Social Concerns

[LoriV]

My 5 year old son struggles with initiating appropriate conversations with other kids except the ones he is very comfortable around that he knows accepts him unconditionally. He is very sensitive and will pick up on negative social cues, but only becomes more anxious and inappropriate with his words and says alot of nonsense talk which is noticed by other children. He is always trying to make the other kids laugh and doesn't seem to feel comfortable being himself. He is very active and does not seem to be able to settle down at times, especially when he is bored. If he is involved in something that interests him, he is able to focus. Teachers say he is very bright, but I notice that he is not always interested in showing what he knows. When the kids are learning to read with the teacher, instead of reading also (which he knows how to do already), he usually sits and sucks his thumb and looks around the room or likes to pester some of the kids to get a reaction from them which is usually negative. He is very social and LOVES to be with other kids, but is quite self-centered and rambles things off the top of his head that are not relovent. He will respond appropriately when asked questions by other kids, but is lost in a free-flowing conversation. I feel so bad for him because he notices every little face or comment or tone of voice and internalizes it - everything! He was doing fantastic the first two weeks of Kindergarten (no paraprofessional). He was noticably more mature (noticed by everyone) he did not speak any nonsense talk. He was like a different child. Now he says he does not like school and is very hyper at home and speaks nonsense often. I think he is feeling the pressure and is acting out his anxiety. He was diagnosed at 3 as having "possible" PDD-NOS or "possible" Asperger's "too young to tell at this point". He has made phenominal strides since then, but continues to struggle with socially and with hyperactivity. He also is not able to see in a book or watch on TV when a child gets hurt or gets yelled at by another child or adult - he runs for cover. It's as if he feels it himself. He also worries about death which he saw on a Pokemon video (no more of those). I also worried about such things at a young age, but not sure if I was that young. My husband feels that he is just immature and will catch up, but I think there is more going on and I want to do what I can to help. I spoke to the Social Worker at the school who has been evaluating my son and said she could tell that he knew she was there for him and that he was uncomfortable. I don't want to make him anymore uncomfortable because he really started full force with the nonsense talk and hyperactivity shortly after I was told he was being evaluated by the social worker. I want to do whatever I can to help my son. Any feedback would be greatly appreciated and I look forward to hearing from you.
Sincerely,
Lori

[Kevin Kennedy, Ph.D.]

This situation likely is not to be explained by immaturity alone. Now, remember that your son is only five, and from a social point of view it's important not to expect too much in terms of maturity. On the other hand, his nonsense talk and activity level (which might be related more to anxiety than to neurological features) deserve consideration. One thing to try to pin down is the differential diagnosis between heightened motoric behavior due to anxiety vs hyperactivity. He may display a condition along the PDD spectrum, though if he does it is not likely that the condition is very serious. Nonetheless, additional evaluation is a good idea. Finally, I do endorse what your husbamd is suggesting, namely that, as time goes on, your son will show more capability in peer interactions, but I'm hesitant to adopt a 'wait and see' approach.