asperger's or something else

[christinadc0527]

I have a student that is displaying the following symptoms.  Am I on the right track or am I missing something?

1.  She flaps her hands in front of her face
2.  socially immature
3.  Defiance with authority
4.  masterbating in class with her hands or with her chair: started last year and has increased to the point where she does it every 10 minutes, to the point where she is sweating,  and cannot stop even when redirected
5.  speech problems
6.  gross motor clumsiness

I know I'm no clinician yet but I thought these were the possibilities.  Am I missing something?

1.  Autism Spectrum Disorder
2.  Obsessive Compulsive Disorder: flapping and masterbating due to stress?
3.  Sexual abuse

[Myrna Libby, Ph.D., BCBA]

You have made some very good observations; I think that this child needs to have a full team evaluation and diagnostic work up with professionals familiar with Autsim Spectrum Disorder.  I also would want a medical work-up for the masturbation to rule out any medical issues.  It is not, in itself, that unusual and we usually try to teach appropriate use of private time.  I do not see any reason to suspect sexual abuse from what you have written and would focus on a diagnostic evaluation by a developmental pediatrician or pediatric neurologist.

[MJIthewriter]

This may be a bit random, but could the child need to use the bathroom and not want to admit that in front of everyone?

I remember doing something very similar (only I didn't realize what I was doing).  I sat on my hands and wiggled when I had to go pee and didn't want to get up to go to the bathroom. It would temporarily make the uncomfortable feeling go away so I could stay in the classroom and not have to ask to be excused. Eventually it would get pretty bad, because the bladder can only hold so much.  I would inevitably have to get the bathroom pass. By then I've already been rocking quite a bit in my seat and probably creating quite a visual disturbance I was unaware that I was creating.  I never really enjoyed having to get the bathroom pass. If I remember I had to raise my hand and ask the teacher to get the pass. Some teachers were very insistent upon asking the proper question, "May I go the restroom?" and not accept such questions like, "Can I go to the bathroom?" or "Can I use the toilet?" Then I'd have to walk up to the front of the class or wherever the pass was located, take it and be interrupted from the class.

Dry skin and itching is another possibility. If the child is itching there, they may be trying to relieve the irritation. I tend to itch everywhere on my body. At times my whole skin would itch, arms, torso, legs, face, scalp, feet, butt and you guessed it...  I’m still not sure what causes the intense itching and discomfort. It is probably a food allergy or skin problem. (I suspect KP because of the texture of my skin) I sometimes find relief from the itching with lotion and sometimes not.

[SueNYC]

As a parent, please bring it up gently and very professional with the parents.  I have had teachers come up to me and ask if he was on meds - not your role. I have had teachers ask me or his siblings (they weren't even his teachers) whether he has an ASD (even the experts don't know).  Why they would ask a 7 year old child is beyond me - just nosy I guess.   One teacher used to make cruel remarks (not his) and called him the pencil geek to his face (he sort of stimmed with a pencil).  You can't even complain about it because the teachers will lie when they screw up and the only reason one wasn't fired (she was an Ivy League grad) was because she fessed up to it - as the principal was rolling her eyes.  We actually liked this teacher (it was her first year) and my husband was desperately just trying to get her to stop her immature behavior.  She actually liked Sam because he read really intense books - it was rare to find a third grader who wanted to discuss Brave New World - so all in all it was an uncomfortable situation to bring her to task.

ll these evaluations take time even if the parents are amicable (sometimes they are not).  In the meantime, I suggest you ask them if you can start a communication notebook.    My son, who goes to a special ed school now, has one.  I absolutely love it.  There is no ambiguity about what happened in the school day.  If he was oppositional or did not cmplete an assignment I know about it.  If he fell asleep in class - I know about it.  Geberally it is only about a paragraph a day unless he had a bad day or sometimes it just says he had a wonderful day.  That makes me smile.  If he had a confrotation - I know about it.  But most important, it is never judgemental.  And please remember to treat each day as a new one with this child.  

Also, if it is as bad as you say, you may suggest "off the record"  so you don't get into trouble, that they contact a Child Advocacy group.  They are about 15X more helpful than the school social worker in getting the necessary help for a child.  They serve both low and high income families.  They have been as imporatant as all his psychiatrists and psychologists combined (and in fact, they were the ones who sent us to one).  

But it still may not go well.  It is amazing how many parents with behavior problem children have come up to us (one with a classic case of undiagnosed Asperger's) and ask me what to do.  Many are afraid to get their children labeled because of the stigma it brings (we have one psychiatrist willing to push the diagnosis of Asperger's even though my son does not make full criteria for AS (even my husband defers because he would rather have the ADHD label).  So don't be surprised if the parents seem to be blowing you off.  It is a process.  It took us three years until we had any real improvement.  ANd honestly, the NYC Board of Ed was not exactly helpful because he was a high academic achiever and why would a straight A student need services.  Good Luck - you seem like a great teacher - just remember - don't seem frustrated, personally hurt by the child, and don't try to diagnosis yourself - because I can tell you - sometimes it is harder than you think.  But most of be compassionate to the child and parents - sometimes these kids can be the hardest to understand and love because of their social development, but in reality, they need it the most.  Parents can truly sense when a teacher really wants to help and one who is counting the days for this kid to move on.

Susan  

[christinadc0527]

Thank you for your response. :)