Or is my 4 year old neurotypical?

[onemorestepalongtheworld]

Hi everyone, this is a very long post so I do apologise, I have posted before about this under a different name, but a couple of months down the line and I'm starting to think I am reading into things that are just totally normal for a 4 year old. My son started school in September and they aren't concerned at all and haven't seen a lot of the things on my list, my husband, mum and best friend are the only ones who recognise there may be differences to the typical 4 year old. I am fully prepared for you all to tell me I am being unreasonable and need to get a grip!! Maybe it's what I need to hear. Ok here's my list;

Licks things (not all the time but more often than other children his age and younger)
Puts things in mouth
Eats inedible things (play dough, flour, glue)
Likes being squeezed/tickled/lots of pressure
Very ticklish
Seems to find touch on his face/neck painful
Asks people to repeat themselves when speaking (had a hearing test, all fine)
Upset by loud noises but happily makes very loud random noises (excitable screaming and shouting)
Distracted by slight noises/movement
Not dry at night
Pooing in sleep at times (when potty trained at 2.5 had fear of pooing so held it and used to go in his sleep every night, finally got rid of the fear but still sometimes going in his sleep and not always recognising the urge to go in the day)
Difficulty falling asleep (still awake at half 10 some nights just laying in his bed)
Says the bath is hot/burning him when it’s just warm
Sucking his skin/clothes at times

One sided conversations
Ignores questions and starts his own conversation
Won’t always look at/speak to even people he knows (does give very good eye contact when comfortable)
Can come across very rude ignoring people
Repetitive routines (started as a young baby, 11 months old would go upstairs to the same room every night to get the same book for months)
Can get very angry and lashes out if someone says something he disagrees with
Doesn’t show emotion when saying some things (‘you are going to die and I won’t have a mummy’)
Difficulty following new instructions, has to be shown what to do
Can take things very literally and has said things at school such as ‘you’re the adult I’m the child, you need to help me’ ‘I don’t need to do that I’m only 4’
Doesn’t like people looking at him and gets embarrassed
Strong emotional attachment to things such as a coat, random items of clothing.
Emotional attachment to anything linked to being a baby

Clumsy
Lack of spatial awareness
Messy eater
Struggles with fine motor skills
Forgets routine daily tasks
Random bursts of energy especially when in a new place or when someone comes to the house
Always on the go but can be totally absorbed in certain tasks
Fidgeting
Picking nails

Obsessed with certain books/characters
Intense role play, takes on the role very seriously
Very good long term memory
Doesn’t show a lot of emotion/affection towards people (but has recognised facial expressions in pictures since around 2 years old)
Very matter of fact
Doesn’t notice if someone is upset or try to help them unless prompted
Almost robotic with saying sorry/comforting people (learnt behaviour)
Sometimes laughing when told off
Can be very sensitive to change and people he’s not comfortable with (having said that he can adapt well to new situations, especially with a lot of preparation)
Would rather stay at home most of the time
Over the summer holidays he totally fell apart without the structure of going to preschool every day, all of these behaviours were exacerbated. *

He has a weighted blanket and meditation at bed time. I use visual cues and social stories to prepare him for things. He met all of his milestones at the average age.

I can see that some behaviours in isolation are not unusual. However displaying all those behaviours is quite a lot.

A lot of those behaviours listed are normal in a 4 year old though, and as a pp said, may be grown out of. The school would see a lot of this in a large proportion of 4 year olds, maybe that's why they do not seem concerned. Can you narrow it down to the more concerning behaviors which you and your family think are spectrum behaviors?

OP - my child can ride a bike too and this for a while made us dismiss dyspraxia

Sensory Info, you've already described quite a few traits.

Ask for referral to a paediatric sensory OT.
www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/Making%20Sense%20of%20Sensory%20Behaviour.pdf?v=201507131117

My daughter is 7 apart from the peeling and pooing (She is nappy and dry since 18 months) she does all of this. To bed down since turning 7 however we moved schools in June... who have told us she is highly intelligent (Not from either of us 🤣🤣) however lacks to grasp the basics so in a just you could give her algebra or ask her to spell particular and she an but if you asked her to do 2×10 or spell boat she would struggle (actually got the 2x10 this week massive deal), and the school suggested being on the spectrum for autism. She is under testing right now as far as I am aware but we have had to take a major step back because of my husband's anger and treatments etc. If no one is noticing the licking at school then someone is not doing there job. Licking and a hard hugger and over enthusiastic behaviour should be noticed. Speak to senco not class teacher

Cancer not anger bloody spell check has it right though

Honestly I would brace yourself to start pushing for assessment by Paeds - this might take a few years to clarify diagnosis (and if none, then no loss), then it might take a few years to get an EHCP plan through (yes, school may well have other pupils with more pressing or noticeable issues, and won’t prioritise their funding for a child not causing problems, but before you know it he’s in year 5 and has not had help he might need, and he is your priority). Your list suggests sensory issues I agree (sensory seeking and sensory defensive behaviours) and some indicators of possible ASD which might be present in NT children of this age but in combination present quite a strong picture.

Easily 90% of things you described apply to my child and they had a diagnosis of sensory processing disorder and dyspraxia initially (aged 5) and finally after much pushing were further assessed and diagnosed with high functioning autism and ADHD a couple of years later.

Now that’s NOT to freak you out or to try and diagnose your child, just to say that some things were clearer as my child got older.

Our school were useless. Denied any problems etc until AFTER I got the diagnosis confirmed and then said “oh yeah we thought as much”. Kids will mask their issues in order to fit in at school and then you will get the fall out in the form of a meltdown or “bad behaviour” later when they feel safe, at home. It’s a common thing and schools often say they see nothing wrong because of it.

You carry on treating the symptoms you see, keep researching and pushing for assessments etc. It may be something or nothing, dont worry, but trust your gut instinct and go with it.

You sound like a lovely mum, more power to you

He definitely has sensory issues. As for the rest could be autistic, might not be. It's important his sensory issues are addressed then it makes it easier to cope with the rest of life (that's my perspective as an autistic woman)

It doesn't sound typical of the 4yr olds I know well. Out of your list, very ticklish, distractible and a bit excitable when visitors come are the ones I could say sound like DS and his cousins.

I did do some volunteering with that age group but I couldn't compare to them as I don't see them in their own homes.

A lot of what you have posted sounds like my DD at 4 and she has Dyspraxia and Sensory Processing Disorder. Some children with dyspraxia have no balance problems at all - its a spectrum. It also overlaps with ASD. We got a diagnosis (privately) when she was 10 as I was keen for her secondary school to understand her needs.

Read "the out of synch child"
Some signs there to monitor and follow up

I agree with previous posters that it sounds like there may be some sensory issues. I know you’ve been referred to a paediatrician by your GP but it might be worth pushing for a referral to an occupational therapist.

You said he’s getting in trouble for minor things at school, what sort of things? I’ve seen a lot of sensory seeking children get in trouble for pushing or leaning on the other kids, if that’s an issue I’m wondering if there’s something unobtrusive you could send with him, like a tight sweatband for his arm or a compact hairbrush, that would provide some of the sensory feedback he’s looking for

My dd is 11 and has ASD and learning difficulties, she displays some of the characteristics you listed about your ds. If you are concerned, go to the SALT drop in in your local hospital, or print out what you have said about your ds and go to the GP. Autism is a spectrum, some manage fine at school with no issues and no EHCP, some need a lot of support.

My son has dyspraxia and ADHD and did lots of the things your DS does, although not to the same extent with the sensory things on your list.

I would push, push, push to get him assessed fully. Whilst it can be reassuring when school say 'he's fine, they're all the same at this age, there's no problems', they can easily miss things if they're not causing a child huge difficulties day to day at this age. I was told DS was fine for years, that his issues were due to his age, because he was a boy and they're all like that at this age, that he was a bit quirky but it was just a behavioural issue he needed to work on, 'they all grow out of it, don't worry!). He didn't grown out of a lot of it, so when he was in Y4/5 it had become obvious his peers his matured more and he was still struggling. Then they were very keen to get extra help for him before he started secondary, to which my reaction was 'I've been saying this for years but everyone told me I was overly concerned and he had no issues!'. They don't spot everything, especially at this age and especially if all is fine academically. But if you wait too long to see if he improves you are wasting time that could be spent helping him. Early intervention is much more effective. Besides, it takes so long to get assessments and diagnoses that it does no harm to be referred and see how he develops while you wait to be seen, if that makes sense?

OP, it sounds like you already compensate for his behaviours; you are his mum and you know what he needs, but it's likely that without these slight adjustments he may not cope so well.

4 is a key age in terms of development because that's when some behaviours that could be seen as autistic will leave the NT child. The ADI-R diagnostic questionnaire focuses very much on behaviour when they were 4.

DS was diagnosed at 9 and when we were going over behaviours from around the 4-5 bracket we found that there were a few things we had already made adjustments for, without even realising.

School wise it very much does depend on the teacher. DS's primary 2/4/5/6 teachers understood him perfectly and made small classroom changes to help him. His P1/3 teachers were awful and expected him to fit into the 'this is how you should behave' box. So it depends who you ask, how much information you will get in return.

Keep writing things down for when you see the paed, the more information the better

Your son sounds incredibly similar to mine. We are seeing the community paediatrician. She says he’s a tricky case and we will probably never know if he’s autistic or not. He has some major signs but then other aspects of his behaviour really don’t fit the diagnostic criteria.
We just parent him as well as we can and make adjustments where possible to help him.

he certainly sounds like he has sensory processing issues, which is often a strong marker for autism. I would speak to the senco or your gp and ask for a referral for assessment.

Op, you know your son so well to be able to write about him the way you do and from personal experience I hate to say it but there’s a lot of the things in your description of you boy that I think are cause for concern.

That is a long list, with many sensory issues. Remember autism is a spectrum and what signs some child display, another may not. No two individuals with autism are the same. That’s not to say she HAS autism. It may be a sensory processing issue. It may be nothing!

What does stand out is the amount of traits she is showing that would not be typical in every four year old. You could take them all and say, every child in his class is showing some of these. But I doubt many would show all of these.

A PP suggested contacting NAS, that would be a good starting point. Phone up and say you have concerns and they will take it from there, asking questions and giving advice.

The main thing is you carry on doing what you are doing. You have found things that work like weighted blankets and social stories that work for your child, keep going. You obviously know your little boy very well and what his needs are.

I'm autistic and have two autistic children, my eldest was diagnosed two years ago and school were amazed as they apparently "didn't see it". I got a referral for assessment via my HV and GP.

My youngest is 4 and not diagnosed yet as school wants to collect more observations but he's way less obviously autistic than what you're describing.

I think your son is either autistic or has something like ADHD or sensory issues and you should definitely push for assessment.

Go via your health visitor if school are unhelpful.

FWIW my aspie son engaged almost constantly in role play when he was 4.

OP, don't make the mistake of assuming teachers and SENCOs will necessarily know their arses from a hole in the ground. One of DS's teachers told me that 'it can't be autism, as he isn't like it all of the time'... I would take your list to your GP and ask for a referral.

Autistic children don’t normally engage in intensive role play, especially at only 4

I wouldn’t consider this a “non-autism” sign, personally. Some autistic kids have very active imaginations.

I was also going to suggest Dyspraxia or high functioning ASD (also comes with clumsiness). Lots of children mask at school so this wouldn't be unusual. I would research ASD not so much to decide whether DS is or isn't on the spectrum but to find coping strategies to add to those you use already.

A priority would be to work out whether he's coping well at school or masking and building up stress during the day. The latter would obviously be a concern.

Sound like a mix of DS and DD1 - I've had concerns about them especially as I have diagnosed dyslexia and dyspraxia.

Schools haven’t been that helpful – though eventually there been some support for specific issues they often dismiss or deny wider concerns. My family tend towards dismissive or it’s a phase or it’s them.

We tend to find we make adjustments at home and offer a lot of academic support and they tend to cope in school. As they’ve got older they have fewer issues in school environment – they’re at secondary and seem to be doing well academically and socially.

I'd keep a watching and try pushing for some assessments – different teachers has different approaches and ideas - it may very well get more obvious the older he gets. Certainly teachers were more open to their being something with our children though still maintaining it wasn't a problem.

Yep I role played too but enforced rigid rules for those also there