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Sensory processing and cognitive processing of language issues in 3 yo - behavior help needed!(14 Posts)
DS (3 next month) has recently been diagnosed as having SPD, with specific issues around auditory processing, transitions / new experiences, dealing with textures and also scored low on language use- he has a ton of vocab and can use sentences and tenses properly etc but when he is overwhelmed he loses it and reverts to one word or noises on a loop / repeating. He also had a few flags for HFA, but they said it was way too early to tell, and that SPD often mirrors autism traits and vice versa.
He's having OT and speech therapy (we're not in the UK so service provision is different) and has had about 10 sessions of each but at home, I'm at my wits end with his behavior and the therapists aren't being a lot of use. I'm reading books etc as I go but tbh am a bit overwhelmed so wondered if anyone might be able to highlight anything worth looking at to try and deal with the below situations
1) saying / doing the opposite of what he actually wants to do. Eg today we talked about going to the beach. He loves it there and always really keen to go. I spent 25 minutes with him this morning arguing with him to get changed so we could go. I've tried letting him choose his clothes, reducing the words I use (so "no clothes - no beach") in case its an overuse of words, leaving him to try and get on with it himself (the disinterested parent approach sometimes works I find) but NOTHING works. If I then admit defeat and say we're not going, the tantrums are insane. I managed this morning as I wrestled him out of his clothes, but he's a big kid and I'm at the point where I just do not have the energy to man handle him anymore in every situation
He often says no when he means yes and vice versa and I can see sometimes he's like 4 beats behind in a conversation so he's clearly struggling sometimes with processing times. This is what I hoped speech therapy would help with, but tbh, the sessions he's had she's just bombarded him with choices and questions which has caused a meltdown
2) his inability to understand or listen to simple instructions and what they mean. He's clever and cognitively in some areas quite advanced for his age. However some of the basics he just doesn't get - or is blatantly ignoring. Unfortunately this is usually related to get him to stop doing something - so asking him to stop / wait / not run off or to not do something as its dangerous (trap his hands in the door etc)
I must have the same conversations with him multiple times every day on the same things as it never changes. I have tried different approaches, tried to only focus on the big issues (danger mainly) so as to try and make it seem 'important' but its not working
Today, I'm afraid I lost my shit with him - I felt awful but he finally listened. This is not the solution I want to work with him, and I'm currently hating how I parent as its not how I want to be but I am at my wits end.
I'm sorry you're having a tough time today.
Do you use visuals with him? Just starting with now/next visuals can really help children to process the information. We use photos of things as my ds responds really well to them but there are loads of online resources like widgit and do2learn that have pre-made visuals. It's taken a while for my ds to get used to it but it helps massively!
Also Makaton can be really helpful for children who struggle to process verbal information as it is supports the word with a visual.
Yes, sometimes, although its had varying degrees of success! Its really helped with absolute stubbornness in the morning to get dressed etc.
I think it could help / we could use it more with the 'trying to do stuff' bucket like getting out of the house. I think I need to focus on this, instead of why on earth his response is always "noo" even when he wants to do stuff.
Definitely will look into the resources you posted, especially as my drawing / visuals are crap
The danger thing is a bit different as we're out and about - DHs solution is to strap him into a push chair at all times which I feel is counter productive. I suspect if I thought far enough ahed, I could use a visual of when to hold hands, stop etc to try and set expectations. I'm so mired in the "aaargrgghh for gods sake stop!" of it all its sometimes difficult to take a step back
I remember that feeling so well! The frustration is huge but I think it's important to remember that although your ds may be able to speak well he functions differently. Have you read 'the reason I jump' that really helped me with my ds's more difficult moments.
To be honest 2.5 - 3.5 were really difficult. My ds is nearly 5 now and everything started getting a lot easier when he turned 4.
We really struggled when out and about and still use the pram a bit now. You need to try and practice things when he's in a calm state so that you can use it when he's not. Something that did work for my ds was using red and green cards for stop and go. You practice using them when he's relaxed and build up the time from a few seconds to minutes.
Persevere with the visuals. My ds really didn't seem that interested at 3 but I can really see that they are helping him now.
Sounds like my son. He has issues with transitions and anxiety. Home is his safe space so even going somewhere he really wants to is hard because it means change, plus what if the thing he is really excited about doesn't work out as he wants etc.
My son isn't into visuals but wants to seek verbal reassurance. Everyone is different. So I go through with him what the plan is and answer a lot of the same questions over and over.
My action plan for getting out of the house is one step at a time so as not to overload him. Mornings are really hard. First just try and get him to go to the toilet when he wakes, then eat something. These are big problems if we don't get them solved as he has introspection issues (can't tell what he feels inside his body easily). Then let him know when he is going to start to need to get ready. We just got this and it helps. You can set the times for each section so when its green, just go ahead and do what you want, when amber warning it is approaching time to stop and when it goes red that is stopping time. www.amazon.co.uk/gp/product/B0007DHU0S/ref=oh_aui_detailpage_o06_s00?psc=1&tag=mumsnetforum-21&ie=UTF8
Also buy clothes that are easy to bung on. Even pjs that could pass for clothes!
Have you tried a transitional object, that can help with getting out of the house. My son wants different toys each time which makes the choosing stage hard but at least you don't need to worry about it getting lost.
If you haven't already get this book. Even if he isn't autistic he obviously has issues that are making things tricky. I think its important to accept that he may always have issues with processing speed and communication. You need to work with him, not against him. I know its hard not to get frustrated but the more difficult he finds things, the more meltdowns he is going to have, which are exhausting, meaning he can cope with less. www.amazon.co.uk/Autism-raise-happy-autistic-child/dp/1409176282/ref=sr_1_1?keywords=how+to+raise+happy+autistic+child&tag=mumsnetforum-21&ie=UTF8&qid=1533976217&sr=8-1
Once my son is in a new situation its too late to try and place limits on him as he is already overloaded. His brain just isn't able to think straight as he is in fight/flight mode. So before you go, in a calm place, e.g. in bed in the morning or once things are settled in car journey explain what your expectations are. You can get social stories about holding hands, keeping safe etc. It has got easier once he has got older but basically you always need to be on high alert when out and about.
Its hard not to get disheartened when things go wrong but sensory issues can be massively difficult to manage if you are living in a world not designed for your kind. If he seeks any particular type of experience (for my son its swinging, climbing and compression) try and build in those experiences before a stressful event. Be lead by what he is drawn to. So my son jumps on a trampoline or climbs on climbing frame/in nature before we go somewhere or while waiting for something he is impatient over. Sometimes you have to adapt so in the train station is there a low wall he could repeatedly jump off or just keep picking him and squeezing him. A lot easier if he wants a fidget toy you can just stick in a pocket!
Thanks liv its really heartening to hear the perseverance paid off! I definitely need to change my perspective about being it in for the long game and whilst stuff might not work immediately, in X months we may see a benefit. I need to regroup and figure out how I change my headspace to match this
ekorre thank you too! the time tracker is exactly the sort of thing I've been thinking about getting but haven't found it (am a bit paralyzed by my lack of get up and go atm, I'm ashamed to say) He's very visual and loves clocks and gets the idea of X time to go so this sort of thing is perfect
We've tried transition toys - I've stopped taking them out (counter intuitive I know) as he'd only play with them when we got somewhere - i.e. when we took them to therapy sessions he refused to get engaged and played with his toys instead.
Am still a bit clueless about what sensory input he likes best, apart from being squashed (not always easy to do!) I need to start watching carefully for other clues
I can't say thank you enough for the comments and tips, its really helping, especially to make it feel like it might be more manageable
Generally, we found DD enjoyed things like swings, see saws, children’s fairground rides (and later gentle rollercoasters), which involve spinning, and swinging about!
Baths had to be lukewarm, no labels in clothes, no loud noises and in particular no vacuum cleaner, interference on the tv, hand driers, babies crying and women’s high pitched laughter!
Speech therapy won’t cure slow auditory processing!
He needs a sensory profile done (Idk at what age), as some areas of the senses may be under stimulated while others are over stimulated. As above, DD can’t cope with loud noise, but loves fizzy sweets and very spicy food!
I think he dislikes swings etc - he's keen to get on, but gets off sharpish and goes BATSHIT at OT when they try and use it with him, same with enclosed spaces (especially if its not on his terms)
The speech therapy is for his use (or lack of use) of the language he has, especially in certain situations. However, the sessions have been patchy and I don't really feel they address some of his core issues - I know we've had relative;y few of them, but they way they're structured doesn't seem to fit with how a kid with transition and language processing issues would understand them. We have a LOT of meltdowns as a result
Overall, I'm less than impressed with the therapy so far. I know we should be grateful he's been assessed and has services (especially as I know how difficult it would be to access in the UK) but none of it seems tailored to his needs (if that makes sense)
Interesting on your DD ladys as DS is very much like this too!
Out of Sync Child (book) is good. Once you have worked out his sensory needs there is a second book - Out of Sync Child has Fun, which has loads of ideas for activities.
Yes there is no point with generic services. You need to work out what his specific issues are and what you can do to help. Any therapy should be fun so that he engages. My son gets music therapy through school and its amazing what they can work on - speech, transitions, social stuff. Mainly its about finding the right person so they have a connection.
Totally agree with Ekorre about the therapists. It should be tailor made. We stopped using a speech and Language therapist because my ds was having a lot of meltdowns with her. She really didn't get autism at all.
I have both of those! They were / are a brilliant read and it was like a lightbulb moment when I read them as to some of the issues we were encountering. DH is meant to be reading them atm but they;re just sitting gathering dust - I need to kick his arse and then take them back
Re the therapy, I agree. I feel its really round peg, square hole approach that has niggled at me since we got approved
He also got 5 hours ABA a week, and the ABA therapist and i have had a couple of nose to nose about her approach. For her autistic kids she has a program where she incorporates the iPad a lot that she tried to use with DS. We don't use it with him as we noticed a marked deterioration in behavior afterwards due to the stimulation and I told her this- she refused to acknowledge it (surely its not a stretch with a kid whos'been diagnosed with SPD?.) and tried to frame it back to me that it was my issue and how did we ever expect him to learn about technology..
I'm also pretty uncomfortable with some aspects of the OT and speech as there's parts where its clearly triggering reactions and meltdowns in the sessions.
DS behavior can seem 'naughty' (I can't think of a better word) refusing to follow instructions, can't / won't sit still, engage with tasks etc and lots of "NO!" in the sessions where its clearly pushing his boundaries. Last week as he wouldn't engage, the OT asked me to step outside to see if he'd improve (supposedly a lot of kids do) but he didn't - he came back 15 mins later to me sobbing his heart out and it wasnt just a tantrum cry, more anguished (if that makes any sense)
I felt any benefit from the rest of the session was outweighed by such an extreme reaction from him. DH believes that unless we make DS engage in stuff he'll never learn to focus - him and I dont agree on approach (a different issue...)
DS is starting a new nursery in September and the sessions will change to there with new therapists, I just hope they can be tailored to fit and he gels with them, but I have low expectations atm unfortunately
The situation with the therapy sessions sounds really hard OP. (I’m a SALT as well as a parent of a child with ASD.)
Try to avoid using negatives (e.g no, don’t, can’t, isn’t, hasn’t) when giving instructions. Children with delayed language understanding/processing can find these really difficult to decode.
Use simple language to tell DS what you WANT him to do rather than what you DON’T want him to do. E.g “feet still” rather than “don’t kick”. “Hands down” rather than “No biting”. Or “Walk” rather than “don’t run”.
Combine these approaches with using simple visuals such as a now-next board.
I hope the new therapists are more helpful in September
Thanks so. I'm trying out the simple language approach - for some reason I'm finding it really hard! Need to identify some phrases beforehand so its easier for me to rememeber and say them
It is tricky as you’re used to phrasing things a certain way. I know all this stuff inside out and I still sometimes say something and think “Why the hell did I say it like that?!”
The more you get in the habit of it, the easier it will get
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