My son is 4.5 years old. He's been diagnosed with Apraxia (a neurological speech disorder) and has sensory issues as well. He's also had various developmental delays. He's been evaluated for autism before, and they said no -his issues are due to Apraxia. Recently, he went to a dev. pediatrician and they said that he had autism, but didn't anymore..... Anyway, I'm still trying to figure out what is going on with my son.
When he was younger, he was very sensory avoidant - and hesitant. Now, not at all. He's constantly jumping around, humming. We have a trampoline and a climbing structure in the playroom - and he's still jumping on couches and beds. He's always moving around it seems. Not like lightening speed or anything --just fidgety. that may be typical four year old though, I don't know...
Our biggest problem is that he seems to have NO impulse control. He is easily frustrated and very impatient and aggressive. He is constantly hitting his little brother. Usually its because he asked for a toy and Mikey (little brother) either didn't give it to him fast enough, or god forbid -said no. Jake lashes out. He has a hard time waiting for anything, and still has a lot of difficulty taking turns.
He often ignores us. When you ask him a question or ask him to do something, it's like he doesn't hear you. Sometimes, I think it takes him a bit longer to process things, but sometimes, I think its just because he's so distracted. He hates to sit down and do coloring or writing type things. He does not like to draw, though he does LOVE to make art projects with stickers and can be occupied with that for a long time. He LOVES tv and computer games. He'd watch/play all day if you'd let him. When he's involved in an activity he likes, he's REALLY focused on it. He has trouble shifting gears to other activities.
His preschool teacher says that he has difficulty with transitions, too. And he often has meltdowns when its time for circle time or table time. He's a very intense kid. He's always interrupting, but then not responding when you ask him something. He has his own agenda and is very controlling of others. He wants things to go exactly his way, or he gets very mad. He has also hit us (parents) and yelled at us --pretty often. He will no longer stay in time out when put there, and often ends up in his room as a result.
Does this sound like it could be ADHD? I know he's young. I had thought he'd never be considered ADHD because he focuses so intently when its something he really likes (almost to the exclusion of everything else) - but who knows anymore. He certainly does not have any impulse control.
Also, if anyone has any suggestions on how to curb the aggression, it would be greatly appreciated. Basically, now he gets time outs. But it doesnt' seem to be working.....
<<Recently, he went to a dev. pediatrician and they said that he had autism, but didn't anymore..... >>
FInd a new Ped, or better yet a Neuropsychologist. Autism does not "go away",
He could very well have ADHD, but at 4.5 it is really too young for a diagnosis, it could laso be the Apraxia, ir even Aspergers, autism or something along that spectrum. I would contact a good Neuropsych for an evaluation. In the meantime has his vision and hearing checked.
I agree with edbson. You do need a good neuropsychologist to do an evaluation.
A lot of what you describes could very well be due to ADHD, but a lot of could be frustration due to his Apraxia and sensory issues OR just plain old 4 (IMO a yucky age ).
A few things you can do, read and educate yourself. Have you read The Out of Sync Child and/or Sensational Kids? Both great books on sensory integration disorder. I highly recommend BOTH. Again to quote edbson, get his hearing and vision checked. Find a good therapist that can work with you on behavioral techniques and work with your son on some of his aggression things. There are several books on aggresion, maybe some one else can give you titles. My children are not aggressive so I dont have any titles for you. As he gets older a lot of this stuff will go away, or at least change. You can be doing some things now though while you get things sorted out to find out how/why these behaviors are there.
Difficulty with transitions is EXTREMELY common at this age. Hyperfocusing on likes can be an ADHD trait, rather than not, again, no why to sort out without a professional evaluation, ideally by a neuropsychologist.
The testing is being performed through the LIU school psychologist. They'll assess cognitive skills, speech skills, fine and gross motor skills, too. I think there's some assessment of behavioral difficulties as well.
The activity level I can deal with. Its the agression, and the 'ignoring' that really bothers me.
the psychoeducational testing in performed by a neuropsychologist. Is this being done though the school?
Yes I meant a psychologist when I said therapist. A lot of people here have used play therapy with their kids with good success also. The psychologist should be able to work with you on customized ideas on how to discipline, handle the transitions....etc., etc. Sounds like you're on the right track. Try to be patient it's such a grueling process. You are doing all the right things and no matter what is going on, things do get better as they mature. My daughter (no diagnosis) used to jump off everything at age 4, especially couches.
I have to agree with edbson, Autism does not go away. Your son could be ADHD with comorbidities, which means more that one problem. He needs a full workup to determine what his problems might be and to develop a plan for his education. I do not trust the school systems evaluations. They tend to downplay problems to get out of providing services.
I would not recommend a psychologist, I had a very bad experience with one. I had my son evaluated at 4 and was told he was just a difficult child and I needed new parenting skills. After about 6 sessions with the psychologist asking us the same questions every week we stopped going. My son was diagnosed ADHD by his pediatrician at 7 during an office visit.
My son and I both can hyperfocus on things and transitions are difficult. Sometimes I get spooked when people try to interrupt when I am hyperfocusing. It frightens me and I start to hyperventilate. Try putting your hand on his shoulder before you start a transition, that will give him a warning that it is time to shift gears. Tell him this is the new plan to give him some warning before he has to stop and change. Ask his teacher to try this and see what happens.
You might have to have to look directly into your son's face when you speak with him. My friend had to hold her son's face so that they had eye to eye contact when she spoke with him. I have thousand things running through my head all the time, so sometimes I don't hear things because my brain is so busy all the time. My hearing is just fine. When you ask him a question or ask him to do something, have him repeat it back.
There are lots of good books out there. I would read a few help you understand what is going on. You need to understand the terminology when you talk with the doctors and therapists. They treat you much nicer when you can speak their lingo and ask intelligent questions. Ask lots of questions, especially when you don't understand what they are talking about.
Reta
I've read both Out of Sync child, and Sensational Kids -- actually most of the books on Sensory Integration Dysfunction (or Sensory Processing Disorder now). He was diagnosed with DSI when he was about two. He was sensory avoidant across the board, showed gravitational insecurity, and motor planning problems. Since then many of his issues have resolved (or at least changed). Gravitational insecurity is no longer a problem -he is now jumping off the couches and climbing everything. He's still not a big fan of swings.
His regular pediatrician has suggested we see a psychologist at a local medical center. Is that the kind of therapist your suggesting? I've been debating on whether to pursue this or not. He does currently have a speech therapist and physical therapist. HE's scheduled to have psycho-educational testing done in April, to help determine his school placement --- as he currently has an IEP for the speech/gross motor issues.
He also over-reacts to everything! EVERYTHING.
And we have had his hearing and vision checked -- twice. They're both fine.
Would a psychologist be sufficient or do we need to contact a neuropsychologist?
The school can only test for educational iddues, they cannot evaluate for ADHD.Our pediatrician has referred us to a psychologist at Hershey Medical Center, but after our appointment with the Developmental pediatrician there, I'm hesitant to pursue it. (they said he had autism, but doesn't now and his main issue is a language disorder -though I realize he does have some difficulty with clear speech, I'm not sure language disorder is the root problem).....
Is there really enough concern to warrant a visit to a psychologist at a medical center --or am I just over-analyzing him?
A Psych at a medical center would probably be perfect, unless is it is the one who told you he "didn't have Autism anymore". IMO that one needs a new education.
I would pursue a Neuropsychologist, and not accept anything else.
In some ways I have had a similar experience with my 5 year old. I have had various professionals tell me many conflicting opinions. From medical and educational professionals I have heard that my son has/is:
just a late bloomer
autistic spectrum disorder: pdd-nos
adhd tendencies
just needs consistent discipline (my personal favorite)
sensory integration disorder
perfectly normal
developmentally delayed
CURED! (re:Autism)
just a little slow
should be screened for Aspergers
With every new opinion I am more confused and left second guessing myslef and my own instincts. Considering that your child is on the threshold of kindergarten and has had developmental delays- and you have concerns- then I would say, Yes, take him in for a psych consult. Hopefully he doesn't need it, and it will only serve to provide you with some reassurance that your son will come along fine. I can understand your questioning if it is really necessary, as you are hearing conflicting opinions and he sounds kind of borderline- maybe it is just a 4 year old thing.
I am not familiar with Apraxia, but since it is a neuro issue- I think a neuropsych would be the best choice- However- it is HARD to get an appt. with a neuropsychologist around here (I am not too far from you) I would settle for a regular psychiatrist if you can't get in anywhere with a neuropsych in a timely manner. Good luck!