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’m definitely not a diagnostician but I am definitely autistic, and know quite a bit about the finer points of the diagnostic criteria. Purely based on what you’ve written I would say that it’s likely that he is autistic - the Pica, licking things, slow processing of verbal commands (i’m inferring this as you said that he asks people to repeat themselves), his tone and facial expression not always “matching” what he is saying, the nail-picking, the significant embarrassment, the intense role-playing etc.

I would say say: don’t worry that him not seeming to show affection/not adopting a suitably solemn tone in some situations/not rushing to comfort people is a sign that he struggles to care or lacks empathy/compassion. For autistic people, especially when we are children, the problem is that we are overflowing with empathy but we are unsure of how to express this in a way which will be wanted by other people (for example, whether we should approach someone who is crying or if we should leave them in peace).

He sounds like a sweet little boy, and you sound like a lovely parent

Find a sympathetic GP and push for a referral. My children's school did not notice they had ASD. My best friend whose son has ASD did not even notice my children had ASD and they have slept over her house a lot for years. I did not notice myself my own daughter had ASD until she hit puberty and life changed dramatically. Its the things you notice at home when you know your child. Everyone is different, but getting a diagnosis was life changing for us. ASD is different for everyone. My son has sensitive skin but for him this results in him liking his skin touched so he is very affectionate. But he is very literal and does not get what people mean when they point to something. My daughter does not have any particular sense sensitives - but we realised her senses are just on high alert all the time so she can get overwhelmed.
Can I also suggest you get one of those chewy bands from amazon to wear to school since he is still exploring his mouth senses it would be better if he had this to chew.

OP has already seen the GP and organised a referral.

Not unusual to have some of these things at 4 but it does seem a lot and he does seem to have high sensory and emotional needs. I would say he is unusual. If it isn't affecting his school work and relationships his teachers maybe wouldn't notice yet.

Also remember ASD is a spectrum so you can't look at other kids. Both my sisters youngest have ASD but both completely diff needs.

It's not uncommon for dyspraxia symptoms it even full blown dyspraxia to go alongside ASD.

My 9 year old nephew was similar to your boy at 4. He was already diagnosed, my sisters hv was very helpful.

My 6 year old nephew has only recently been diagnosed.

Yeah DS1 has ASD and full blown dyspraxia

@averythinline 😂 yes I certainly don't want him to grow up just yet!! He comes home every day saying he's been put down on the behaviour chart and gets very upset about it saying he's made a mistake, which is not helping him in wanting to go to school, obviously I want him to have consequences if he's done something wrong but a lot of the time it's things on the list that I don't believe he can control! (Not saying he's an angel.. he's more than capable of being a pickle)

Previous posters have mentioned getting a referral to an occupational therapist, would this only be done through the school? As the gp said they don't refer to that 🤔 the senco at my son's preschool recently said if he had started at their school in the September she would have been referring him this year for occupational therapy due to his clumsiness and struggles with fine motor skills

@FetchezLaVache lol'ing at your phrase about holes in ground 😂 that brightened my day, thank you!

@SprusselBrout nearly cried at your post. Thank you! #emotionalwreck

Thank you all so much for your informative replies! I've certainly considered sensory processing issues and dyspraxia due to my brother having dyspraxia. Not sure on ASD, because the children I've known with ASD have been severe and it's been so obvious that they struggle, I know my son struggles because I'm his mum, but if it's not obvious to everyone else maybe I'm reading too much into that side of things. I went on an anxiety course and he displays a lot of signs of anxiety but the person running course said that could be due to the sensory processing. I guess I've just got to wait and see what happens. Thank you again so much for your replies!

Just off this it sounds like he's very high functioning ASD, ADHD, SPD and dyspraxic. All these things do commonly go together. Problem with high functioning/mild symptoms is you are very likely to be overlooked at this age because all 4 year olds are quirky and it might not be severe enough to need a diagnosis. Keep making a note of all these things, it will really help further down the line if he is still having issues. As he gets older, these quirks will either be more noticeable or less. Only time will tell. Does he have trouble regulating emotions?

@slappinthebass very much so, yes! I'm going on an 'emotional regulation' course in the new year!

Glad my previous post was (hopefully!) helpful OP

I hope you don’t mind if I hop in again just to say that as far as emotional regulation is concerned, often the issue that autistic people have (again, especially as children) is that we might not be able to express our discomfort/upset (even if we are generally verbal) until it has burgeoned and become intolerable, in which case our distress will become obvious, seeming to have come on quite suddenly and out of nowhere. I think part of this is because some autistic children put a lot of pressure on themselves to have “good behaviour” at all times and so need extra reassurance that they are very much allowed to say something if they are uncomfortable or upset, before it snowballs.

I went to the GP with similar (but not as strong as perhaps you have) concerns raised at school for my 6yo DS - in particular, the school SENCO had suggested issues with proprioception, and asked for an appropriate referral to investigate more.
I got sent a questionnaire to complete, and he was seen by a development paediatrician, who has now referred us to OT.
So why don't you go and have a chat with the GP about your concerns, and ask for a paediatric referral? I'd focus on the behaviour and on the continence side of things, which might get more traction with the GP, maybe.

As an aside, we've also been doing retained reflex therapy with DS for the past year. It seems a bit woo (or it did to me when we first started), but I've really bought into it now, and feel like it has made a massive difference for him. Have a search on the internet, or there is a good book called "The Well Balanced Child" which explains the theory behind it.

Your list is very similar to my son who is diagnosed with Autism and ADHD.
The waits for assessments are very long so I would suggest talking to your gp and seeing about getting the process started if you have concerns

Hi OP, ASD parent here. I recognise almost all of the things you have put in your list. My son was diagnosed at 3 years old. The early diagnosis has made all the difference. He is also very outgoing, chatty, sociable (on his terms obviously, and very often not in an agreeable fashion to others so struggles with friendships...but does try!). I agree with the poster who says ASD is a spectrum..no two children will be the same and neither will they behave in the same way but it would be clear to me that you son is probably there. I am glad you have pushed for a referral. If you get a diagnosis, the floodgates open for help and support and I have done every course available, read every book and bought everything I can for management strategy. So far, so good. I think you also have to expect that your DS may mask very well at school. Mine does. It's when he comes home that it all floods out. I really do hope you get a speedy referral and that you both get the support you need. You're doing a great job so far...and make sure you journal everything!! Good luck

ASD is a spectrum, what you've described is behaviour that falls within that spectrum. Take what you think you know about ASD in others completely out of the equation, as no two kids with ASD are alike. Just because you've met some autistic kids that aren't like your child it doesn't mean your child might not be autistic.

My son has ASD and doesn't have ritualistic behaviour. You can take him pretty much anywhere. He's a happy boy 95% of the time. Still autistic though.

op, can you suggest to the school that they praise your boy by giving him a reward chart rather than punish him with the naughty chart or whatever it is.

Praise the positive. Ignore the negative. Though I have to admit to not liking describing behaviours as positIve or negative as everything is done for a reason.

@SprusselBrout thank you, it honestly is all really helpful! I'm not sure if this is the case for my son but he does erupt suddenly. But usually as a knee jerk reaction to something!

Bear in mind OP that eruptions that appear to be knee jerk can sometimes be the result of pressures that have built up over time, for example the school day.

@PollyFlinderz I don't think the school would be on board with that as they don't think there's anything wrong!

@TheFormidableMrsC thank you!! I will keep going as I am and see what happens :-)

OP, please push for an assessment at least. If your son has autism, then he will receive appropriate support at school and you will be able to access resources that will support you. As I said in my earlier post, my DS has benefited hugely from early diagnosis. The school will have to accept a diagnosis and indeed they are then able to access additional funding for support for your son. This is why it's so important. I also notice you mention eruptions...if my son has one of these, it is usually a meltdown and triggers are wide and varied. Not to be confused with a tantrum. I wish you lots of luck and hope you will update at some point!

@TheFormidableMrsC I'm awaiting a referral. I went to the gp in early September, so just have to wait and see. I went back to the gp recently who said he'd send a letter to chase it up as well!

One step at a time...it's a long path, but you're doing all the right things