2 yr old with balance and social issues

[Julie M.]

I have a 2 1/2 year old fraternal twin boy who has always been delayed in gross motor skills.  He is very clumsy and is flat-footed.  He was diagnosed as a low muscle tone child by an OT.  However, recently I have noticed that he also has problems socially, not wanting to be involved with group activities or playing with other children (he will go to a different room).  He also acts up when we do anything new.  He seems to get overstimulated and shut down.  He is a nail biter.  He will never sit down in a new group environment (such as storytime at a library, etc).  He can be very violent, throwing toys, grabbing and hitting.  I am convinced that the balance issue and his behavior are related.  His twin is not like this at all.  The boys were 4 weeks premature.  Does anyone relate to this story?  I have made an appointment with a neurologist and an eye doctor in the hopes that someone can help us.

[Julie M.]

Joyce -
You have no idea how much better you made me feel today.  We saw the neurologist and he suggested his balance had to do with his prematurity.  We haven't gone into testing for the other scheduled.  I guess there are days when I think there is behaviors yet, we got the flu on the day we had the testing something wrong or "different" and days when I think he is just a typical 2-year-old who will outgrow this.  I thought I would give it another 6 months or so to see if there are any improvements.  

I will say, however, I did try taking his piano away for a few days - and it worked!  He seemed to finally recognize that other things existed.  When he played his piano, it was like he was in some sort of trance!  As far as the fan fixation, it is still there, and when we went trick or treating, he asked to see everyone's fans.  I have started a "first-then" strategy with it.  "First let's eat lunch, then we'll talk about fans".  This has worked a little bit.  I hope he outgrows it as your twin did.  

Thanks again for writing.  It is nice to know that this might just be a passing thing.

[Joyce]

Hi Julie,
I was just reading your post and wanted to tell you I got a little giggle when I read the part about the ceiling fans and trick or treating, only because I have fraternal twin girls and last year when they were 2 the smaller of the two had a similar fixation, only hers was with t.v.'s and dogs. She would literaly shove full grown adult homeowners out of her way to get a peek inside thier house while screaming "DO YOU HAVE A T.V.?, DO YOU HAVE A DOG"? She also talks all day long. Actually it scares me to think anyone could have so much to say! She had failure to thrive,but has recently gained some weight, doesn't care much about t.v.'s and dogs anymore but she still rambles a lot, and I might add she has one volume - "LOUD"! If I may suggest one thing for you to try just to see if it helps, what would happen if you took his piano away for a few days and gave him some other activity he hasn't yet tried that is age appropriate. I hope I don't seem to foward but your little guy reminded me so much of my own little bundle of amazement. Oh yeah, she also was a nail biter and outgrew that too. I have to say my personal expierience is, the more interacting on thier level and the ability to divert a bad oncoming situation by switching gears quickly helps a lot.
              Good luck,
                Joyce

[Kevin Kennedy, Ph.D.]

Dear Julie M.,

Rather than trying to offer opinions re: what you might do within the home, in the absence of a definitive diagnosis, my best guidance is to pursue the ongoing evaluations. Your additional information suggests your child may (and I underline may) display a type of childhood emotional disorder called Pervasive Developmental Disorder. This condition, of which there are several sub-types, involves difficulties in communication, social interaction and behavior. A developmental pediatrician or psychologist, or a child mental health clinician, would be in a position to help you sort out the possibilities.

[Julie M.]

Thank you for your prompt response.  I realized I forgot to add some very important information about my son's behavior.  He also has a fixation on ceiling fans (we went trick or treating and he asked to see a fan at each house).  He also is very sensitive to different textures and won't eat anything that is mixed together.  His language is fine and has been tested by a speech therapist.  However, he is not real responsive when I ask him questions.  He tunes me out and acts like I am not there.  He cannot seem to make simple choices.  He talks all day, often repeating the same thing over and over.  He will ask himself a question and answer it himself and do this 3-5 times in a row.  He will sit by his little piano and push the same key over and over for about 15 minutes.  He is starting to stutter.  I am scared for him.  If he is overstimulated, what can I do to help him?  I have already decided not to do so many activities.  How can I change our home environment and how I respond to him to keep things more simple for him?

[Kevin Kennedy, Ph.D.]

Dear Julie M.,

You are on the right track in seeking additional evaluations. It sounds like there is some difficulty with his neurosensory apparatus. Hopefully, this will simply require maturation in order for him to improve. But he may display sensory integration problems which are not prone to remediation through development alone.

The aggressive behavior may be the result of feeling overwhelmed and vulnerable in social situations. Remember, he is only two and one-half. These days a lot is expected of very young children from the point of view of social interaction. Some children are not ready for the kinds of social engagement they are exposed to.

Part of your son's evaluation may well incude an assessment by a developmental psychologist, to help pinpoint the areas of development where he is 'on target' and those areas where he is in arrears.