Baby play, food issues and lack of sociability

[Hugsandsquishykisses]

My DS is now five years old. He was adopted at 18 months and in general is doing well. He is delayed in a few areas and even now his speech is very unclear, but he is a lovely happy boy and we love him very much. We do have a number of issues emerging though.

He has had ongoing problems with food – he will only eat a very limited diet and when offered other food, will either refuse, gag, or store it in his mouth until he drips saliva and then has to spit it out. He forgets to eat and drink without being reminded and this can be an issue at school, as he can become very tired and just wants to curl up at the end of the day. I have to feed him most meals which I don’t mind doing, but obviously I can’t ask them to do this at school. They are aware of his food issues and whilst not unsympathetic, seem a bit mystified as to what to do. He has got slightly better over time and will now eat a small range of fruit and veg, but only to get other foods that he likes.

At school, he is generally able to follow routines and keep to the rules, but is not sociable with the other children. He prefers to play on his own a lot and doesn’t like physical play like bike riding and going on scooters.

At home, we have to peel him off screens as he is really comfortable curled up all day watching television or playing on games. He doesn’t like getting wet hair in the rain, or being even slightly cold, or hearing loud noises. We do encourage him out on walks and he will do these, but it’s never something that he would choose to do. The only ‘playing’ game that he likes to play is ‘babies’.He likes to be my baby and talks like a baby, crawls and likes me to feed him and do everything for him. I have no problem with this as he was very neglected and understand that he is probably trying to recreate a lot of the baby bonding type stuff that he clearly missed out on.

I guess I’m just wondering whether any one else recognises this kind of behaviour with their adopted child? Will it gradually reduce, as he seems very different from the other boys in his class? I’m also wondering- could it just be him and maybe he doesn’t need to change? Also, some of the behaviours do seem to overlap with behaviours seen on the asd spectrum, but as they also overlap with trauma responses, I know I’m unlikely to get an assessment.

Thanks for reading.

@Hugsandsquishykisses

My son has a diagnosis of ASD, yes a lot of his behaviours may well be a trauma response, both ASD and trauma gets him the support he needs.

At the very least it sounds like your son has some sensory issues going on. There is a useful book called Raising the Sensory Smart child, sorry I forget who wrote it.
But I think you really should push for an assessment, it might be ASD, it might be trauma, it could be both. Either way or both there will be therapy and support he should be able to get access to.
Look at the Adoption Support Fund, you are legally entitlted to an assessment of need.
My son is 16, his behaviours have changed over the years but fundamentally I can’t change him. His still has ASD, he is still anxious, still has sensory issues. But his obsessions and anxieties change and he is learning to manage them better.
your son will be what he will be, but both you and he can be helped to manage differently.
One thing to bear in mind, school is probably very stressful for your son, if he is well behaved it will be taking huge amounts of self control which is exhausting for him. My son was always exceptionally well behaved at school but would be literally bouncing off the walls when he got home. He spends a lot of time on his phone/ps4 but I’ve given up worrying about it. As long as he is using it safely, its how he decompresses.

@Ted27 thank you for your reply. I was wondering how old your son was when he got his asd diagnosis? I’m thinking that five might be too young for an assessment for my son, but I could speak to his adoption social worker and check.

Yes, he does find school stressful and even now likes to take his special teddy in. They have a really old fashioned traffic light system to supposedly encourage good behaviour and he is terribly anxious about coming off green. He has only on one occasion dipped down to amber and found it terribly upsetting. He told me he had put his name back on green when the teacher wasn’t looking - totally missing the point of the whole thing!

Thanks for book recommendation- I’ll Google it.

@Hugsandsquishykisses

He was diagnosed before he came to me, as far as I know he was 4
Poor lamb, these behaviour systems have a lot to answer for.
I think a useful reframing is thinking in terms of can't not won't do.

There are many things my son doesn't do, not because he wilfully will not do, but because he can't. So we focus on what he can do and work around what he can't.

@Hugsandsquishykisses I can't really offer specific advice but I wouldn't delay pushing for an assessment. There can be a reluctance to assess when young but there's also a reluctance to diagnose when children get older. With assessments it's thought to be good if any difficulties are documented from a young age so asking for an assessment now would help to get all your concerns documented. It would also help with support at school. I've worked in early years primary for a number of years and unfortunately there is a huge difference between the support given to children with a diagnosis compared to those without. I don't agree with it and part of my job is to work with those who are affected by trauma but the majority of the time it's only those with a diagnosis who get the help they need.

Thank you for the responses. I will contact his adoption social worker next week to try to get the ball rolling I think.

When he was at preschool, they began to assess him for an EHCP due to his delayed social skills, but they were unsure whether there would be sufficient evidence to move forward. The staff at his current school are very pleasant, but I think he goes under their radar a bit. When I have asked how he is, they say he is “fine”. However they also tell me that he prefers to play alone and there have been two incidents in the last week where he has just had to lie down in the afternoon because he has felt so tired/ lacking in energy. I’ve picked him up from school and he drags his feet, almost looking depressed. I’m not sure whether this is due to insufficient food intake or as pp said - the exhaustion associated with the whole stressful school experience. During lockdown, he would yawn all through his 9am zoom lessons - even after a full night’s sleep, so maybe a mixture of the two?

I think the thing that worries me most is the fact that he really doesn’t seem to want to play with other children. To start with I put this down to very delayed speech, but he can talk now, although a lot is still unclear. When we queue to go into school, the other children are all shouting hello to each other and he just stands next to me and the others don’t even seem to register him being there. Then I think to myself- well that’s ok - maybe he’s just a bit of an introvert and as he gets older he will be the kind of boy who has one or two special friends? It’s a bit difficult to unpick what’s going on, but maybe that is where the assessment is needed.

Today has been a good day so far though as he has washed the car with me (under slight duress!) and is now at the park with his dad. This means I will feel less guilty this afternoon when he begs me for his IPad or wants to watch ‘The floor is lava’ on repeat.

Do you do any play dates out with school? He may find large groups over whelming and the noise of a school playground can be intense even for us adults. It's also a transition point which will be stressful in itself.
Maybe a walk in some woods, the beach or a quiet park with one friend might be good for him. At the end of the day most of us don't have big groups of friends but a few close friends.

Yes, he is totally overwhelmed in busy environments. I remember taking him to an amazing water play park when he was 3 with my sister and her children. We sat on the grass near a big sand pit and he just collapsed on the floor crying because it was so busy and he couldn’t cope. Play dates could be a good idea, although he has never been invited on any. I guess we could be brave and do some inviting when Covid permits.

I agree re assessments, and whether trauma and/or ASD there are so many things you can do, 1:1, interventions, therapeutic work - information about this and recommendations as a result of the assessments should really help to help your dc be happy and to reach his own potential. (NB - many professionals are thought to have ASD traits!)

The description of your dc on the rug and being depressed reminded me of the description of "hypo- arousal" in the window of tolerance video which I have attached below, and if so this would tie in with trauma. In case you haven't come across this before, the window of tolerance is our state of mind when we are happy and relaxed, taking things in, feeling joyful, learning (see minutes 1.51 - 2.16 in the video), and we get pushed out of it into distress either hyper or hypo - when we basically shut down - it is when a child who suffers from trauma reacts in panic to something and shifts into survival mode or brainstem - the video explains this better, and describes "hypo-arousal" and what parents can do, by talking about feelings and helping your ds understand and tolerate his feelings and grow. You could try talking to him more about feelings at the end of each school day.

Re friends, I think that children who have suffered from trauma and who are jumping in and out of their window of tolerance do not pick up on social cues in the way other children do and that teaching them the basics makes a huge difference. The book "How to be a Friend: A Guide to Making Friends and Keeping Them" by Laurie Krasny Brown is brilliant for five year olds, and older. You could volunteer at school to see the dynamics between the children first hand so as to help him develop strategies for getting on with the other children. Another good thing is play areas at weekends, because there will be other kids on their own there with their parents, who may well be keen to play if he goes up and asks.

I know this is an unpopular view here sometimes, but I really would get tough on screen time. It will not be helping with the imaginary play or the social skills or helping the brain wire up in healthy ways, it is addictive, it can exacerbate asd... etc etc etc. What you can do is make sure you have activities lined up. And no child will ever tell you they want to go out for a long long long walk every weekend but it might just be the thing to do him the world of good!

Re food is there anything you could send him in with, which he loves, however weird, would he would definitely eat midday?

Good luck!

@sassygromit, thanks. I have done some training around this before, but the link is very useful and put in really simple terms. It actually made me feel really emotional watching as he seems to be largely living in a state of hypo arousal - especially at school.

Screen time is a tricky one as he really seems to need it to relax and escape. I get what you say about it stifling the imagination so I try to intersperse it with other more active things, but I’m reluctant to take away something that helps him unwind and escape the stresses of the day.

Also, yes to sending food in to school. He has raspberries and grapes each day as if I send in an apple or banana, they won’t be touched. He will only eat these if I peel and feed them to him, which the staff don’t have time to do. I did also send him in a cheese sandwich today to have at break, so hopefully he’ll eat it.

@sassygromit that’s such a great video, thank you for sharing.

My son sounds very similar. By the end of the school day, I think he is lying in the classroom somewhere (not that the teacher is being completely honest about that). She tells me by the end of the day it’s like he isn’t there (waves her hand in front of her face). Hmmm.

I completely get where you are coming from with screens. My son went through a period of time where before school he would be “plugged in” as we called it. Earphones on, tablet in hand. It was his attempt to keep calm and regulate before school as he found (and still does) separation so difficult. I don’t think it lasted long to be honest. He enjoys drawing or playing with his toys before school instead. It means he will now chat away to us rather than ignoring us. I never forced this change. Could you swap the tablet for something else? If not, he is at least keeping himself regulated (which for us, was amazing as he spent the mornings hurting me prior to this).

When it comes to food, give him whatever he will eat, even if it is not the healthiest. When you say feed him it, put it in his mouth? I wonder where that comes from. Is it down to texture or is it something else? Does he tell you his preference to food? My son finds it difficult to tell us he doesn’t like something because of fear of going hungry (which isn’t the case but stems to early trauma).

Hopefully he will eat the sandwich. Does he get school dinners or packed lunches? Does that make a difference? Hopefully, things change

@121Sarah121 my son has always found separation difficult too. It has helped that he is allowed to take his special bear in, although he doesn’t take much notice of it in school - just needs it when he says goodbye to me and at bedtime.

The food thing is so weird. He wasn’t on any solid food when he came to me at 18 months and it’s been an ongoing issue ever since. He is quite tall but petite and very thin. Left to his own devices he eats very little and says he feels full very quickly. You know that sometimes you hear people saying “don’t worry, your child won’t starve himself” - well I think mine actually might, or at least eat so little that he would not be able to function properly. I have now got into the dubious habit of feeding him most meals as this helps to get an adequate amount of food in him (and he really likes me doing it). He will eat anything beige - cheese, crackers, bread, potatoes and now a limited amount of fruit and veg. And yes, I actually have to break small bits of banana off and put it into his mouth. If not, he will maybe eat a quarter of a small banana by himself (with me watching) and leave the rest.

@Hugsandsquishykisses I’ve tried a transitional object but this hasn’t quite worked. He has no interested in it really. He doesn’t have attachment to many things to be honest. He has lots of photos in his bag.

Have you spoken to a dietitian or gp about it? It sounds more trauma related than texture then. Maybe he just isn’t that into food. My birth daughter (who doesn’t have any food anxiety) just isn’t that into food. I put her coat in the wash recently and found an unopened packet of chocolate buttons. I’ve never known a child to not eat chocolate! I asked her about it and she just shrugged saying she had forgotten about them... she just isn’t interested in food.

Anyway, I’m waffling. My son has terrible food anxiety due to early trauma. At one point, I tried to encourage him to let me feed him by doing an aeroplane because he would shovel it in so fast. It was nice bonding (even if he was older) and showed huge trust on his part. When he first joined our family, I had to cut up a banana and give him a fork to slow down as he would choke on it by trying to put too much in his mouth. Sounds like we have opposite problems. Over the past few years, it has become less of an issue. Has things become worse or just not progressed? I wonder if it would be worth looking at weaning again. Sounds ridiculous I know but it sounds like that bit of development was missed. Might help to revisit it (even by just looking at some tips on nhs website etc might help?) I only suggest it as we have a lot of issues with toiletting (my son has lots of needs) and we sometimes go backwards in training (reminding him to go more frequently, set times, going with him etc not putting him in nappies although that has been suggested a few times by professionals). Sorry I am no help. Just another confused parent doing her best

I haven’t spoken to a dietician. Would I access that via the GP? I did visit the GP re an assessment for asd about a year ago. He looked at my son and said he made good eye contact, so I had nothing to worry about. However, I have subsequently read that many people on the spectrum can make good eye contact. I do think I may have more luck if I access these things through adoption support - that way I’m hoping to get a more holistic assessment.

Yes, my boy loves his bear. It’s a ratty old thing given to him by his old social worker! It’s a BAB teddy, so I’ve said when lockdown ends we can choose it some new clothes.

He has a mix of school dinners and home packed lunches depending on what is on the menu. Good idea re revisiting weaning, possibly. I do worry a bit that I might be making things worse by feeding him so much as he becomes reliant on it. Like you said @121Sarah121 we are all muddling along, doing our best, hoping to undo the harm and praying that we don’t inadvertently cause any more.

I think your GP would be your first stop for support. I don’t think you are doing any harm but as you are finding, he isn’t really eating when you are not together. I wonder how you go forward from where you are at? I’ve no clue so can’t really offer advice.

I think there is a long waiting list for a paediatrician. It took 18 months for my sons first appt after a referal was made (after about 6 weeks in placement). Cahms also has a very long waiting list where we are. It could be that the GP has put in a referral but it hasn’t been processed yet. Might be worth chasing it up. You can self refer in my area and it might be worth asking the school for a referal. Is educational psychology involved? You can ask for that too. Just contact the school. They can put a referral in to cahms too. Do you have post adoption support? It might be worth giving them a phone. Can you tell I’m a bit of a nuisance?

That’s lovely that your wee man loves his bear. It would be lovely to pick new clothes and maybe even a new friend for a birthday? They are so expensive!

I wonder if it is worth looking into weaning again. Most people start about 6 months and if his life was chaotic at that point, he might find food stressful. Maybe he was shouted at if he dropped food or got in a mess? Maybe he associates food with punishment so it is easier for you to put it in his mouth to avoid it? Just a thought. Do you take the wee man food shopping with you? Pick recipes from a book? Does he cook with you? I’ve done all of these things frequently with my son to build up positive experiences with food. There is nothing he loves more than food shopping and enjoys the social aspect of cooking together. Beware though. It takes a very long time for a 5 yr old to peel potatoes!

OP I think you are right to start with the holistic assessment. For ASD and/or developmental trauma this should be with a psychiatrist or clin psych as far as I know. I know of a child who was exactly the same at 5 with food (I was even going to suggest a pot of plain couscous or rice for lunch, along the lines of the beige!) - also would starve if not pushed to eat - also would lose weight very quickly - also also going through phases of spoon feeding to stop food getting cold as child was so slow - it all immensely improved as the child recovered from trauma and they ended up good, and substantial, eaters! The child wasn't adopted, but there was severe developmental trauma, and the parents focused on other therapeutic work, the aim re food was just to make sure their dc ate a lot as they lost weight quickly, and that it was as balanced as possible.

Thanks @sassygromit and @121Sarah121. I have a zoom meeting planned with teachers after a tricky school day on Thursday and am also waiting to hear back from Adoption Support. Any suggestions or ideas for strategies that have proved helpful for school staff to use, would be gratefully received. Thank you.