Could this be aspergers, dypraxia or just a child with behaviour problem

[sueby75]

Hi I am hoping someone will be able to identify what I am talking about, and give me some ideas/advise about what I should do next.  I have an 8 year old son who since about the age of 18 months has always been a challenge.  He met all of his developmental milestones earlier than he should have done, crawling at 5 months, walking at 9 months, saying individual words around the same time and talking full sentences by 18 months.  he has always had this big independance streak which particularly as a toddler became a battle of wills, every decision I made for him he challenged with major tantrums and drama.  He continues to this day in that vain.  He is articulate and bright, he functions academically at his age range and above, but his social interaction with others remain way below par.  He cannot see things from other peoples point of view, he has to be in the centre of the action whether he is wanted there or not.  He never picks up on marker that people  give that he is about to or has crossed the line.  He constantly tells tales and is the worlds authority on right and wrong but those rule don't actually apply to him, for example he will tell adults a child is swearing and that he needs to be punished, yet its perfectly acceptable for him to swear himself.  He fails to see that actions will have consequences and how those consequences will affect others, for example he asked if he could let his sister aged 18 months out of her bedroom and take her downstairs, I told him she was too heavy and wriggly for him to take down the stairs and she will falll, but he did this anyway and dropped her down the stairs.  I to this day don't think he meant to harm her but he wouldn't listen.  There are other unwanted behaviours also, stealing, lying, and aggression when he cannot get his own way.  He has an over the top view of right and wrong, and he has massive mood swings where he is over the top, energetic and gregarious and very "in your face" and there.  then there is the other side when he tantrums in spectacular style, screaming, shouting, being abusive, banging, slamming, breaking things (last night it was the side rail of his bunk bed) Jumping up and down and then there is the self harm, biting himself and banging his head.  He is very negative about himself and has low self esteem, calls himself stupid, ugly and horrible.  His peer group find it difficult to like him as they don't know which child they will get at that given moment.  They sometimes find him charming, imaginative (knows some wonderful imaginative games) inventives funny and bright, but in a split second that can change and he will dominate, boss about, become aggressive and then when thwarted will resort to telling tales...even lie or embelish facts to get the child into trouble and therefore reinstate himself as top dog, which is where he needs to be in any game or situation he is in.  Then there are routines.  Where ever he is  there has to be a clock, he needs to know where he is going, what he will be doing when he will do it then we get the running commentary.  If some one is late, or we are running late we get a countdown down, we should have left 5 minutes ago or they should be here by now.  Every thing is an issue.  He does do slightly better at school as the rigidity of the school regeme is predictable and the same.  He will struggle if there is a change in routine, say for a play or talk that wouldn’t normally happen or if there was a supply teacher in that day.  When he is not at school, he has to know what the plan is for the rest of the day and if it changes for whatever reason he is not happy about it.  He nags people and chatters incessantly.  If an adult is in a conversation he has no idea he needs to wait, he will interupt and keep interrupting until he says what he needs to so, and usually it will have no bearing on the conversation taking place or have no real purpose or function but that he had to say it there and then.  Also with the incessant chattering is the volume.  He is very loud to almost shouting when he talks, and within seconds of being reminded that the person he is talking to is in the same room he is back to unacceptable volume levels once more.  He is very keen for people to like him and those people that do like him, its important to him they don’t know he has the negative behaviour as he wants them to think good about him.

All this considered, I have a sad little boy who doesn’t seem to fit, and while I don’t want to change him to make him fit, I do want him to be happy and want to support him and get him support to achieve this.  I have over the years sought support from the health visitor who assured me he would grow out of it in time (he hasn’t) then from the school, which he had to be moved from as he was being bullied and they wouldn’t take action as his behaviour to other children was the reason he was being bullied (thankfully his new school is much more supportive) Then my GP who refered me to the local CAHMS for assessment who decided it was a parenting issue and discharged him.  Unfortunately his behaviour escalated over Christmas which led to an incident with his younger brother, and I felt no option but to make a self referal to Social Services to access support.  They too despite reports by other agencies which support the family state I am the issue having a negative attitude to him and therefore he acts out.  But now support willl be put in place but this centres around myself and my son to build a better relationship.

I guess what I am asking is

Does my child have other traits I should be concerned about or is this really just a parenting issue and I am looking for a way to absolve myself.  I see it as just wanting to get help to support him, and to support us to do that.  Please help.

Sue

[dino89]

Yes I can relate to everything your saying about your daughter and it made me cry because mine was the same, the bad news is that as puberty kicks in it may get 100 times worse BUT...now can you believe she is living independantly with her boyfriend who shes been with for 5yrs and they have a child of their own.It was a long and painful journey, but if you hang in there its worth it.She didnt cope with school after 13 so I took her out and taught her at home all the things for living,cooking, cleaning, shopping,gardening etc.Not easy,but we made time tables and persevered,at this time some days I thought we made progress,but other days she would cut herself and drink and eat household substances to try and die.then she decided it was time to hit the pubs and night clubs, she was 15 then and my family criticised me saying I should stop her, but that was impossible, she was violently wilful and bigger and stronger than me.Iwould get phone calls from the hospital saying she was unconscious from alcohol  or something.then abit later she was in a psychiatric wing for some assessment when she met her boy.they struggled for a long time and still are in some ways but she has learnt to consider others, she is so affectionate to me and gentle now its hard to believe its the same girl and I thank God everyday.SO THOUGH TIMES ARE HARD DONT GIVE UP THERE ARE NO PROBLEMS ONLY CHALLENGES!  

[freebird227]

A lot of good stuff has been put ot there that I agree more focus needs to be on the child development issues. I wonder have you ever had a mri w/contrast done? My grandson had a sub achronoid cyst attached to the Hippa Champus of his brain and it started to growing causing him lots of social problems He had extream poblems with transition from one activity to another. Hated last min. changes in plans. Missed social cues.Emotional meltdowns. Al the time it was the cyst that by it's very nature was not supose to grow. He had brain sergury this past Dec. and he is a different child. He still takes topomax  for his tourrets but other than that he is all good. Be Blessed

[sueby75]

Sally 44,

Thanks for your response it was very useful, The dysphasia thing came about when I was talking to a woman about  h is behaviour and she asked me a couple of questions a nd she said he sounded like her daughter and she has dispraxia.  He dodnt have any of the big coordination problems but he does struggle using a knife and fork, and still at 8 cant tie his own shoelaces despite lots of practice.  He has been to the hospital  to day re. this and the doc is confident it isn’t that but again not going to totally dismiss it he is going to get further info before making a final decision and we are to go back in a couple of months (more waiting) I am in the uk, so will got to NAS that will be useful, cahms as yet haven’t been much use up to now although a minor breakthrough today and they have offered us an appointment for next week (Yayy)  I googled the two things you suggested but they didn’t seem to fit him do, I don’t know.  I don’t want to rule anything out though.  His language skills and his speech are or seem to be very good, it’s the non verbal prompts he doesn’t get get, changes in tone of voice, warning looks etc and body language.  He never knows when he has crossed the line before it ends invariably in tears.

It was interesting what you said about the sensory stuff.  He does quite often seem as though he cannot hear you to the point I had his hearing checked about 18 months ago and it was found to be normal.  He does wear glasses for reading though rarely bothers to put them on despite nagging, and when he was younger he loved spicy food, chilli and curry, and loves strong flavours such as sprouts and kale.  He knows the time butIf I said to him for instance you have got time out 8 minutes on the stairs he has no comprehension of how long that is.  But everything has to be run by him, where are we going what time will we get there how long, are we there yet, why is it taking so long, and its relentless.  I am already keeping a diary but thus far noone seems interested in it, but I am perservereing non the less.  So thank you you have been really helpful I gues the battle continues.

RockRose

School are already really helpful in my quest to get him help but Social workers still seem to be focussed on my parenting skills,(despite the fact they fully accept my other 3 children are absolutely fine with no concerns)  I guess I just have to keep battling on and trying to get people to listen - tough job.  

But Brwneyz72 you were the most interesting of all as My son is exactly like that, steals anything that isn’t nailed down money lolly sticks from school, other kids pack ups, food out of the cupboards.  The best one was a few weeks ago we had been to mums for Sunday dinner he ate as he always does like he has seen food  for weeks cramming it in without pause for breath and then had a second helping.  After lunch he went into the kitchen when noone was about and helped himself to not one cake bar but an entire box of cake bars.  I have to lock food for packups away else I would have to shop two or three times for it, and like you have no idea what to do about it and the lying is phenomenal, and I just have know clue whether he is telling the truth or not as he is so convincing so I have taken to just thinking well he is lying which isn’t fair on him.  An example of this was I came downstairs to find an empty bag of Doritos. I asked him and his brother who had taken them, he denied it was him, and I knew immediately it was him as I could smell them on his breath and still he denied this, in response to Sally about his interpretation, this doesn’t seem to be a problem in my sons case as he does appear to understand exactly what is being said, but I am open to the suggestion and will raise it with cahms next week.


Thank you all for your help, just knowing someone has listened to me without judging has really helped.

[Sally44]

If she is eating alot, do you think she has any sensory issues eg. being under or over sensitive in any of her senses.  That includes vision, hearing, touch, taste, smell, balance and proprioception.  Some children on the spectrum have difficulties feeling their internal sensations such as when they need the toilet, or are hot/cold or whether they are hungry or full.  If she doesn't feel full she may constantly be seeking food.  I'm not sure what the answer to that is - it tends to be linked to the proprioceptive sense, maybe wearing something like a weighted jacket might help her get some input through that sense.  You can get those from an Occupational Therapist.
You say she is constantly lying.  Is she capable of lying to get what she wants?  That would suggest she has theory of mind ie. understanding what she has to do or say to get what she wants - and those on the spectrum tend to have difficulties with that.  Or is she just saying stuff that isn't correct/true.  For example my son was travel sick in the taxi to school this morning and when he was asked what he had for breakfast he said he'd had lots of yoghurt.  He hadn't had yoghurt at all.  But when asked the question that was what came into his mind as a response.  When they find language and communication very difficult, they can't always get the right words together to say what they want or need to say.  So they tend to say what comes into their head, which might be the complete opposite of what they want or what happened.  Also does she use echolalia or delayed echolalia in her speech - google that to see what it is.  Also google Semantic Pragmatic Speech Disorder to see if that is relevant.  They can have great difficulties with understanding the meaning of words, which sometimes comes across as wrong, rude or even a lie just because they have used the wrong word.  My son has trouble with words like 'mistake' because he hears the segment 'stake', as 'steak' and thinks the word is something about meat - which it isn't at all.  

[Brwneyz72]

My daughter was recently diagnosed with Asperger Syndrome and displays a lot of the same characteristics that you describe. Please don't let anyone tell you that it's your fault!  I went through that for 11 years before I found someone that finally understood.  They put her on meds which helped...for a while.  They don't seem to be helping now though.  She is worse than ever.  She steals and lies about EVERYTHING, including food.  She tells she hasn't eaten dinner and then we find out she did...after she ate (another) huge dinner.  She eats us out of house and home when we're not around, goes through our things, and again and again takes things that doesn't belong to her...even though we've told her not to.  I am at my wits end and not sure what else to do.  We've done everything.  The only thing left is to put her in a mental facility like the doctors have recommended.  ...sigh

[RockRose]

Sue - needing to know ahead of time,  all the time,  what is coming up next is anxiety.  

One problem with that is if you treat his anxiety medically his impulsive behavior will skyrocket and he will engage in behaviors that are totally unacceptable.

I don't know what to tell you to help him,  and I hope you are able to get hands-on help from the agency you contacted.  I'm really hesitant about that,  because already they seem focused on your parenting rather than this child,  and it seems to me you are very fair in your assessment of him,  and very clear what his abilities/disabilities are.  

I wonder if you can get the school to do a write up similar to what you've done?  That might be helpful in refocusing the social workers to the problem.

[Sally44]

I just wanted to check why you mention dyspraxia, what is it your son does that makes you suspect this?

[Sally44]

There are things in your post which you could say are typical of both autism (Aspergers), and ADHD depending on the severity of them.  He also has some abilities which those on the autistic spectrum struggle with, however it is interesting that he appears to be able to play imaginative games, yet he cannot predict outcomes or recognise other peoples responses to his actions.  Again it is a false belief that those on the spectrum have no imagination or empathy or humour or cannot show emotions.  They commonly have what is called 'a spiky profile', this means that in some situations they can do these things, yet in others they don't appear to be able to use the same or a similar skill.  
As you've mentioned CAHMS, are you in the UK?  If so I would recommend contacting the National Autistic Society on www. nas.org.  They should be able to put you in contact with professionals in your area - as you seem to be hitting a brick wall.  Typically a child on the autistic spectrum would need to be seen by a Speech and Language Therapist (for language and social interaction skills.  They might have great expressive language but have problems understanding what is said to them, problems with working memory, auditory memory, predicting outcomes etc - they also need their social interaction assessing to see if it is at the same level as their peers and what difficulties they have.  For example my autistic son wants to play but has difficulties initiating it and sustaining it.  Another child might try to be very controlling because they want the 'routine' of playing how they want to get the end result they want, and they may not recognise that other children don't want to play that way.  A Clinical and Educational Psychologist should assess their areas of strength and weakness from a cognitive point of view.  This is important because you need to know the intellectual ability of your child.  He seems very self aware and now has self esteem issues as he can see that he cannot do what his peers can.  He would also be seen by a Clinical Paediatrician to check that there are no other medical explanations for his difficulties.  
Does he have any sensory issues such as appearing deaf, covering his ears, acute sense of smell or taste.  What is his balance and co-ordination like?
Google Semantic Pragmatic Speech Disorder to make sure that isn't applicable.
Also google Executive Function Disorder.  You mention his obsession with clocks and time.  Without the clock does he have no understanding of time?  
Voice volume, strange intonation, accent etc is common with those on the spectrum.  It is also common for them to give unrelated answers to questions or interrupt to say something unrelated to the conversation.  Needing routine and have difficulty with change is typical for children on the spectrum.  That is why in school they tend to have visual timetables so they know what is coming next, and they need to be taught about change and how to handle it better.
As he is having difficulties now, it will get worse by secondary age.  So, if I were you I would be pushing for a diagnosis, because a diagnosis (depending on what it is), should get you access to an Enhanced Resource school in your area (if you're in the UK).  Special and Enhanced Resource (mainstream with expertise and extra staffing), require pupils to have a Statement for them to get a place.  However in ER schools you can get your child a place in that school just as a mainstream place and they have to support his needs - and they maybe in a better position to actually identify what his needs are.  But my initial response would be to contact the NAS and start the process of assessments.
Needing to keep to time and rules and routines etc are all common on the autistic spectrum.  I would contact the NAS and get him assessed through a multi disciplinary team who have experience of diagnosing autistic spectrum disorders.
I would recommend you keep a note book and write down examples of what he does and says both with language and social interaction.