Social anxiety or something else?

[Lily27]

My DS just turned 6yo doesn’t know how to initiate play with his peers. He has mild CP GMFCS 2) so he can walk but can’t run, jump or play sports. His speech can be difficult to understand but it’s improved quite a bit. He’s in year 1 at mainstream school with 1:1 support. He’s able to access the curriculum and is quite bright but appears socially and emotionally delayed.
I’m struggling to figure out how to help him. He never gets asked on play dates so DH asks other parents if DS can have a play date with their DC. When we take him to the play date DS doesn’t engage with the other child. He parallel plays and talks to the adult parent a bit but not to his peers. He tried to make friends when he started at school with a couple of other boys but couldn’t keep up with their running and football. So they exclude him - it’s heartbreaking….

He plays very appropriately with games eg snakes and ladders at home but not with other children. But he is quite socially unaware eg if a child takes his pencil or sits on his chair or whatever he hits them. School has worked on structured play sessions with 1 or 2 other children and those go well. But he doesn’t follow up when an adult isn’t present. School reports that sometimes children approach him to play and he refuses, preferring to be on his own during break.

My gut feeling is that deep down inside he’s painfully aware of his differences with his NT peers. Somehow he is much more chatty and happy talking to grownups who respond and take the time to understand what he’s saying.

DH thinks he needs lots of play dates. I’m not so sure as they don’t work and leave me feeling uncomfortable. Just not sure how to help my son as he’s missing out on play and the development that comes with it.

Anyone else on here had similar issues? Would a play therapist be helpful? Just don’t know how to help him

Hello.

You say he’s good with structured play and interacting with adults - that’s excellent. Liking your own company & being able to amuse yourself is also a skill. He must be working very hard in school to overcome his physical hurdles (another great sign - kid has guts & perseverance) so wanting some downtime is understandable and healthy. And other kids approaching him to play suggests strongly that he’s liked.

Only suggestion I’d have is to go for more structured playdates (if you want to carry on with them). Maybe a cooperative board game? Or building a lego city?

Hi orinocosfavoritecake thanks for your reply. Those are good suggestions and we will keep trying with the structured play dates and from now on me or DH will play an active role to get him interacting and get the play going. If we leave it up to him he doesn’t do collaborative play with peers.

I guess I am not sure what to make of his reluctance. CP complicates things in terms of interpreting his behaviour. School asks if he could be on the spectrum due to his lack of initiating peer play and joining in. Every now and then he will have a big meltdown about some seemingly small thing. On the other hand he never had any of the more classic markers eg he has never had any difficulties with joint attention eye contact etc. it’s really about how he connects with his peers that’s the problem. I’m inclined to think he is anxious and feels diminished around them because he can’t move or talk like the others. But could it be that he is ASD?

He might be autistic. I don’t know, and at this stage I’m not sure it matters. If he is then knowing he is in future might help him, but right now it’s about ensuring his needs are met.

So - right now he seems to need downtime on his own and for social activities to be more planned than freeflow. Might be autism, might be just him being him.

He doesn’t become a different kid if he gets a diagnosis of autism. He doesn’t suddenly stop growing and learning and acquiring skills. He’s just him with all his strengths and struggles.

Yes I would have thought that a playdate that was shorter and had a clear joint purpose (e.g. making biscuits, building Lego, doing a craft, helping in the garden - even playing a computer game like Minecraft together if you can find something cooperative they would both like to do - like maybe building forts next to each other, or building a zoo together) might be good?

DD was somewhat similar - much happier with adults than other children. She's Y3 now and is pretty social but still doesn't seem to have/need a particular "best friend" - she's happy to hang out with other kids/play football with them/do schoolwork with them - but she's just as happy on her own. It's tricky to get the balance right but I would focus on experiences that you know/have a strong likelihood of being positive/fun for him (even if that means socialising with another adult for now, or with a peer in a very structured way), and give plenty of downtime.

FWIW DD didn't have any obvious problems with joint attention with us (she did have less contact with other adults, and little with peers). Eye contact can be a bit overrated anyway. On one hand, it feels helpful to see your child looking at you when you talk to them so you "know" they are listening. On the other hand, DD (autistic) often is listening even when she's not looking at us - while DS (NT) can look you right in the face and then it turns out he clearly hasn't absorbed a single thing you've said (either that or just completely ignores it). So I suspect the focus on eye contact is more about what we're used to than how useful it actually is for practical purposes!

In your DS's case I think it's hard to untangle from the CP as you say - there may be other reasons why he's less likely to initiate as you suggest. OTOH our friends with a very social child with mild CP also got an autism diagnosis when she was older as she had enough traits that an autism Dx was also appropriate.

As orinoco said, it's worth exploring. Either way some help/scaffolding for him to experience that social interactions can actually be fun and useful sounds useful (and either way plenty of down time to recharge his batteries also sounds useful!)

It takes 2/3 years to get an autism diagnosis btw.

Thanks, orinocosfavoritecake, LightTripper. Your suggestions are very helpful and as OP says, getting a diagnosis would take ages. The school isn't pushing for one, there are just wondering if it could be the case. We met the school yesterday and we said that he has always had a great deal of social interaction, back and forth, appropriate play with toys and games etc., but does all that by himself or with adults but avoids peers. at the same time he loves being around other children. what the school says is that he doesn't seem to pay attention to what the other child is thinking - e.g. in snakes and ladders, does he take note of where the other person is relative to where he is on the board? I don't know -- does any six year old??
I'm feeling quite confused. and don't know how worried I should be. I can't help thinking that if my DS has autism, then who doesn't?
Of course at this stage the solutions are as you both say - lots of structured play to encourage joint peer play whatever the root cause of his difficulty is - autism, social anxiety or developmental delay
LightTripper, how is DD doing now?

She is doing very well! She really enjoys school - especially science and (to our complete surprise) PE. She definitely does things a bit differently: I suspect the other girls are making their little cliques/friendship groups (they are in Year 3) and DD seems quite happy to be on her own or just playing with a group - but she is friendly with lots of the kids and has a bestie from her old school that she gets on well with most of the time.

Our main problem is anxiety: new things in particular, or just when she gets tired. There are some things she is particularly sensitive to (having her photo taken, performances, certain loud noises or strong smells). She can manage and even enjoy new things, but she worries a lot in advance and it takes a lot out of her. She can get quite fixed on certain topics or objects - she finds it quite tricky to move from one task/thing to the next, so we need to give plenty of warning. She hates not finishing what she's started, so we need to leave extra time for things like homework (and similarly at school they give her count-downs to when she needs to finish, and opportunities to finish work later if she needs to).

But generally she is a very funny, kind, interesting kid having a good time in the world!

I think for us it seemed worth having a Dx just for DD's information (so she knows she's not being "too" sensitive or weak if she finds something overwhelming) - and also because I know a lot of autistic kids aren't diagnosed until the wheels come off in teenage years (when school and the social world both get more complicated) - so we wanted her to know what was going on and feel confident in herself as a good basis for dealing with whatever may come down the track later on. Only time will tell if that was the right thing or not! Certainly for now she seems happy to know she is autistic and it makes sense to her.

I was initially very resistant to the idea that she might be autistic - but the more I read (particularly input from autistic adults) the more I realised I was probably autistic myself - and therefore saw her traits as just "normal" and assumed they were things that everybody did/felt/experienced, when actually it became clear through the Dx process that wasn't the case!

That sounds wonderful, glad she is doing so well. Thanks for sharing...