she'll recite the names of th people she knows over and over again. She has terrble anger problems and she tends to get very violent hitting biting pinching sctraching pulling hair and throwing her toys. She walks on her toys all the time and flaps her hands she also walks around in circles alot. She is very much a home body or she likes to go to the mall by our home if we take her to a new place she seems to lose control and acts out. She is on a routine and it one thing isn't done at around the same time she gets all out of sorts. She has a much higher intelligence level then any of the other two year olds we have seen around. she can pronounce words like accumulated and magenta she can count to 13 and she knows all her colors and animals and the sounds. I am just wondering if all of this is normal and i am just to worried or if i should have my daughter tested for autism or could you please tell me what all these things could be related to if its not autism? Thank you
The 'strange/odd behaviour' that you mention in your post I would recognise as being on the spectrum so I think you should go and ask for a multi team evaluation through your doctor. I will deal with the things you bring up and give some suggestions that may/maynot be the cause.
I agree that the biting thing could be either out of frustration/anger or sensory issues. If it is from an emotional source it is maybe easier for us to understand. From a sensory point of view anyone of their senses can be out of whack. One of the senses is proprioception. This sense tells the brain where your body is and what it is doing. So if your daughter cannot 'feel' her body parts she may bite them just to see if they 'belong' to her. When babies are born they also don't have a knowledge of where they end and another person or the environment begins. So if she also has these sensory issues she is going to be really confused about 'self' and 'other'. This lack of 'self' awareness could also be a part of the separation anxiety or it maybe more classical separation anxiety.
The 'appearing deaf' is also a sensory thing. So is the toe walking and hand flapping. What alot of autistic children/adults do is (they either learn, or it happens automatically) they tend to function through one sense at a time. Therefore if they are looking at something they may lose their function of hearing or touch etc. For, for example, if my son is making a lego model and I talk to him that forces him to switch from 'doing' to 'listening' and that really upsets him because the interruption of his concentration may make him have to start from the beginning again. On some occasions when I have talked to him he has dropped a cup that he was holding. So that switch from 'monitoring self and holding the cup' was forced to switch to 'listening' and he couldn't maintain both and therefore dropped the cup and blamed me for it. The other thing that is important to know about sensory problems is that they fluctuate day to day and throughout the day. For example my son and the cat run for cover when I get the vaccum cleaner out, but he also appears deaf when I call his name, and he covers his ears at loud and unpredictable noises, but he sometimes seeks loud noises, sometimes he tells me he can hear things that I can't even hear, at school has drum lessons! So their reaction to the same situation/sensory stimulus will be different.
Children/adults with autim also have different attention and focus. They put 'all' of their attention/focus into what they are doing and what they are interested in. Therefore if they are watching TV they are effectively deaf to us calling their name. This can make them unaware of things happening in their environment because they cannot separate their attention and for example, watch TV and monitor what mum or siblings are doing in the same room.
The anxiety/anger about change/expectations is very common. Their world is a very confusing place that does not make sense to them alot of the time. They cannot automatically make connections between things as we do, or it may take them much longer and they may need it all explaining to them.
What is useful if you are going out in the car to a number of places is to firstly tell them that you are going out and tell them where you are going and (very important) make sure you go to the places in the order you said you would go to them. You can help her with this by having some pictures of the places you are going to stuck with velcro onto a board (again in the order you are going to the places) and as you go to each place she can take the picture off the board and put it in an envelope etc. When she is older, if she is able, you can move the child onto having a written list and they can tick off each place as they visit. This gives you some really good examples of how to the avoid the tantrums that work, and it explains what the anger anxiety is about. If you said we are going to the supermarket, but then decided you needed petrol and went to the petrol station first, she is going to get anxious because what you said isn't happening. Another (older) child might 'connect' that mum needs petrol to get to the supermarket. An autistic child will not make that connection until (if ever) they are much older.
I would recommend you google the name Olga Bogdashina and read an article printed in Autism Today. She really is at the forefront of explaining these sensory/perceptual differences in people with autism. She has visited our city and given seminars to parents and professionals and her sensory profile questionnaire is completed by parents to give professionals a sensory profile of their children. Her book Sensory and Perceptual Differences in Autism and Aspergers has the questionnaire at the back of it. I cannot emphasis how relevant I think this book may be to you understanding your daughter's behaviour.
If your daughter doesn't have any speech/language problems/delay then you may be looking at a diagnosis of Aspergers, although she may have language processing problems and literal interpretation of words etc. But she needs assessing by Speech and Language. If she has speech/language problems then it is more likely that it is an autistic spectrum disorder. It is very good that she is talking. She maybe repeating words names as a way of reducing anxiety and calming herself but you could also google echolalia and delayed echolalia in autism and see if any of that fits. She maybe using these big words herself or she maybe repeating them from things she has seen on TV or DVDs. Again this is part of typical development up to a certain age and to a certain degree, but echolalic speech is very common in autism. My son is about 50/50 his own speech and echolalic speech.
My son also walks around in circles repeating TV dialogue to himself he may also mimick the moves he has seen on TV or act them out.
I think alot of parents would say their autistic child is a 'home' bird. It is because home is recognisable and more secure to them. As soon as they step out of that door they don't know what they will encounter. There can also be anxiety about stopping things and starting things called 'transitions'. So if you take the toys off your child because it is time to go out you will get a tantrum because you forced them to 'stop'. They need frequent warnings that in 10, 5, 2, 1 minutes we are leaving the house. You can use a traffic light system using coloured cards which says green is okay to continue, amber is a warning that we are about to stop, the red card means we stop what we are doing. Apart from that you can try to 'time things' so that they finish when you are due to go out. Even now (my son is 7), I would not put on a DVD and attempt to leave the house with him half way through it, unless I wanted a huge tantrum and the rest of my day to be hell!
I'm sure this isn't at all what you wanted to hear, but there is a vast range of abilities of those affected by autism and you may find that your daughter is on the higher functioning end. As she has so many sensory issues going on you need a referral to OT and specifically one that has experience about autism and sensory integration. It may be worth you paying privately for an OT to see you asap to at least set up a sensory diet that you can start with your daughter, because you will see quite alot of her behaviours lessen through that.
If you have any other queries post again.
I agree that the biting thing could be either out of frustration/anger or sensory issues. If it is from an emotional source it is maybe easier for us to understand. From a sensory point of view anyone of their senses can be out of whack. One of the senses is proprioception. This sense tells the brain where your body is and what it is doing. So if your daughter cannot 'feel' her body parts she may bite them just to see if they 'belong' to her. When babies are born they also don't have a knowledge of where they end and another person or the environment begins. So if she also has these sensory issues she is going to be really confused about 'self' and 'other'. This lack of 'self' awareness could also be a part of the separation anxiety or it maybe more classical separation anxiety.
The 'appearing deaf' is also a sensory thing. So is the toe walking and hand flapping. What alot of autistic children/adults do is (they either learn, or it happens automatically) they tend to function through one sense at a time. Therefore if they are looking at something they may lose their function of hearing or touch etc. For, for example, if my son is making a lego model and I talk to him that forces him to switch from 'doing' to 'listening' and that really upsets him because the interruption of his concentration may make him have to start from the beginning again. On some occasions when I have talked to him he has dropped a cup that he was holding. So that switch from 'monitoring self and holding the cup' was forced to switch to 'listening' and he couldn't maintain both and therefore dropped the cup and blamed me for it. The other thing that is important to know about sensory problems is that they fluctuate day to day and throughout the day. For example my son and the cat run for cover when I get the vaccum cleaner out, but he also appears deaf when I call his name, and he covers his ears at loud and unpredictable noises, but he sometimes seeks loud noises, sometimes he tells me he can hear things that I can't even hear, at school has drum lessons! So their reaction to the same situation/sensory stimulus will be different.
Children/adults with autim also have different attention and focus. They put 'all' of their attention/focus into what they are doing and what they are interested in. Therefore if they are watching TV they are effectively deaf to us calling their name. This can make them unaware of things happening in their environment because they cannot separate their attention and for example, watch TV and monitor what mum or siblings are doing in the same room.
The anxiety/anger about change/expectations is very common. Their world is a very confusing place that does not make sense to them alot of the time. They cannot automatically make connections between things as we do, or it may take them much longer and they may need it all explaining to them.
What is useful if you are going out in the car to a number of places is to firstly tell them that you are going out and tell them where you are going and (very important) make sure you go to the places in the order you said you would go to them. You can help her with this by having some pictures of the places you are going to stuck with velcro onto a board (again in the order you are going to the places) and as you go to each place she can take the picture off the board and put it in an envelope etc. When she is older, if she is able, you can move the child onto having a written list and they can tick off each place as they visit. This gives you some really good examples of how to the avoid the tantrums that work, and it explains what the anger anxiety is about. If you said we are going to the supermarket, but then decided you needed petrol and went to the petrol station first, she is going to get anxious because what you said isn't happening. Another (older) child might 'connect' that mum needs petrol to get to the supermarket. An autistic child will not make that connection until (if ever) they are much older.
I would recommend you google the name Olga Bogdashina and read an article printed in Autism Today. She really is at the forefront of explaining these sensory/perceptual differences in people with autism. She has visited our city and given seminars to parents and professionals and her sensory profile questionnaire is completed by parents to give professionals a sensory profile of their children. Her book Sensory and Perceptual Differences in Autism and Aspergers has the questionnaire at the back of it. I cannot emphasis how relevant I think this book may be to you understanding your daughter's behaviour.
If your daughter doesn't have any speech/language problems/delay then you may be looking at a diagnosis of Aspergers, although she may have language processing problems and literal interpretation of words etc. But she needs assessing by Speech and Language. If she has speech/language problems then it is more likely that it is an autistic spectrum disorder. It is very good that she is talking. She maybe repeating words names as a way of reducing anxiety and calming herself but you could also google echolalia and delayed echolalia in autism and see if any of that fits. She maybe using these big words herself or she maybe repeating them from things she has seen on TV or DVDs. Again this is part of typical development up to a certain age and to a certain degree, but echolalic speech is very common in autism. My son is about 50/50 his own speech and echolalic speech.
My son also walks around in circles repeating TV dialogue to himself he may also mimick the moves he has seen on TV or act them out.
I think alot of parents would say their autistic child is a 'home' bird. It is because home is recognisable and more secure to them. As soon as they step out of that door they don't know what they will encounter. There can also be anxiety about stopping things and starting things called 'transitions'. So if you take the toys off your child because it is time to go out you will get a tantrum because you forced them to 'stop'. They need frequent warnings that in 10, 5, 2, 1 minutes we are leaving the house. You can use a traffic light system using coloured cards which says green is okay to continue, amber is a warning that we are about to stop, the red card means we stop what we are doing. Apart from that you can try to 'time things' so that they finish when you are due to go out. Even now (my son is 7), I would not put on a DVD and attempt to leave the house with him half way through it, unless I wanted a huge tantrum and the rest of my day to be hell!
I'm sure this isn't at all what you wanted to hear, but there is a vast range of abilities of those affected by autism and you may find that your daughter is on the higher functioning end. As she has so many sensory issues going on you need a referral to OT and specifically one that has experience about autism and sensory integration. It may be worth you paying privately for an OT to see you asap to at least set up a sensory diet that you can start with your daughter, because you will see quite alot of her behaviours lessen through that.
If you have any other queries post again.
My three year old is autistic and he has the violent outbreaks as well. I once found him in his room cutting himself over and over with my husbands buisness card out of rage and his arm was covered in blood and he was emotionless. He doesn't do the bitting himself however, I used to be a child care worker and I had a child in my class that bit herself all of the time and she was evaluated and diagnosed with autism. The new enviroment thing is a sensory issue which tends to come along with autism as well. My son was like that for awhile and still is with just a few places but, the best thing for him was early steps. If your child is 25 months old she will qualify for an evaluation. They are miracle workers! What they will do is actually come to your house and evaluate your child and if she qualifies for services like speech or occupational therapy they will acutally send someone out to your house a few times a week for therapy and you won't even have to leave your home. My son did this and it helped him a little but, when he turned three because he was in that program, he was able to be refered by them to the school board at which point they did their own eval and accepted him into elementary school at the age of 3 and when I tell you that my son is a changed person, I mean it. Daycare did not help him but, the school setting and schedule did! They will not be able to actually diagnose autism but, they can however lead you through all the steps and give their advice and intervention and believe me, early intervention is the key to helping with autism! If you wait too long it is hard to help the symptoms! Best of luck and I hope that I have helped you. Just look up early steps on your computer in your area.
If you're concerned enough to post here, chances are you have a pretty good reason to have your child evaluated to get an offical opinion.
There are quite a few questions that come up like this and you can feel free to look up the archive. You can look up MayoClinic.com for signs of autism.
Since this is a FAQ, I'm thinking of just going ahead and making a medhealth page to direct parents to.
About the biting, you can feel free to read some of my writings on the health page. It may be helpful or may not. With me, I've observed it when I feel frustrated with a feeling I didn't know how to cope with. Anger was one of them.
What helped me was to be able to identify what I was feeling and learn better coping strategies... Unfortunately it took me quite a few years to be able to fully stop biting myself and I still have to resist the urge when I feel frustrated and angry like I'm losing control and trapped like a wild animal in a corner.
Thankfullysuch temper problems became increasingly more rare as I learned to recognize triggers and cut them off at the pass. This is an ongoing process though...
If you've ever felt so angry you "just want to pull your hair" "or throw your arms up in the air" or whatever related expresison, maybe that'd give some clue.
If it's sadness, which was another trigger such as feeling lonely... I thought I had to cope with it by myself. It's like having a major upset 3am in the morning with no one to talk to and no way of getting it off your mind. That's like it felt for me. To make it harder I assumed people were able to will their emotions away with a magic word or something... I'd try to tell myself what I was crying about was small and that I was stupid... That only made me angry that I couldn't stop the emotion, evne though my mind realized the emotion was not logical.
I'm learning: Bottom line: Emotions are NOT logical and I have to accept that... If I'm crying because I think someone rejected me, the feeling is not wrong regardless of what I know. I feel rejected. That's it. That's what's making me cry, not the situation per say. To resolve it, I need to find someone I feel comfortable talking to, until we can work it out and distract me from the feeling. Finding other things to occupy my mind helps too. Eventually when I feel better I can approach the person and find out the truth if given the chance.
Trying to mentally block the feeling by telling myself the person may just be busy, isn't going to help... It just creates anxiety because there's a gap between what I can rationally think out vs, what I feel.
That could be what your child is dealing with. With autism, many people I believe try to cope with things like pain solo because they know no better option. For instance if my feet hurt, I'll either try to tune out the pain by not thinking about it, or just put up with it and ignore it. It doesn't instinctivly come to mind to open my mouth and say "Hey my feet hurt, we need to go home." No. I just ignore it, try different ways of walking to avoid the pain, and then wait until it gets to be so bad I can't walk anymore. At that point, it still isn't first to my mind to express my discomfort. If it's really bad, I'm liable to throw a tantrum before I verbalize the pain.
There are quite a few questions that come up like this and you can feel free to look up the archive. You can look up MayoClinic.com for signs of autism.
Since this is a FAQ, I'm thinking of just going ahead and making a medhealth page to direct parents to.
About the biting, you can feel free to read some of my writings on the health page. It may be helpful or may not. With me, I've observed it when I feel frustrated with a feeling I didn't know how to cope with. Anger was one of them.
What helped me was to be able to identify what I was feeling and learn better coping strategies... Unfortunately it took me quite a few years to be able to fully stop biting myself and I still have to resist the urge when I feel frustrated and angry like I'm losing control and trapped like a wild animal in a corner.
Thankfullysuch temper problems became increasingly more rare as I learned to recognize triggers and cut them off at the pass. This is an ongoing process though...
If you've ever felt so angry you "just want to pull your hair" "or throw your arms up in the air" or whatever related expresison, maybe that'd give some clue.
If it's sadness, which was another trigger such as feeling lonely... I thought I had to cope with it by myself. It's like having a major upset 3am in the morning with no one to talk to and no way of getting it off your mind. That's like it felt for me. To make it harder I assumed people were able to will their emotions away with a magic word or something... I'd try to tell myself what I was crying about was small and that I was stupid... That only made me angry that I couldn't stop the emotion, evne though my mind realized the emotion was not logical.
I'm learning: Bottom line: Emotions are NOT logical and I have to accept that... If I'm crying because I think someone rejected me, the feeling is not wrong regardless of what I know. I feel rejected. That's it. That's what's making me cry, not the situation per say. To resolve it, I need to find someone I feel comfortable talking to, until we can work it out and distract me from the feeling. Finding other things to occupy my mind helps too. Eventually when I feel better I can approach the person and find out the truth if given the chance.
Trying to mentally block the feeling by telling myself the person may just be busy, isn't going to help... It just creates anxiety because there's a gap between what I can rationally think out vs, what I feel.
That could be what your child is dealing with. With autism, many people I believe try to cope with things like pain solo because they know no better option. For instance if my feet hurt, I'll either try to tune out the pain by not thinking about it, or just put up with it and ignore it. It doesn't instinctivly come to mind to open my mouth and say "Hey my feet hurt, we need to go home." No. I just ignore it, try different ways of walking to avoid the pain, and then wait until it gets to be so bad I can't walk anymore. At that point, it still isn't first to my mind to express my discomfort. If it's really bad, I'm liable to throw a tantrum before I verbalize the pain.
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