To ask for advice re: 4 year old DD? ASD? Something else? Nothing?

[Knoxinbox]

Name changed as I feel like I’m sharing some pretty personal things about DD....

My DD is just turned 4.... I’ve always had a concern at the back of my mind that maybe she is not neuro typical...

I came across this link and she ticks so many of the criteria:

taniaannmarshall.wordpress.com/2013/06/22/first-signs-of-asperger-syndrome-in-young-girls-pre-school/

However I feel like many of these traits (stubbornness, inflexibility, obsessive interests, delayed social skills etc) are also “normal/typical” 3/4 year old behaviour traits....no??

For a long time I kept her emotions in check by basically meeting all her needs. I’m a SAHM, I BF until 3 and coslept etc. I didn’t actually leave her until she was 2! And even then I only left her with DH to go to the dentist! So she was largely happy and meltdowns were infrequent (every couple of months or so?) could be somewhat predicted and worked around.

This year though we have relocated internationally and had a baby (now 3 months old) and her behaviour has really deteriorated. She flies off the handle and has meltdowns at the slightest thing: at the weekend she screamed and cried until she was almost sick for 30 minutes because we asked her to stop looking at her books because it was lunchtime. She had a series of 10 books and had only looked at 7 of them and didn’t want to stop until she had finished them all - which is typical of the sort of thing that bothers her, like she cannot deal with the task not being “completed”. This evening she screamed until she was almost sick because she didn’t want to be apart from me. DH was trying to give her a bath and I was trying to BF the baby to sleep at bedtime and obviously couldn’t do that with her in the same room screaming. So he took her out the room and she utterly flipped out it was horrible and I ended up feeling like I’d let both my DC down

She’s very anxious, almost displays certain OCD type behaviours sometimes, has huge separation anxiety and still sleeps in my room with the new baby. She refuses to potty train, has meltdowns over things like being measured for shoes, having her hair washed or toenails cut or putting on suncream....

She also has hypermobility and suffers from constipation unless on daily movicol (her diet is good: full of fruit and fibre). She suffered with severe Cows milk and soy protein allergies as a baby and only grew out of them around 3.

She’s always hit her major developmental milestones (although she didn’t walk until 15 months) has always been very verbal and communicated well although has only recently started to talk to people outside our immediate family. She’s not great at eye contact though and I feel like she doesn’t really understand other children or how to play with them...

She can be quite obsessive about certain topics like dinosaurs for example. She knows about and can pronounce book fulls of the complicated names and has done since she was 2.

I don’t know maybe it’s just our circumstances this year. I’m certainly not trying to label her! I’m just really worried about how she’s going to cope with starting school next September...

Any advice? Thoughts?
Anything sound atypical? How do you even generally get assessed or who would you report concerns to? HV?? Would you just wait and see how things pan out with starting school first?
Any website or book recommendations?

Thanks in advance!

taniaannmarshall.wordpress.com/2013/06/22/first-signs-of-asperger-syndrome-in-young-girls-pre-school/

Hopefully a clicky link^^

Ps, posted in special needs forum but only had 3 replies. Then I had an OP name change fail and asked MN to delete that post and they deleted the whole thread?!

I'd speak to either your HV or GP. It depends on what it's like to get an appointment.

It sounds as though something is going on.

She can be 'in the system' which School could then speed up things.

You don't want any behaviour being blamed on starting school and for them to see how she goes. A year will be over before you know it and more will be expected of her.

I'd carry on as much as possible with Parenting to her needs.

No real advice but we have had similar concerns with our DD although with ADHD. DD was prem and we were told she may develop behavioural issues at birth so slightly different to your situation.
Does she go to nursery? Do they have concerns?
We contacted our HV who came out to see us and offered some advice on dealing with challenging behaviour. We also have a 10 month old and feel it may partly be due to the new arrival and change in homelife.
I’m not sure how early they would diagnose but when we spoke to our HV we worded it as wanting to nip any issues in the bud prior to school. Could you contact them for a chat and see what they say?
Sorry this is a bit garbled but I think you need to trust your instinct. A lot of the behaviour is typical of 3/4 year olds and if I had a pound for every time I’ve relayed the issues we have with DD and been told it’s entirely normal blah blah . . . But we don’t feel it is entirely normal. There are some things that somehow just don’t seem quite right. And actually I’ve stopped talking to friends about it because everyone has advice and tells you not to worry. So if you do have concerns I’d raise it with your GP or health visitor. If it comes to nothing that’s great but if not and issues become more apparent at least you know who to call.

Thanks both. No she doesn’t go to nursery. I’m a SAHM so we don’t need the childcare. I toyed with it for the social aspect but I honestly don’t think she would have coped with the separation from me. She also relies heavily on me to guide her through social situations and act as her security blanket that she can check in with frequently.

Also she’s not toilet trained yet and simply wouldn’t let anyone else change her nappy. It was a huge deal and months of preparation for her to let DH change her nappy when I was in hospital having the baby (elective section). As she had point blank refused him since just before 3

Wow sounds a lot like my DC2 except your DD is a bit older and mine is less clingy. Even down to allergies, hypermobility and trouble with poo. Mine's a second child though so simply can't get their own way all the time and will accept other adults. I just have a gut feel there's something slightly atypical. Can't help much I'm afraid though on a solution.

DC 1 however, who doesn't have those similarities and was previously fairly easygoing, went into meltdown city for about 6 months after DC 2 arrived, so that could be responsible for the deterioration in behaviour in your DD? Tbh it took about 18 months to calm down and still isn't back to where it was.

Hi there, as a reception teacher and mother of an autistic child, I would say that you have enough there to be concerned about. Diagnosis of girls is still very patchy and unreliable. I started by writing a kind of referral letter that outlined all the things I was concerned about and took it to the GP. She referred us straight through to psychology and DD was diagnosed in about 4 months (ADOS interview with psychologist for DH and me, 1/2 day obs in school by a speech and language therapist for DD).
One significant thing they will want to know about is shared attention as a baby/toddler - did she point at things, to draw your attention to them? (different to pointing to something so that you would tell her the name, or get it for her).
And one last thing to look at because of her hypermobility and bowel issues - there are co-morbidities between ASC and Ehlers-Danlos syndrome. Might be worth bearing in mind.
It sounds like you are doing an amazing job of parenting her and minimising the anxiety and stress she feels. If she is autistic, a diagnosis will help you to understand what she needs even better. My ND-DD is amazing, and it is a privilege to be a part of her life.

I'm going to say something you probably don't want to hear. It sounds like a lot of issues have been of your own making. Going along with what she wanted in the early years for an early life is now back firing because she doesn't have the tools to cope with being away from you. Of course she is going to find it difficult to adjust now.

That being said, you can ask for help and support. She sounds very like my eldest, especially obsessed with dinosaurs. He could pronounce names I couldn't at 2YO! My youngest who is 3 struggles in social situations and is very anxious. I'll be honest, I babyed him and let him get away with things I never did with my eldest. He has selective mutism and although he enjoys nursery school and takes so much in at it, he doesn't speak while he's there.

I know you've said she doesn't go to nursery but I do think encouraging her into more social situations will help her. Even if it is just a gradual start.

Speak to your GP and HV and get their thoughts on how to manage the situation.

I do think it sounds a lot like high function autism OP. Obviously no one can diagnose over the internet (and I'm not qualified to diagnose in person!) but yes there are certain flags. I would probably go for an assessment and in the mean time it can't hurt to research what techniques can be used to help her IF she has ASD and see if it works. The fact that she couldn't cope at age 4 with any kind of separation from you is worrying. Lots of children in the UK have started full time school at age 4.

I would definitely start getting help ASAP. If you're in the UK get a referral via your HV or GP. It sounds like it will be very stressful for her when she starts school so it will be a very good idea to have help in place already.

I know one little girl who had suck bad anxiety on starting school she started self harming at 5 years old. (With help in place she's doing much better now at 7 years old).

I’m having similar thoughts about my daughter who is a little older than yours. She is very bright but her moods are incredible. She becomes incredibly grumpy if she doesn’t want to do something, to the point of throwing things at me, getting in my face, flat out refusing to do something and shouting. Around anyone else though she is an angel. Although she can be a little stubborn with her friends. She also has hypermobility and she will stop doing something whilst she works through a tummy pain- Like bowel spasms.

Bed time and leaving the house are the worst times for us, she just doesn’t want to deal with the change of scene for those two things. She also seems to act like a baby with not talking properly, grumpily talking and every little thing being a hassle for her. Maybe it’s just her way but it has made me wonder if there’s something else going on.

I'm going to say something you probably don't want to hear. It sounds like a lot of issues have been of your own making. Going along with what she wanted in the early years for an early life is now back firing because she doesn't have the tools to cope with being away from you. Of course she is going to find it difficult to adjust now.

I doubt very much this is true. It sounds like OP's been responding to her DD's anxiety not creating it. My eldest coslept, we did extended breastfeeding. I was a SAHM and stayed with him most of the time. Despite this he was keen at 2.5 to go to nursery and coped fine with school at just turned 4 (August baby). Most other children in that situation are the same.

Going along with what she wanted in the early years for an early life is now back firing because she doesn't have the tools to cope with being away from you. Of course she is going to find it difficult to adjust now.

I know what you’re saying and I can see how it appears that way. Maybe I have I don’t know... it’s hard to explain but she needed me to parent her that way. It wasn’t for an easy life if anything it makes/made life harder.... she had a traumatic birth and I think she really needed me to be there for her so much. It’s truely her personality she’s not trying it on she feels truely anxious and scared in certain situations. It’s hard to explain.

Also, we’ve always got out and about lots socially in terms of music/nature/playgroups and forest school etc... I just didn’t feel that nursery care away from me was productive in fact I genuinely believe it would have been counter productive and made her feel even more insecure and clingy.

there are co-morbidities between ASC and Ehlers-Danlos syndrome. ASC or ASD? I googled ASC but nothing came up...

I also know quite a few families with ASD kids and many many of them have issues with with holding, one recommended the book constipation, withholding and your child (I think that's it I was passing the recommendation between friends of mine who don't know each other - apparently it was helpful on that issue and has a chapter on ASD).

One significant thing they will want to know about is shared attention as a baby/toddler - did she point at things, to draw your attention to them? (different to pointing to something so that you would tell her the name, or get it for her).

Hmmm this is hard to say. I remember thinking at one point that she doesn’t really paint but then she started doing it... we did baby sign language from 6 months and she used it a lot from 7-18 months

When you say draw your attention to them do you mean in conversation? I can’t think of a reason for a baby to point unless they wanted something or to know it’s name

Am I missing something?

She's had massive upheaval maybe she's just lashing out at that? I think surgery and learning depression from you is would be a good thing.

Jesus, no surgery required. Nursery!

Placemarking so I can come back and comment

(Hugs)

DC 1 however, who doesn't have those similarities and was previously fairly easygoing, went into meltdown city for about 6 months after DC 2 arrived, so that could be responsible for the deterioration in behaviour in your DD? Tbh it took about 18 months to calm down and still isn't back to where it was.

Yes obviously this year has been a huge amount of upheaval for her. Moving back to uk from abroad (moved to other country when she was 7 months so it’s all she knew) sobwe left her home/all she knew, moved countries and had a baby, plus we are moving again in a few weeks from our rented house to a bought house which she knows about. So obviously that is a huge amount of upheaval for a young child to cope with

Knox - ASC is Autistic Spectrum Conditions (some people prefer it as it focuses on autism more as a difference than a pathologized disorder).

Shared or joint attention is something that neuro-typical babies do more than autistic babies. It is a kind of triangular attention, where you and the baby are interested in the same thing, and the baby moves their attention between the thing and the adult (and the adult does the same thing with them). So the baby might point at something and look to see if you are looking at it too.

One thing we didn't realise with my daughter was how little she understood facial expressions. When she was tested by the speech and language therapist, she was shown a cartoon picture of a sad face with a blue tear. She said that someone was worried because they'd got paint on their face! Can your DD look at a picture of someone and talk about what they might be feeling?

In terms of your house move and introducing changes, visual representations work really well. Because my DD had no language delay (in fact was well ahead), we assumed that her understanding was as good as her speech. But she is not able to process verbal information particularly well, so visuals work much better. You can make your own books/social stories about things - so take lots of pictures of the new house. Show her which her bedroom will be. Take pictures of the furniture that will be going in there, and stick them on the room (our DD couldn't understand that we would move the furniture from the old house to the new, and thought we were going to be living in a house with bare floors and no beds or sofa!). The more she can rehearse something visually and mentally before it happens, the easier it will be for her. Same with going somewhere new, or a tricky day. If you create a visual timetable - pictures of what is going to happen in the right order - this will help to reduce her anxiety.

Anyway - sorry for the huge post. It sounds like you are doing a fantastic job of understanding and meeting her needs, whether she is autistic or not.

Hi op. I totally understand why you are worrring.
I have an almost 16yr old ds who was diagnosed with ASC ( think the term had just changed when he was diagnosed ) when he was 8yrs 9months.

I knew from around the age of 3 that he was a little different as he was obsessed with Egypt and hieroglyphics and also planes and street sweeper machines! Nursery said not to worry as school would "pick it up" if something wasn't right.

That wasn't the case.
He started reception aged 4yrs 6months and did amazingly well right though the infants, school had zero concerns and I took him to the doctor several times who said that school would definitely notice if there were any concerns. It was so frustrating.

Ds hated loud noises, was extremely organised and all of his toys were perfect and lined up, he had sensory issues, I could go on.

What happened for us was ds got a newly qualified teacher in year 3 who recognised his traits straight away and got the ball rolling. After many visits from the Ed Psych, SALT and trips to Alder Hey ( our local hospital ) he was diagnosed and I was told it would have been classed as Aspergers but they no longer used the term and it was ASC.

Ds is now in year 11, has taken some GCSE's early, is on target to do amazingly well next year and he has a very bright future ahead of him.
He still has many issues which we've taken in our stride and he's spotlessly clean which is a change for a teenage boy!

At his diagnosis meeting the consultant told me this " play on his strengths and work on his weaknesses " and that's what I've always done.

Trust your gut instinct op, best of luck

If the behaviour coincided with the move and the new baby that must have a lot to do with it, although, my husband's cousin too over-parented her children too and all three are clingy whingey nightmares.

I think a nursery is a really good idea for a couple of terms (obviously after Christmas), to prepare her for school. I'd do morning only though. If she's not used to children her own age, she's unlikely to know how to play with them.

One thing, that I actually learn on here, is that for children who can be a little anxious about things is to point of the similarities between things as some people naturally look for differences, which can make things that are done infrequently seem more daunting. For example for the measuring feet - have a look at new shoes on line and remind her last time that she enjoyed new new shoes and there will be some of these to choose from. Remind her what happens and make it into a treat.

Thank you so much for your replies I will read them properly in a minute.... but can I kindly request that this thread doesn’t turn into an over personal negative critique of my parenting.., I know MN can be quite anti-attachment parenting but I honestly believe it’s what my DD has needed. I think pulling away from her or forcing her to go to nursery when she’s going through such emotional upheaval right now will actually make her more clingy and insecure right now. That’s not the way to make insecure children independent.

Also just to add that she isn’t in any way clingy and whingey like you describe. On an average day she is very well behaved, polite and sensible. She just gets genuinely scared almost terrified if she feels like she can’t get to me when she wants to if that makes sense. She’s not overindulged

I think it’s a tough call. I agree with others, talking to health visitors/those with early years expertise etc will be good.
They tend not to diagnose young because they still have so much development to do so you can’t tell if it is a stage or not. However, if you are responding to her needs and treating her in a way that helps, the diagnosis is neither here nor there at this stage (it maybe helpful later on) so I would keep it in mind but continue doing what you are doing and maybe look at parenting advice for children with ASD anyway as it may help

Where is the best place to find parenting advice/strategies for managing ASC behaviour?? Book or website recommendations?