Behaviour/Disorder/ADHD/ASD???? Or normal?

[cathpalmer]

I'd really appreciate any insight you might be able to offer me.

My DS is nearly 10. We've been having problems with him at school since he started in Reception.
It began at first with aggression towards his peers - hitting, kicking etc. Something he'd never displayed at home or nursery previously. Eventually he grew out of this physical aggression but now we are having other issues.
For the past 3 years the teachers during parents consultations have reported that he is very immature for his age - he doesn't respond appropriately to his environment - if he struggles with his work at school he will cry at the top of his voice, he gets very stressed with his work, his handwriting is awful (his 6 year old sisters is much better), he doesn't concentrate very well.
Socially he struggles too, he doesn't have friends - even friendships that I've manufactured for him (with my friends children) don't seem to work out - people become annoyed with him and irritated.

When he talks to anyone, he will dominate the conversation - going round in circles to make his point and talking louder than others to demand their attention. He doesn't recognise cues to stop - for example when my daughter fell over and hurt herself, he still didn't stop talking to allow me to help her.

He walks constantly on his tip toes - he can walk on his feet properly if we prompt him, but within a few steps, he forgets and goes back to his toes.

He still cannot ride a bike without stabilisers, he can't swim despite having lessons, and can't use his heelies - although he's owned them over a year (and his sister has mastered them).

He is very fearful of things - won't climb up high on a climbing frame etc.

He attends Cubs outside of school and seems to do well in that, but can attention seek quite a bit. Also, he's an alter boy at Church which requires him to do the exact same thing each week - almost by rote. But yet, he still needs prompting to do them.

He was bullied quite badly at school by some of the boys in his class although it's hard to know if this is as a response to his behaviour. He recently has been very innappropriate at school telling a girl to "take all her clothes off and take a picture." He swore that it was a joke, but he didn't really understand why it was innappropriate in the first place.

Not sure if it's relevant but he's very short for his age - shorter than all the children both in his class and the class below him.

Any ideas? Is there a reason for this? Is it a behavioural disorder, a processing disorder or am I just approaching it all wrong?

[smu06set]

As a parent of a diagnosed asd 10year old, i read 'walking on tip toes, unable to ride a bike, difficulties in social interaction' as classic asd. Though im not a trained professional! To be diagnosed they have to fit the 'triad of impairment' - could be worth a google for you.

[Falafelings]

Lots of those traits are typically Aspergers. Is it worth talking to the school/GP

[TheSconeOfStone]

My daughter has many of the characteristics you describe and was diagnosed at 8. I went to the GP when she was 6 due to problems at school since foundation.

I would recommend a conversation with your GP just listing the issues rather than trying to give a diagnosis yourself. Emphasis the impact on your son's education.

[ThermoScan]

Agree with advice about going to GP and asking for referral to diagnose/exclude ASD.

[elektrawoman]

Does your school have a SENCO you could talk to? They can often refer as well, or if not go to the GP.

It's quite hard for us to make a judgement on here but lots of those things you describe would raise concerns with me.
My DS has struggled at school since Reception and last year I asked the SENCO if she would refer him for an assessment. He had speech & language assessment, paediatrician, then Occupational Therapy assessment. In his case it's Sensory Processing rather than ASD. He doesn't have a statement, but I am really glad we went for the assessment as it has helped me to understand him a lot better and now instead of getting frustrated I can think 'oh he is doing x because of y' and I can guide him better now I understand the problems. It has also helped the teachers manage his behaviour.
To be honest I am surprised the school haven't mentioned an assessment before now.
It's difficult to diagnose yourself - I was totally convinced DS had ADHD until we saw the Paediatrician.

[cathpalmer]

I've been back and forth to the SENCO many times, she agreed that there seems to be a behavioural/emotional issue, but said that she'd completed a questionnaire on him and he'd only ticked 2 out of the 10 boxes and therefore it wasn't ASD.
I had an appointment with her booked last week, but she canceled saying that there were other children in the school that had had to take priority that day. (There are some children with complex needs in the school - although it's a standard mainstream school).
I went to the GP to get and Educational Psychologist referral, but he said that they should be done through the school.
I think the problem is, that whatever the situation is for him, he is probably only mild - not severe and thus it's not strikingly obvious. The teachers are not so concerned that he doesn't have friends, their concern seems to end with him reaching targets or not and whether or not he's disruptive.
I've got another appointment with the SENCO on thursday. I have asked again for a referral to the Ed Psych but she said that it's a last resort and that we should 'consider other agencies first.'
I'm getting more and more worried - he starts high school next september.

[elektrawoman]

Hi that's doesn't sound like an adequate response from the SENCO, in my opinion.
My DS's condition is mild and there are certainly children in the school with more complex needs but that's irrelevant, as what is important here is your child's experiences.

If his handwriting is poor (like my DS) I am surprised this isn't an issue for school as being able to write with near cursive writing is one of the targets now, so that's definitely been flagged to me as a problem and something I've been able to request help with.
Just because he doesn't tick the boxes for ASD doesn't mean there aren't other issues - what about dyspraxia and dyslexia, has he been tested for these?
DS didn't tick all the boxes for ASD either but the Ed Psych noticed he was uncoordinated (one of the tests was being able to walk heel to toe along a straight line on the floor and he kept falling over) so referred him to OT who did further tests which highlighted issues with motor skills / poor proprioception / sensory issues. Nothing bad enough for a statement. He was referred to a club to help with motor skills as a start.

The emotional issues you describe are hard to unpick because they can be so tied in with what is happening to physically. So for example if a child struggles with writing, is aware they can't finish the work quickly and neatly like the other children, they will get frustrated. And this will have a knock-on effect (like attention-seeking).

I think you are very wise to want this looked into before secondary school.

[GinAndTunic]

As someone with Asperger's, it does not sound ASC to me, at all.

And for all of you who try to diagnose online - you're not qualified to do so. Leave it to the experts.

[elektrawoman]

Gin - no one has tried to diagnose online - we've all said that she should ask for a referral for a diagnosis

[Snowkitty]

I really feel for you OP, you're getting a very poor response from those whose job it is to support you and your son. Regardless of how severe your son's difficulties are, its clear from your post that they are having a negative impact on everyone, including his classmates and teachers, and a proper, professional, assessment is what's needed here.

Given how close he is now to moving to high school, my advice would be to insist you get an assessment asap - and don't take any more excuses. Go back to your GP, the SENCO, involve the Head, do whatever it takes. Sometimes you just have to make a nuisance of yourself, and be the one who shouts loudest.

My DS is 14 & exhibits several of the behaviours you describe. He doesn't have a statement, but has a diagnosis of Dyspraxia, ADHD and Aspergers. He's bright and mostly doing very well at school now, but a lot of this has been down to getting a diagnosis, which means his teachers understand what he finds difficult and support him. Before we had a diagnosis (year 5ish), he was made to feel like an idiot and was often in trouble for having poor handwriting, being slow to get changed for games, slow to start and complete tasks, daydreaming etc.

We were also fobbed off by school for a long time, but for us, living with him, it was clear he really needed help. School (primary) were really unhelpful. We got a referral from our GP to a Paediatrician without argument, but the system is so slow and in demand that after months of getting nowhere we got private Ed Psych and OT assessments done, it was a revelation and we've not looked back. Just understanding his daily challenges has been massively helpful, little things can make a big difference.

[Itmustbemyage]

My Ds has ADHD and a lot of what you have said matches up with his behaviour
Physical and verbal aggression
Hyper emotions and emotional immaturity
Lack of friendships due to his overwhelming need to be in control
Being bullied / other kids pushing his buttons to get a reaction
Inappropriate behaviour - including sexual behaviour
Needs constant prompting to do routine tasks
My son was the opposite in his physical activity he was/is an extreme risk taker on occasion to the point of causing himself actual harm he is very gifted at sport so we signed him up for a lot of activities to help manage his activity levels.
The only way to get to the bottom of this is to get professional help and a diagnosis, my son's school were rubbish and I went to the GP who did refer my son to a Paediatric consultant who was amazing (not an Educational Psychologist the school only arranged this once my son had a diagnosis).

[cathpalmer]

I've managed to get another SENCO appointment tomorrow after yet another canceled appointment. I'm going to write down all my concerns and ask her to respond to each of them.
In the meantime, I've got another Doctor appointment for 2 weeks time. Hopefully will get a referral.
@Snowkitty - would you mind telling me how you found a private ed psych and OT? How much was it private? I'm so desperate to get to the bottom of this.

I agree with what others have said, none of us are professionals and thus cannot diagnose, but it's so helpful to have other perspectives. I know and love my son so much and I just know that something's not quite right....

[Kleinzeit]

You might have better luck with the GP if you ask for a referral to CAMHS (clinical psychologist or developmental paediatritian) instead. As far as I know educational psychologists don't diagnose ASCs and other neurodevelopmental conditions at all though they may refer on and they do provide support for children in school who have diagnoses.

[user1476527701]

School have to pay for the ed psyc so if there are other children in the school that they think need it more you have no chance of getting seen by ed psyc unless you pay private, however you can still be referred to paediatrician via the school nurse

[gatorgolf]

We paid £500 for private ed psych assessment but that was after having seen nhs paediatrician. My ds is disruptive in school but I have friends whose kids aren't distuptive and they have had a job getting anyone to take them seriously.

[Bex134]

Your gp is definately the person to make the referral to either camhs or community paediatrician. I work for camhs and we'd often have referrals like this and we decide with paediatrics which is best to see the child. Those with developmental difficulties would usually go to paeds whereas more if a mental health flavour would come to camhs. In your case I would be thinking paeds due to the coordination difficulties you mention. At this point you are looking for an assessment not diagnosis. Referrals are usually rejected due to poor information so I'd suggest you write a brief summary of your observations and concerns which gp can send with the referral form, they don't have time to list everything and usually only write a few lines. Don't write too much though as pages and pages is as bad as too much info. Half a side or so should be plenty.

Good luck, hope it helps.

Oh and Senco won't want to involve ed psych if there's no major impact on learning. There's usually only so much funding per term and children are prioritised. Like previous poster said they won't assess for underlying difficulty anyway and would only end up making a recommendation to be seen by another service.