Autism and Psych. problems

[momtoaiden]

My 29 month old son is globally delayed with a complicated medical history.   Because of all his surgeries, blood draws, etc early intervention and his therapists have suggested he see a pediatric psych.  His regular ped said he was suffering from PTSD and due to his feeding issues, recommended a speech therapist that specializes in infantile feeding disorders.  Autism has been thrown around since my son's delays began to surface.  Most noticeably, his expressive speech is between 9-12 months.  However, his cognitive/receptive language is about at level.  I have done extensive research trying to figure out what is going on with my son, and did not feel I had any grasp on things until I began reading about attachment/PTSD.  There is almost no information on biological children who have attachment issues, but is it possible?  My son is attached in many ways, but he is also very wary of me.  After his last surgery, I would describe his change in  behavior as depressed/terrified/timid.  Whenever he feels the slightest bit threatened, he abuses me and self-abuses. 25 months, his dev ped said he was suffering from his surgeries; she was not worried at all about autism.  Emotionally, he was having a good day when he saw her.  He saw her now, 29 months, and was in his terrified state.  She diagnosed him midline spectrum.  I can see where she came from, but my concern is there is something quite serious psychological going on.  I explained he does not always behave this way-you can break him of it, but it is getting worse, not better.  Can he have attachment and autism issues?  

[momtoaiden]

This is where I am encountering problems.  My son has been in early intervention since he was 11 months.  I was proactive about it (with the help of his ped) because he was born with a cleft.  However, with the onslaught of doctors and therapists, I've now seen a strong, steady emotional reaction.  He is to the point where he completely clams up, shuts down, tunes out in the presence of a doctor and any new therapist.  They say with a diagnosis of autism it is good because he will get more services, but he regresses with more services.  Any progress he has made, has been from loving *you do what you need* approach from me.  That's how he branches out with food, play, everything.  He's just terrified of life now, and I feel like I've put him through it partially even though I was trying to help him.  I'm a teacher and you always hear "early intervention is critical", but it seems he just had too much.  But how do I know?  And I cannot find support anywhere for this since he is my biological son.  I get the attitude that I am in denial about autism.  I truly just want to help him, and I am afraid there is much more going on than autism.  If I had a crystal ball and could see for sure, I'd drop all therapy and just let him be himself for awhile, but then I get terrified that if I'm wrong for some reason, I'll have missed that important window of opportunity.  My instincts tell me though that he needs me and no one else is able to reach him.  His speech therapist that was with him for over a year said there was no way he was autistic.  His cleft speech therapist said he was not autistic, but has severe emotional problems, but with no doctor/diagnosis backing, I am not sure how to help him.  This probably is the board for it, but I am not sure what to do anymore.

[Kevin Kennedy, Ph.D.]

It is possible for one's biological child to display attachment disorder. Attachment is a process that occurs over the first several years of a child's life, and the first eighteen months are critical if a child is to develop a sound attachment wherein the child attains a level of security that basic needs will be met. Attachment issues can arise if children are exposed to less-than-adequate parenting, but such issues can also arise if a child is exposed to separations from parents and at the same time is 'subjected' to difficult times. That is why frequent hospitalizations at a very young age can interfere with the attachment process. From a psychotherapeutic perspective, not much can realistically be done to influence this process with a child as young as your son is. However, if you continue to provide attentive, responsive parenting you can expect some change for the better. This would not be true so much of a child with an autism-spectrum disorder. Such disorders are neurointegrative in nature and are not primarily the result of inadequate attachment during the first several years. However, there is growing evidence that, with intensive therapeutic (not psychotherapy) efforts deisgned to 'teach' engagement, communication and interaction, even children with serious pervasive developmental disorder conditions can display some improvement. This is an evolving field, but there is room for optimism where previously pessimism prevailed. But it is critical that intervention happen early.