Regarding getting angry/over emotional/saying bad things etc. My son does that and he has a diagnosis of high functioning autism. After the tantrum he is very upset with himself and how he has behaved, but in the heat of the moment he just gets overwhelmed. And that is exactly what happens to children with autism. The mood and emotional control part of the brain is at the front, and with autistic children/adults this area of the brain gets totally flooded when something happens to upset them or make them angry. They cannot control it and they cannot stop it. But they can be taught ways of calming themselves down, and using an area as a quiet place to calm down is a good idea as well. I send my son to his bedroom - not as a punishment - but I tell him you are saying mean things again you need to go to your room to calm down. And that is what we do. I don't stay with him as he is old enough to be left on his own, and after around 8 mins (he is 8), I go back to his room to see how he is doing. If he is still upset I leave him again. If he has calmed down we talk through what happened.
Do you think that autism or aspergers may be involved, or have you already ruled that out?
But you have also got bi-polar going on as well. Are you sure of that diagnosis?
I don't know alot about medications because my son doesn't need them. But general comments I have seen elsewhere on forums suggest that if the medication for the diagnosis isn't working then maybe it is the diagnosis that isn't right. And I know you are in a horrible place at the moment because you've got all the behaviours and nothing seems to be working.
Is she having periods of depression and then mania - or is it more like tantrums out of the blue at changes or not being able to get or do what she wants, or having to stop watching TV or having to leave the house etc.
There are medications that can help with sleep issues.
What made them suspect sensory issues? Does she appear deaf if you call her name sometimes, does she ever cover her ears at noise, is she okay with having her hair brushed/cut or nails cut. Is she okay with clothes or does she need tags removed. Does she complain of smells or tastes of food, is her balance and co-ordination okay?
Is her speech age appropriate. Does she have age appropriate social skills?
Google Semantic Pragmatic Speech Disorder to see if that is how her language is.
He is also afraid of the dark and I always have to accompany him upstairs to get toys or go to the toilet. The last time I refused to take him and told him to go on his own, he got a stool and pee'd in the sink (he had seen it done on TV!).
I presume you've also looked at ADHD as a possibility. But having said that, alot of the medications you have been using would be used for a child with ADHD, and again if it hasn't worked then maybe ADHD is not the cause.
Has she been assessed by a Speech and Language Therapist. Did her speech develop normally, or was she delayed or did she ever repeat things you said or words/phrases she has seen on TV/DVDs?
The other thing that made me think of being on the spectrum is your question about behaving differently at home as opposed to school. This is typical of children being on the spectrum. Sometimes it is because school is so structured that that child copes better at school than at home where there is no visual timetable to follow and things just 'happen' instead of being planning and visual for them to see. Or the child is not coping at school at all and is holding it together whilst at school but all the emotional stress and anger comes out at home. This will be because there isn't enough structure at school and they are being expected to do things they cannot do or don't understand. The first thing to do would be for a Speech and Language Therapist to assess all areas of speech ie. expressive and receptive - sometimes there is a huge difference. For example my son has age appropriate speech, but his understanding of speech is about 3 years delayed. He also has auditory processing and auditory memory difficulties. So although he is higher than average intelligence, he cannot remember things said to him and needs them repeated frequently and for all his timetables to be visual and for classroom lessons to be broken down into smaller chunks that he can cope with.
So how is your daughter doing in school? Can she read and write.
The other thing I wanted to mention with sensory integration is that is varies day to day and throughout the day - so the same sensory experience can cause pleasure on one occasion and pain on another. For example my son frequently appears deaf if I call his name, or covers his ears at sudden unpredictable noise (eg. vaccum cleaner), or likes to make noise like popping balloons and enjoys going to drum club (although he may initially cover his ears whilst approaching the room). And that is a huge range of behaviour to auditory noise and that can happen on one day. Then on another day he is fine with everything. But that is what the difficulty is the perception of incoming sensory information varies enormously.
Wow, thank you so much for all your information!! I have never been concerned with my 7 year old for autism or anything like that. The reason we wonder about sensory is when we go into a store, she has a huge meltdown everytime since she was tiny! She has always had a big sense of smell. She can smell something that is at our house from grandmas house and smell grandma on it. She smells things before we do. My 7 year old is having a hard time in school with learning but yes the structure is what keeps her going good at school, she needs structure! She has always been a great talker. Been talking in sentances since she was 2.
As for my 4 year old daughter I believe she may have some form of autism. She has so many symptoms of it, but I don't know. We go in about a month for testing. She has the following: Does not enjoy giving kisses and hugs, "Hoards" items such as her polly pockets obsesses with toys at first it was polly pockets than it turned to purses and babies. She lines things up, like her movie cases, toys ect. Speech delay. She has been recieving help with speech for 2 years in preschool but still very hard to understand. Mentalatity is at the age of a 2 1/2 year old. Pretty immature acting at times but others she is grown up acting. Noises. Use to panic at sounds of sirens but better now. Doesn't like when I vacume. Repeating things to her? This is the most frusterating symptom! We have to say the same thing over and over again to her for her to understand what we are telling her! I say it very slow after the third "What?" Her behavior is excalant. She is a very good girl, our little rock. She is calm, loves and preferes to play alone. She has been through a lot with her older sister though! The counslor says it is just like being in an abusive relationship but she can't leave! My poor baby. My 7 year old has hurt her badly many times just because of 4 year old taking toys away or 4 year old not playing what my 7 year old wanted to play!! Frusterating!
If your 4 year old is being assessed for autism, I would consider having your 7 year old tested for Aspergers.
Also google Irlen Syndrome - that helps alot with sensory difficulties/autism/dyslexia etc. Irlen lenses are lenses that fit into typical glasses frames and are worn by the child/adult. My son has a pair and they are brilliant. Many autistic adults also wear them.
Your say your daughter hurts your 4 year old because she won't play in the way she wants. That is a rigid behaviour being expressed through needing to have control of play and only playing in a certain way - not being flexible or allowing other children/adults to alter the course of the play. That would be seen as being on the spectrum.
I think it might put your mind at rest to know if that was the cause of her behaviours, especially as she has the sensory ones as Temple Grandin said she believes that everyone on the spectrum as Sensory Processing Difficulties ranging from mild to severe. So that in itself should cause professionals to observe and assess her for Aspergers, especially as you say her speech was age appropriate. And also bearing in mind that the medication isn't working. Her behaviours might be down to Aspergers rather than ADHD, and there are alot of similarities between the two - but the medications for one don't necessarily work for the other.
Have you also googled Semantic Pragmatic Speech Disorder?
There is a huge range of abilities of those on the spectrum. Some say Einstein and Bill Gates are probably on the spectrum - whilst other children are totally non-verbal and appear to be in their own world. There are many academics with Aspergers, so it isn't a question of intelligence, it is a question of ability to communicate effectively and to interact socially. You can google the DSM IV diagnostic criteria for both autism and aspergers and see if that sounds relevant. On the Autism forum, on the Health Page, I have posted the diagnostic criteria and parents have posted examples of the childrens behaviour that met the criteria. You might find that helplful.
Your 4 year old daughter needing auditory information repeated is probably down to auditory processing difficulties and working memory difficulties. She may benefit from one of the listening therapies. Occupational Therapists are trained to deliver Listening With the Whole Body listening therapy in the UK. There is clinical evidence that this treatment shows positive results. I would be asking about it through your OT and seeing if both your children could have it.
Also google Central Auditory Processing Disorder to see if that is a possibility.
Does your older child have any obsessions or special interests that she likes to spend her time on or likes to talk about.
Having such an acute sense of smell is also typical of being on the spectrum. I have heard other parents talk about how their child will refuse the same tinned product if it has been bought in a different supermarket because 'it smells different'. This will also mean that at times she may get frustrated/lose her temper because of smells at home or in school. Try to use fragrance free stuff. And let her smell stuff to see if she likes it. If she cannot stand the smell don't use it. She isn't making it up. Some smells make my son run away or even vomit. I also have hyper sensitive smell and there have been times when I have had to get off the bus because the smell of someones perfum or hairspray is making me feel ill. All these things are pointing more towards Aspergers.