Normal naughtiness, sensory issues, something else?

[systemsaddict]

Hi, I posted this in behaviour and a couple of people advised I try it in SN as well, thanks oddgirl, coppertop. I'm concerned about my son, who started Reception in September just turned 4. We've struggled with his behaviour at home for a long time but starting school seems to have made it a lot worse. I don't know if it's normal exhaustion / immaturity, or whether assessment from a health professional is in order and if it is, how to start that process. Teacher is clearly very frustrated with his lack of co-operation.

The main issue is that he is incredibly resistant to most everyday activities, including:

• getting dressed, every item of clothing causes a battle / running away / hiding behind the sofa;
• going to the loo, he always holds on till too late, has wet pants, refuses to go if I suggest it, and we have only just cracked poos in the potty with the help of Lactulose and long potty-sits after breakfast and dinner;
• sitting at the dinner table;
• eating a lot of foods, particularly anything at all that is mixed or at all slimy in texture;
• getting into the bath, and then, once he's in, getting out of the bath;
• having cream on his eczema;
• pretty much doing anything when he's asked to.

At school, he doesn't line up outside school, or sit quietly on the carpet for the little time they have to, or do anything he is asked to without being constantly pushed. He's bright, reading already and working at the top of the class apparently, despite being the youngest. The teacher didn't seem to think this was such a good thing though, it seemed more that it highlighted his behaviour. OK working one-to-one at school but can't work in groups.

He alternates between being incredibly silly and being incredibly frustrated, at which point he gets really worked up, lashes out, scratches us, kicks, screams, sulks, and can get really hysterical - sobbing on the floor in a foetal position. He gets SO angry. The only way I can get him to do anything is to threaten to delete his favourite TV, Sarah Jane Adventures or Dr Who, about 500 times a day. Home life is a constant battle. He can get really worked up if I try and talk or get him to talk, and shouts furiously 'Stop it with all those words mummy!!'

As a baby, he was very quiet, still and observant - much more so than the other babies his age - but could also get very worked up, especially if tired, when he would bite and headbang. Needs loads of sleep. Has always hated getting dressed / undressed, screamed and fought for every nappy change, bath, cream. Walked late, potty trained late, talked early. Has had some strange phobias - sloped streets, hand driers. Absolutely has to win at every game or there is a very dramatic meltdown. Is affectionate, makes eye contact. Sometimes can't bear to be touched, other times he's all over me and completely over-the-top in my space. Spends half his life hanging upside-down.

Sorry this is so long! Does this sound like normal not adjusting to school very well, or does it warrant further exploration - and if so how? SIL is a paediatric occupational therapist and has suggested we get him assessed for sensory processing issues, but I wouldn't even know where to start in doing that, or whether she's just seeing that because, well, it's what she's trained in.

THanks ohmeohmy - I was wondering has your son's dx helped, have you had support working out strategies to support him? My SIL lent me the Out-of-Sync child and yes it was all very familiar! (and also made me realise I was extremely dyspraxic as a child), and it did really help to start thinking of things more in sensory terms; but I struggled to go from that to working out sensory activities for him that would be helpful, there seemed to be so many different options and I got a bit lost.

It has helped me to deal with the more 'odd' or challenging behaviours by enabling me to understand him better and so differentiate between normal naughty and sensory issues. It also means I can advocate for him and suggest things for the teachers if he's having difficulties at school. Because SPD is so complex it is really helpful to have expert input. We are currently having lots of assessments at the neurodisability clinic at Gt Ormond St and the team of paediatrician/Occupational therapist ad speech therapist were working hard to figure him out so it's definitely not easy and I have definitely not sussed it out completely yet!

There is a companion book called The Out of SYnc Child Has Fun which contains all sorts of games and activities grouped by sense and whether they need more or less stimulation in that area.

Looking back at your OP the toileting is something that we have had difficulties with: we were told that massaging around the buttocks and thighs either deep pressure/squeezing (or with a hand held massager that vibrates) can help 'wake up' the sense that the bladder is full.

The OT I heard talk recently said always give them more of what they crave rather than trying to make them stop. And if you do that the effect lasts for a few hours. So if he needs to hang, do it lots, make a tent or cosy corner they can go on their own when they don't want people near them, move'n'sit cushions (Can get them on line or TKMaxx often have them- basically rubber cushion filled with air) means they can stay in one spot but still feel like they are moving so are getting the sesnor feedback they need.

The lining up at school seems like it is not wanting to be touched. There are clothes without seams you can get- can't remember the website but they tend to be for kids with excema so google about and you might find them.

Forcing him to do things that make him feel stressed will make everything worse. I am not an expert but would recommend you get him assessed. It is dealing with all this sensory overload all day everyday that is making him tired. You're on the right path, trust your instincts, continue trying to understand him and you will help him.
Sorry gone on a bit. PM me if you like. Happy to chat anytime

Thanks so much, that's really helpful! It gives me some very concrete information to go on.

You're right that pushing him when he's already stressed only makes everything worse. Both me and his teacher have eased off a bit the past couple of weeks and he is already much happier and easier to deal with.

On the lining up I am now staying with him till they go in, which helps - he managed to stay in line the other day by banging his head into my leg repeatedly and licking me, but at least he did it! - or by arriving just after they go in and joining them through another entrance that they can use if they miss the line. I do feel uncomfortable about doing this but it makes the start of his school day much easier. I guess this is the sort of thing that having an official dx will really help with, if there is a reason to adopt particular strategies rather than just being slack on him if you see what I mean.

You know I hadn't even realised he might not be feeling the bladder fullness properly, was just frustrated that he always leaves it till beyond the absolute last minute!

And I will stop getting annoyed that my living room is constantly trashed as he always throws the sofa cushions off so he can hang off the back like a bat and instead see it as a creative way of getting the sensory input he needs!

If it helps, i have a sideline making clothes for kids with SN. So far I've done elastic soft-waist school trousers, trousers and leggings with extra room for nappies and a weighted vest. I do it because it's fun, and make a fairly minimal profit which keeps the costs down. Message me if you want anything made :)

good to know purplepidjin

Leningrad - thank you - yes - all of it. I have come across this recently in my search to make sense of this and every single diagnostic criterion fits him like a glove (where other ASD criteria don't, really).

But, I am really trying hard not to self-diagnose him with this; partly because I don't know how severe these behaviours need to be to 'count'; partly because I am scared of pissing off the health professionals by coming in and saying "I think he has this", if you see what I mean. Especially since it doesn't seem to be a completely accepted diagnosis.

Strategically I don't know what is best. He starts the assessment process next week with a home visit.

Have you got experience of this? Do you have any thoughts about how it would be best to broach this with the child development team, or whether it's best just to focus on his behaviours and let them make sense of them?

Just seen your other thread on this LG, will try and read through it tonight as a few of the things (like that he can't bear being spoken about) really sound very similar. Would be good to keep in touch.

In case anyone remembers this thread from way back, an update: just seen the paediatrician, who feels he definitely has sensory issues which would benefit from sensory integration therapy, and which are making school difficult for him, exacerbated by being one of the youngest in the school, and no associated ASD or ADHD.

However, sensory integration on its own is no longer funded in our area ... if he did have other issues we could see an OT, but as it is they can't even give us informal advice about it.

Still, in the perspective of everything Riven and others have been going through, this is relatively minor. At least I know a) I wasn't going mad, there was an underlying issue, b) I can go off and research what we can do to help him, and c) we have a professional dx that I can use in working with school to find ways to make things easier for him.

She was quite encouraging though, said since he is so bright this is all likely to improve as he gets older as he will work out his own coping strategies.

Thanks Leonie, yes I know the SLS is in aqueous cream which is much better used just for washing, but other emollients don't have it and are supposed to be left on (we used Diprobase successfully in the end) - can you tell we spent many months exploring the different emollient options? fortunately he is doing better now), the resistance is to all creams even Vaseline around his lips (which is all he really needs at the moment, but refuses!)

yes I don't think my GP told us either! some are not so clued up on this. I found out through the National Eczema Society info which was really good - I do recommend them!