Hand Flipping and Lack of concentration in a classroom situation

Hi,

My son who is now almost six years old started flipping his hands from the age of around 4 1/2 years. Prior to that he used to run up and down the room. We have checked for autistism and the test proved he was not autistic. We were told to ignore the behaviour but it just got worse especially when he watches TV. He also has the habit of getting up from his seat in class and walking around flipping his hands. He does not listen to the teacher's instructions and is distracted watching the other kids in the class. However, in a one-on-one situation he is extremely attentive and does great school work. He has beaten/pushed other kids from time to time and complains that the kids in school dont want to be his friends.

We have set-up system with him that will reward him with some TV time, stickers or comic books if he does not flip his hands at all, listens attentively to the teacher in class and does what she says and finally behaves himself in the playground by not pushing other kids.

Is this a good strategy? What is the issue with our son?

He behaved very well in school when he was told that we were going to school that day to check with his teacher. I feel that he does not want to listen but will if forced to by rewards/punishment. He is very aware of the consequences of his actions but will do it if he can get away with it.

He also was diagnosed with sensory integration dysfunction and complains about loud noises. We will be testing him auditory perception and OT. His speech is fine though it can be one-directional (could it have to do with a hearing problem - he seems to be able to hear well but takes some time reacting to instructions given to him especially if there are a few instructions).

Sorry for the long note but the hand flipping seems to be attracting the most attention..what can we do???

[Kevin Kennedy, Ph.D.]

Dear Bimal,

Your son displays some syptoms (symptoms) (repetitive bahaviors, difficultiy with social engagement, problems with communication) which are sometimes indicative of a range of conditions called Pervasive Developmental Disorders. Autism is one such condition, but it is only one, and even with Autism there is a broad range of severity. PDD is often associated with such conditions as Sensory Integration Disorder and various Speech/Language Disorders and learning disabilities/disorders.

It may well be that your son does not display Autism, but he may display PDD of another type (e.g., Asperger's Syndrome). This will need to be clarified. On the other hand, he may not display PDD of any sort; instead, his difficulties may reflect sensory integration, speech/language, and/or other neurobehavioral conditions.

The only way to specify the diagnosis is to continue the evaluation process, even if Autism seems to have been ruled out.

Your strategy of reinforcement for appropriate social and classroom behavior is very sensible. Try to be sure it is systematic and very,very consistent, with good collaboration between home and school. Part of the plan should be strict limit-setting and discipline in relation to any form of aggressive behavior. But your emphasis on a positive approach based on reinforcement is to be encouraged. Dr. KDK

[blucio]

A related discussion, hand flapping was started.