My grandson's behavior

[chayamalka]

My grandson has antisocial behavior. He doesn't interact with other children. I see that he has mild autism but my daughter-in-law denies it. She says he just has an anxiety problem and antisocial. He is a well behaved boy. He is 5 years old and goes to a special school now. But my son wants to put him in a yeshiva and in a regular class, not in special ed. The classes usually have 25 children. His IQ is 90. They also want to leave him back 1 year because he was born in July, so being 1/2 year older might help him adjust to others. Are they doing the right thing? He loves to go to synagogue with his father and pretends to read the Hebrew while the men pray. The rabbi praises him for being well behaved which raises his self esteem. But there are special ed yeshivahs with little classes. I don't know if the children there are severly disabled and will that hinder my grandson? Please help.

[Sally44]

Sensory issues can affect any or all of the senses of hearing, touch, vision, taste, smell, balance and co-ordination.  And it varies day to day or even throughout the day because it is a perceptual problem.  The senses can be over or under sensitive and as I said, it can fluctuate between the two.  It is called Sensory Integration Disorder and an Occupational Therapist is the professional who would address this.  An example of behaviours (and a child may have one or many behaviours) is appearing deaf or not responding to name when there is no hearing loss, covering ears at sudden sounds, making alot of noise, difficulty finding things in complicated visual backgrounds, looking at patterns on floor, attracted to bright/shiny things, avoidance of sunlight ie. pulling up hood, picky eater, complaining of smells or tastes, over reaction to light touch, needing tags cut out of clothes, upset with hair washing/brushing, nailing cutting etc, appears not to feel pain when hurts themselves, poor balance, clumsy, doesn't like to climb like peers, screams if feet taken off the floor, poor co-ordination, problems throwing/catching a ball.
As you say it is difficult if parents are not recognising the cause behind the difficulties.  But in reality, if he is placed in a school environment where he cannot cope he will begin to show frustration and behavioural problems and it will become obvious to the parents and school that that is not the right place for him because he simply won't show much progress either academically or socially.

[Sally44]

I am not a professional, I am a mother of an 8 year old boy with high functioning autism.  Finding the right educational setting is crucial for both their education and self esteem.  What I did, which you could consider, is I had a private report done by a Speech and Language Therapist who had experience of autistic spectrum disorders and speech disorders.  You need to find an independent professional not tied to the health or education service (because if they are independent they are more inclined to tell you what the child needs, as opposed to what the system provides).  They assessed his receptive and expressive speech, working memory, auditory memory, assessed him for auditory processing disorder and semantic pragmatic speech disorder.  She assessed his comprehension skills and information gaining skills using inference etc.  And she also assessed his social interaction skills.  That will give you a good idea of his areas of strength and weakness.  
Then we had a private Educational Psychologists report (independent as above), and they assessed his emotional understanding and response, his cognitive abilities (again using non-verbal assessments as he is autistic).  This gave us a very clear idea of his IQ.  You say your grandson's IQ is 90, but was that using non-verbal assessments, because if he has difficulties with language or language processing or meaning that will automatically bring his scores down and is not a true reflection of his intellectual level.  The EP was also experienced with autistic spectrum disorders and made a number of recommendations about teaching approaches etc.
These two reports should help give you a better idea of what type of schooling would best suit him.  The EP can actually be asked to visit the school to assess if she thinks the environment (ie. classroom structure/size, teaching strategies, experience etc) is going to be appropriate.
Although holding him back a year might make him fit in more at the beginning.  If he has social interaction difficulties they will remain unless they are addressed and he is taught (by teachers experienced with those on the spectrum) and supported during playtimes/dinnertimes.  
Does your grandson have any sensory issues?

[Rigil]

The Doctor does give the stereotypical straits for autism etc, however we are quite different in many behaviours and personality.  Classical autism is quite different from Aspergers syndrome and you have suggested mild autism.  If your grandson's IQ test may not represent his true intellect if he is overly verbal and visual.  This can impact negatively on the by 10-20 marks.  A neuropsych assessment would be a better indicator of your grandson's weaknesses and strengths, he may have learning difficulties that no one is aware of as yet.

I'm assuming the Doctor is psychology based.  Her recommendations are sound in relation to assessment and behavioural therapy/govt assistance.  From experience and speaking to others with Aspergers venture clear of psychiatrists, medication is their main arsenal and have little knowledge of pervasive development disorders.  

Sally's insight into her son's differences is helpful and you won't see them in the DMS-IV criteria for autism spectrum disorders.  Your grandson's willingness to please and be accepted by his peers is common in some folke with ASD and we look for constant reassurance of ourselves.  Some of us are reclusive and shy from social contact.  

[Eileen Roscoe, PhD]

Autism is characterized by deficits in social interaction and communication. Examples of social deficits include lack of initiations in social play and lack of interest or awareness of others. Examples of communication deficits include delays in spoken language, lack of initiation in conversations with others, and stereotyped or repetitive vocalizations. In addition, individuals with an autism spectrum disorder often have stereotyped motor actions, have a restricted range of interests, and show a resistance to change in routine. These delays are usually observed prior to age 3. In addition, Autism is usually associated with a delay in cognitive skills and a diagnosis of mental retardation, which may range from mild to profound.

The lack of social interaction in your grandson is consistent with a diagnosis of autism. You are in a difficult situation if your son and daughter-in-law do not recognize deficits that you have observed in your grandson. I suggest that you recommend to your son and daughter-in-law that they seek the assistance of a qualified professional who specializes in the diagnosis of Pervasive Developmental Disorders so that they may recieve an accurate diagnosis for their son. Although diagnosis alone will not point to an appropriate intervention, it will lead them to identify appropriate services for him. I also recommend that you suggest that your son and daughter-in-law seek the support of a Board Certified Behavior Analyst, who would be able to conduct the appropriate assessments and to assist in developing a curriculum for increasing appropriate social interaction and play behavior. Please visit the website of the Behavior Analysis Certification Board (http://www.bacb.com/) where you will find a directory of service providers.

[chayamalka]

Thanks again for explaining all this to me. I will discuss this with my daughter who sees Bobby and his mother much more often than I do. Maybe she can convince my son and daughter-in-law to have Bobby tested for all these things and get the right school for him. I will let you know what happens.

[chayamalka]

Thanks for all that information. It would all be a good thing to give him all that assesment. But I have one problem. My son and daughter-in-law are in denial of him having autism. I see that it is very mild but he does have symptoms: plays by himself, just scribbles in a coloring book while his cousin same age colors in the lines, slow to answer my questions, gives one word answers. He interacts with his younger brother who is extremely smart and friendly. His IQ test was given by a regular yeshiva school psychologist and it probably was the usual assessment, verbal. I don't think he has sensory issues. By that do you mean hearing difficulties? I will relay this to my older daughter who is close to my daughter-in-law and would know how to relate this stuff to her in a sensitive way. My son and daughter in law don't discuss this with me. I have a physical birth defect on my foot and leg, growth imbalance, and maybe they think I am sensitive about Bobby's autism. Thanks for your help.