To wonder whether DS is ok?

[SuiGeneris]

DS is 4 and recently I have started wondering whether he might be different from other four-year-olds. At times he is quite aggressive towards other children: either he beats them up or goes very bear them and then shouts. His language is, we are told, in the normal range for his age but seems less extensive and clear than others we know. He can get very upset for small things, such as a banana or piece of toast being cut in half. He hates parties and noisy environments: today at a party he asked to leave and go to a quiet room after getting very upset because a boy had taken what he considered his sword. He had then beaten up the boy before breaking into tears and sobs and asking to go somewhere quiet. Yet, after 45 minutes he wanted to invite the boy home and was puzzled by the lack of enthusiasm with which the invitation was received.
He almost never follows instructions, esp if in a class/party, yet his teacher at nursery says he is very focussed on his activities and often wants to discuss things with her.
He loves singing yet his tone of voice when speaking is odd, not monotone but lacking in variety.
He had/might still have some hearing issues- we are waiting for a review.
Also, at 4, he still wets himself regularly (more than once a day) and often does not get to the loo in time for solids either. Things were better in this dept but have got worse over the last 2/3 months. Thoughts? Is this a normal, albeit challenging at times, 4-year-old behaviour or am I right in feeling uneasy?

Is this a normal, albeit challenging at times, 4-year-old behaviour or am I right in feeling uneasy?

Could be either.

I would suggest keeping a diary or list of incidents that concern you. Then once you have done this, take your list to the GP and ask if you can be referred for a paediatric opinion. This in itself may take several months, by which time you might that either:
A) these issues have resolved as he develops.
B) these issues have continued or worsened and the difference between him and his peers has become more noticeable.

If it turns out to be B, the SEN boards on here are supportive and helpful while you are going through the assessment process with him.

It's so worrying when we have this feeling...from what you say I would suggest that you see your Health Visitor or GP...you can do it without DS present so you can talk freely.

There are a couple of things which stand out and which I would check out.

I've got a 4 YO and they can be a little 'trying'

We're also getting her checked out for hearing problems (recommended by nursery but we'd been wondering before they mentioned it) because she shouts instead of talks (it must be bad if they'd noticed it over the noise of all the other children ).

We were the same as you, the things we'd noticed could be easily explained by having to compete in a noisy nursery environment or the fact that she'd had a cold for the past however many weeks and couldn't hear properly etc. But then DH and his dad have some hearing loss and although her vocabulary is good, some of her speech is 'sloppy'.

For me, I would be more concerned about 'beating up' other children (what do you mean by that exactly? What's he doing?), and a bit less about the wetting himself, but whether you need to worry about it might depend on whether you've had a good go at addressing it already by reminding him to go to the loo or whatever all the time.

But they could still be explained away as the norm for a 4 YO, it's frustrating if you can't find a way of saying what you want and having to do things you don't want to and not understanding why.

Mine also gets upset about things that should be whole getting broken, like a biscuit or bread stick, she just knows it's Not Right and suspects it's going to taste funny

Thank you. We are seeing the GP in 3 weeks, so will prepare list.

Beating up can mean, like today, pounding on the chest with fists, kicking, punching etc.

We have tried reward charts and naughy corners, as well as reminding him to go to the loo, but getting him to go is always a battle and he just generally does not go on his own. We went through 4/5 pairs of trousers today.

I think you need to stop giving him the chance to "beat up" other children by staying much closer to him and removing him/distracting him before these situations occur. Regardless of the cause, he's obviously having difficulty in social situations and his reaction is to become aggressive with other children.

What do you think could be the cause of him lashing out at other children?

Something he's seen done and is copying? Anxiety? Frustration?

I just remembered SIL having problems with one of her lads still wetting himself until he was 5 odd I think because she thought he just couldn't be arsed to stop whatever exiting thing he's doing and go (he's 16 now and no problems ).

Could that be it? Or is it more that he doesn't associate the feeling with the consequences? Or that he genuinely has no control over it?

I didn't used to like to go to the loo on my own because the flush was so loud and it freaked me out

Is he at state nursery? I had fairly similar (not identical, but the same sort of "level" of concerns, if that makes sense) about my 4 year old DS. His nursery teacher also raised a few issues (interestingly, not exactly the same concerns that I had - she clearly saw different behaviours in a different environment). I had always had a few niggles about him - he is lovely, and bright as a button, but not run-of-the-mill. His state nursery was able to organise an educational psychologist observation and high level assessment fairly quickly (about 3 months after request). To be honest, nothing very much came of this: the ed psych made suggestions to the teacher which seemed to help DS; I had a long chat with her about him, and she said that while she saw the behaviours we'd both mentioned, she wasn't sure that they weren't within normal range, could be explained by enviromental issues / class dynamics, and thought a lot was down to his personality (I specifically queried ASD as a possibility and her advice was, although she wasn't qualified to say yes or no, that she saw nothing to warrant further assessment).

The process helped me, helped DS, and I think helped his teacher to understand him better. A couple of years on and I don't really have those niggles any more - he's still not exactly your average 6 year old boy (introverted and highly strung at times!), but he's pretty well adjusted and copes well with school. I'm glad that we had the assessment though, as otherwise I think I might still have been wondering. It's worth considering.

The aggression towards other children sounds ott for a 4yo, what on Earth did you do with him when he did that at a party - I would have been mortified and dd on the naughty step for a week

It does sound like their might be hearing issues, my dd has needed 2 lots of grommits for glue ear and suffered with some issues around tiredness and grumpiness prior to diagnosis.

Yes, he has had relatively bad glue ear for a while, we hear next week whether he needs grommets. Treating medically for the moment.

On not giving him the chance to hit others: I try, but also have a 1-year-old and a life to run, I cannot always sit next to DC1. At the party I was on the other side of the room, arrived, stopped him, asked him why and that's when he became very upset, crying desperately etc. he was so upset he cried hard for a goos ten minutes despite being in my arms etc. Naughty step would not have been appropriate. Once he had calmed down we discussed again that we do not hit and that he should have asked an adult to intervene.

Ed psych might be useful but we are in a private nursery so I guess we would need a private one.
Cognitive development seems ok, possibly even a bit advanced (he can add and spell some words, very interested in science etc). Would they spot the need for an assessment though?

you can ask gp for refferal to a developmental paed. x

I think whether they would spot the need would depend on the nursery. But FWIW my DS's issues were completely separate from his intellect - if anything, his development seemed quite asynchronous because in terms of intellectual and academic milestones (talking, numeracy, reading) he has always been noticeably ahead of where he "should" be, whereas socially, at least as a younger child, he was a little behind (and there was therefore a big gap). The ed psych was very good at identifying how he was able to see problems and worry about hypotheticals which would go over the heads of many 4 year olds, but then lacked the skills to deal with his emotions.

after an assesment with paed they can then send ed pysch into nursery if needed.

Local authority Educational Psychologists will see children in a private nursery, however their advice is fairly limited to what your child needs to get on in that particular setting. They can't diagnose any underlying problems at all. For that, you need a referral to a developmental peaditrician. You may be able to ask for an ep referral through your nursery at the same time though, it depends on your LAs individual rules.

I am not a medical professional and have no qualifications for diagnosis but you seem to be describing done autistic spectrum traits to me.

Special needs boards are fab, may be worth getting your thread moved there.