Here some suggested organisations that offer expert advice on SN.
should I be concerned about my four year old boy?(10 Posts)
Apologies in advance for any clumsy or incorrect phrasing; I'm new to talking about special needs. And I know that the obvious answer to my question is 'how would we know - get an assessment!', but I'd really appreciate any thoughts from people who have been in my position.
I'm all over the place about my son. Some days I think he's undoubtably showing signs of autism; the next, that his behaviour can be attributed to his unique character, the traits and habits he's inherited from me and his dad, and 'just being four', and that I'm being an over-anxious first-time mother. The answer won't change the way I feel about him, of course, but I just want to know how best to support him as he begins to stretch his wings.
He didn't have any issues as a baby - normal birth, not particularly fussy or irritable, check-ups fine, crawled and cruised when he was supposed to. He started walking at 14 months, later than most of his friends, but still within the average range. Between the ages of two and three, it became clear his speech was slightly behind his peers, and his nursery flagged up concerns about his hearing and interaction. Hearing tests suggested glue ear, but his GP said to wait it out. He then moved to a different nursery, who said they were concerned about floppiness in his movements, indistinct speech, lack of interest in mark making, solitary play and awkward interaction with peers. I took him to a private specialist who diagnosed low muscle tone and hyper mobility. The nursery brought in an OT who observed him for a couple of hours and concluded he had limited vocabulary, fleeting eye contact, didn't know how to interact with other children, immature pen grip, no imaginative play, food aversions ... basically, what I read as a load of ASD red flags, but they didn't suggest going down the diagnosis route, rather said they'd give him half termly assessments and keep an eye on his 'sensory issues'. The SENCO also said they weren't thinking of autism, but I don't know whether they were playing it safe so as not to panic me.
He's also had a history of tonsillitis, and so last month had his tonsils and adenoids out, and grommets inserted. His speech has improved since then, and become much clearer, and he's now quite vocal, although has now developed a stammer.
In large groups he can become overwhelmed, and we've had a few terrible experiences at children's parties where he clings to me or lies on the floor. He isn't a child that other children are instinctively drawn to, as I think his interactions initially seem 'off', but he can warm up and 'get it;, and he is loved by and very happy playing with his cousins and children he knows well. He adores fun fairs and other hectic places. At home he is mostly lively, loud, jolly, affectionate, gives good eye contact with those he knows, and although he has tantrums, they're not extreme - I wouldn't call them meltdowns, just normal four year old behaviour. He likes books, telly, mucking about, soft play, his scooter, animals, tractors, trains. The usual.
He doesn't have repetitive behaviours or obvious stims, and, although he likes routines, doesn't freak out at changes to them. He isn't great at transitioning between activities. He doesn't like having his hair washed, and is a terribly fussy eater - he likes very plain food, mostly white carbs and cheese, and sugar, but does eat some vegetables and fruit. He has recently developed a habit of chewing on non edible objects. He isn't at all violent or aggressive; rather particularly gentle. What most people say about him is that he is a 'sweet boy'.
His dad is dyslexic and, I suspect, undiagnosed dyspraxic. Our son is very much like him, and so I wouldn't be at all surprised if he has inherited those traits. But I just can't decide whether there is anything more, or whether he is a shy, gentle, diffident late developer who maybe has dyspraxia and happens to be a very fussy eater, or whether all these things together clearly point to autism. If it looks likely to be the latter, I want to get right on with giving him the support. I know it takes an age for a diagnosis, but there may be things I can do at home before then.
I know it's an absurd comparison, but I keep thinking of that book, 'He's Just Not That Into You', which berates women for making all sorts of excuses and inventing pleasing explanations for men's behaviour, when the answer is actually very simple, and quite liberating.
Sorry, this is longer than I intended. But any thoughts or wisdom are so appreciated, thank you.
Are you in the UK? Have all the assessments/interventions been private?
I think there is enough there to request an NHS assessment (if you're in the UK). It sounds like he would definitely benefit from a multi-disciplinary assessment to work out what's what IYSWIM?
I agree with polter if you are in the UK I would go to your GP and request a referral to your local child development centre for a multi disciplinary assessment.
Thank you both. Yes, we are in the UK, in north London (Camden). The physio we saw initially was private, and the second assessment was NHS, via the school. I will call the GP tomorrow. Thanks again.
The assessment process will help you help him, highlighting difficulties and giving you the opportunity to really examine his difficulties.
He sounds lovely. My child is particularly gentle and loving and doesn't have the sort of episodes I would think were what would be described as melt downs. he also is autistic, and language disordered. Autism is NOTHING like the popular press portray it. It is far more easily equated to anxiety in all its presentations. Anxious people can withdraw, become angry and unreasonable, crave routine, be rigid etc etc. I'm not sure there are any autistic behaviours that cannot be attributed to anxiety.
zzzz that's an interesting perspective, and really rings true. Your child sounds lovely, too! You're right, I must remember that, whatever the outcome, he is the same darling boy. I just feel panicked that I'm not equipped to help him in the way he might need. I couldn't love him more but I'm not an exceptionally patient, calm or inventive mother, and his dad isn't on the scene. He's also an only child and whilst at the moment he seems pretty oblivious that he's a bit different, I have these visions of him starting school and being slowly drowned by anxiety and inadequacy and being bullied and misunderstood and his spirit crushed and retreating into a sad, solitary shell that I can't pull him out of.
Anyway, enough of the indulgent catastrophising - I'll pull my socks up and get on with it and get down to the GP. Huge thanks.
if he does have autism he will still be more like you than any other autistic person. You will take the bits from your own childhood/parenting and add the extra bits just as you would if he was born gifted in an area you had no experience in. Childhood and growing up takes a long time. You will learn as you go along just as you learnt how to care for a baby.
I agree that you should go to gp with information given here and ask for referral to developmental pead.
Their assessments will help find out if he has something to diagnose but more importantly help find his areas of weakness and strength and help you find a plan to help him.
Fwiw my Ds didn't have a temper tantrum to meltdown really until he was 8yo!
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