My 4 1/2 year old

[andrea25]

My 4 1/2 year old son was diagnosed with autism at 22 months old..Despite early intervention and now preschool speech therapy and occupational therapy it seems he has made little progress..He seems to be losing more speech and seems to have become a little more self injurious and aggressive..I have mentioned this to the doctors and they say its completely normal..I don't argue with the diagnosis of autism but does anyone have any suggestions..Could this possibly be something else..We do have an appointment in April with a geneticist. A few other things about him
that have noticed physically he has a abnormally large head as well as what seems like deep sunken in eyes and very small widely spaced teeth.The pediatrician recently put him on risperadol for his self injurious behaviors..anyways any suggestion would be helpful..

[Angela77]

A Board Certified Behavior Analyst would be able to conduct a Functional Assessment of your child's behavior to see what is motivating the self-injury.  After the function of the behavior is identified, a Behavior Improvement Plan should be written and consistently implemented by the people who are involved with your child.  Does your son have an IEP?  Perhaps you could request an increase in speech therapy to help with language issues.

[888mom]

I agree with chikp on people with autism are not so different than people without it. Probably all of us in the world have some sort of idiosyncracy of something that is on the autistic spectrum without being autistic, and society makes accomodations for us.  I have sensory issues with sounds and smells and if anyone touches my hair or face.  When I was a teenager I had some problems with self-injurous behavior where I would get upset and I'd dig my fingernails into my hands or forearms, and if someone asked me why I did it, I honestly did not understand why I did it.  It was like I couldn't control myself.  At one point the school shrink thought I was suicidal and that brought my parents in and it was just really bad explaining it and they did not understand, so they thought I was suicidal and it was just easier to have them think that than explain why I did what I did.  I had all those teenage girl hormones running and couldn't communicate what I was feeling because I didn't know what I was feeling sometimes.  Had to go to the school shrink lots of times because of that but learned to tear things up that weren't my skin, like shredding paper or scratching my jeans which were thick material.  I have not done it since I was a teenager and a preteen, but I remember it vividly being an issue with my parents and school.  and I think I understand my daughter sometimes why she wants to bang her head into the wall so I know she isn't crazy.  I hold her and have her bang her head into my stomach at those times and try to minimize the things that frustrate her to doing that.  She's doing it a lot less like maybe once a week now instead of daily, but there are times I have to stop her still.  But, so we all have our issues that we have to work through.  I really don't think normal people exist out there.  People have accomodations made for them for lots of things.  Panic disorders, agoraphobia, anxiety attacks, lots of phobias, OCD, ADD/ADHD, the list goes on and on.  Aside from mental disorders there are physical disorders that people make accomodations for.  So, I don't see why making accomodations for certain things about autism is such a problem in our society.  Now controlling behaviors like if your preschooler wants to do stuff in public that are disruptive, like pulling everything off the shelf, that you stop.  Normal preschoolers try to do disruptive stuff when they are angry too, and you stop them.  So, it's not like we're letting our kids who later turn into adults get away with things.  We still have to parent and discipline but we have to understand them and why they do what they do.  Some things you make accomodations for, others you don't.


Andrea25,
The teeth thing... is your son getting enough nutrients and vitamins?  What did the doctor say about his teeth?  Is he taking any supplements if his diet is not diverse enough?  Sometimes dental health correlates to our diet.  Sometimes it doesn't.  One of my friend's kids has teeth that didn't grow enough enamel, so she took him in for his checkup at 2 1/2 and he had 5 cavities!  She brushed his teeth and he had good brushing habits, but because of the enamel thing, his teeth were pretty bad off and it wasn't their fault.  It was just something genetic.  My daughter has a lot of taste aversions, but I find ways to get her vitamins in.  I have to buy her freeze dried apples since she won't eat regular apples since they are too hard for her (I get the gerber ones that melt in your mouth since they don't have any preservatives or additives or sugar or salt and are just freeze dried apples).  She also likes freeze dried blueberries that aren't gerber brand, but found one at Super Target that is just blueberry, no preservatives.  She eats watermelon and canteloupe, but that's about it for fruit.  I give her Gerber veggie puffs still.  They melt in your mouth.  SHe is now starting to get used to cheerios at age 2 1/2, especially if I cut them in half for her.  She won't eat vegetables, but I never stopped feeding her baby food vegetables so she will still eat those.  Well, it's still healthy, and if it's the only way I'm going to get her to eat a vegetable besides peas or really mashed up sweet potatoes, I'll do it.  Sometimes I mix baby food green beans in with her sweet potato and add a little brown sugar and Smart Balance butter to make it more appetizing.  I have a friend who eats baby food as an adult because she has some sort of stomach disorder where she can't process veggies or fruit unless they are totally pureed like baby food, so she eats baby food to get her vitamins and so forth.  She used to feel so embarrassed about it, but I don't think she should have been.  I figure, if it works, do it.  You could even mix baby food stuff in to things you make.  I home bake bread and muffins and will mix baby food fruit or veggies in to it. Plus there are different ways to get vitamins.  There are chewables, gummies, and pixie stick stuff you can dump in drinks.  I had to try them all out and found my daughter likes the gummies but the pixie stick ones ruined the taste of the drink or were too grainy on their own and she just didnt' want the chewables for whatever reason.  Maybe they were too hard.  She does like soft stuff like soups where the veggies are so soft and mushy from cooking or liquidy like yogurt.  And she eats yogurt and soggy frosted flakes or soggy corn flakes (but they have to be soggy).  So figuring out what texture it is your child likes is important so you can make things that appeal to them and make them healthy.  I think some kids don't like the mushy stuff and prefer the hard textures.  

Don't know what to say about the language thing.  My daughter is only 2 1/2.  She learns a word, says it for a week and then doesn't say it again.  She counted to ten a few times a month ago and never has said a number again, for example.  She also knows her alphabet and once sang the alphabet song.  She has not tried to sing the alphabet song again.  I think it's like she knows she can do it, so why do it again?  Only consistent thing with words is her sign language.  And even then you have to prompt her for it most of the time, unless she really really really wants it.  Like the televsion or if she's really hungry or thirsty, she'll let me know.

So, normal to lose language?  Even for being autistic?  I don't know.  As a parent, it must be really frustrating not to be able to have your son communicate with you.  Just be patient with him.  It's not that he doesn't want to, it's that he just is not able to.  But, his therapists or doctor or whoever really needs to address the language thing to let you know how you can work him through it.  I'm sure he wants to communicate but is having problems.  I personally wouldn't just accept the doctor saying it's normal and then not telling you what to do about it.  Do you have a speech therapist still?  Or therapists through the school system?  

Okay, I'm like going on and on so i hope any of this was helpful or made any sense ... but I tend to post at night when I'm sort of, well more than sort of, tired, but it's only time i'm able to get on.  Plus i'm kind of a stream of consciousness writer.  

[chikp]

I think it may also be helpful to stop looking at people with autism as being so different than 'normal' people.  When you try to see that we all experience frustrations and have aversions and idiosyncrasies you may be more able to understand people on the spectrum.  I think that everyone has told a story that included the phrase "I was about to pull my hair out!" or "I just wanted to scream!".

For instance, I have a sister who will not eat strawberries.  Why?  Because of the seeds on the outside of them.  This applies to any berry with small seeds and some veggies with seeds inside like eggplant, I think.  Now, if she were on the spectrum, this quirk(?), aversion (?) may be over analyzed and someone may have the bright idea to shove a strawberry into her mouth.  If she reacted violently or resisted strongly, she would be tagged as 'aggressive'.  Never mind the fact that someone forced her into a situation where she felt completely overpowered and ignored!  Frankly, I am the same way about shrimp.  

What I am saying is that you should look at behaviors as a form of communication.  Sometimes the message is 'you've pushed me too far' sometimes it is completely different.  

Oh and sorry about the long posts, I've had the flu for since Friday and I am just starting to feel better.  I think I have a bit of cabin fever and some newly regained energy to spend.  I hope that these responses are helpful!

[MJIthewriter]

Somewhere I also have a suggestion for parents. I don't like being caught in arguments/fights with people. What I consider a "fight"" in this context is let's say hypothetically I'm a child and playing with a toy. It's time for me to put it away and eat dinner.  Asking me to put the toy away, may not get a response at first.  My dad/mom would get frustrated, come down, ask again. I may not respond. My dad starts yelling at me... In response to the loud raise in voice I start getting defensive.  I may yell back, which would cause dad to yell even louder.  There we have a fight...  In the end, I may lash out either by attacking myself, hitting dad, or throwing my toy. If dad were to take my arm and try to pull the toy out of my hand at any stage, I'd get tactilely defensive. To have my arm grasped onto feels painful like a burn. As a result I will try to yank my arm free and may also inflict pain on whoever is grasping my arm and won't let go.

Yelling and grabbing ahold of my arm, does not work so well. Likely if you are doing that with your son, it won't work well either.  I think chikp has some pretty good advice.  A lot of my frustration, even today is the inability to express my thoughts/feelings in a way people can understand.  

But eventually it comes to a point where the mainstream society needs some kind of mental behavior conditioning!  I don't like how society expects every person in the world to be able to read their minds... not even normal people can do that! It's unfair to put those expectations on an autistic person.  When people put those expectations on me it leads to me feeling trapped and prone to retaliate at a more reflexive, instinctive level than a sane one. It gets on my nerves when society views me as some kind of “retard” deserving of pity… When people start patronizing me, it makes me frustrated to no end. If they keep it up, the urge to bite my arm gets pretty strong.

(Sorry you had to get the last part of my post, but I still feel it needs to be posted somewhere. I'm in a bad mood this morning and this has been on my mind, and contributing greatly to my mood.)  I find writing as a good way to release feelings that I cannot express verbally.

[chikp]

I think that a behavior analyst should be able to help you with some of the behaviors you described.  Applied Behavior Analysis (ABA) has gotten a bad rap in some communities which I find unfair both to the families and the methodology.  What the behavior analyst can do is work with you to find the functions (there could be many) of the self injurious behaviors and intervene to simultaneously extinguish those behaviors and teach socially appropriate replacement behaviors.  Sounds complicated but it does not have to be.  Often when the child realizes that the "appropriate" behaviors are more effective than the maladaptive behaviors, they will go with what works.  

For instance, I used to work with a child in a clinic who would throw himself on the ground and bang his head onto the floor until we let him sit in his mother's lap.  He was there for OT and a social skills group which was almost impossible to get to because of his behaviors.  The other therapists asked me for some suggestions.  The first thing I did was cover the floor of the area he would be with thick gymnastic mats so that when he fell to the ground, he would not hurt himself.  Then we made sitting on his mother's lap contingent on completing a simple task.  We also reduced the length of the sessions to 30 minutes instead of an hour.  We had a few sessions where he had to be fully prompted through his task (i.e. a puzzle) but I was able to fade my prompts completely, fairly quickly.

We gradually increased the amount and difficulty level of the tasks and stopped placing mats on the floor!  His therapy sessions were now productive and he was leaving his mom in the waiting room with a smile and a wave and running back to the therapy room!  

Well, I guess all of this is meant to illustrate that even the most severe, frightening behaviors can be modified with patience and a systematic plan.  If you don't know where to find a behavior analyst, you can email me privately and I'll try to help you.

[mjthewriterdad]

MJIthewriter has a couple  journal entries called "Extreme anxiety attack causing self injurious behavior" and "Frustration ".


See if they help you understand what's going on

[mjthewriterdad]

Self injurous behavior is always scary to me.  I don't know what to do, either, but have seen it in my own child at times.  She mentions when she feels trapped and cornered like and wounded animal trapped, is when she feels the need.  Maybe he can't communicate his frustration.  Hopefully my daughter will contribute to this thread.