son been assessed as having seperation anxiety and attachment disorder, im not so sure[sad]

[brandy77]

I havent been on here for ages, been reading through all the posts and finally out of desperation im posting.

History: 4.5 year old son has medical condition, sort of controlled by tablets/injections. Took 19months to diagnose, numerous hospital investigations.

Has always had controlling, aggressive or loving, clingy behaviour from as far as i can remember, but me and my family put it down to the hormone problems. Nurses thought it was low blood sugar making his mood swings so volatile but blood tests etc were normal.

Cahms intervened to help my son integrate into preschool last September as he was extremely clingy/anxious. Specialist support assistant involved, saw pyschologist, he settled after about 2months and now loves his playschool. Anxiety lessened and shadowing me around the house stopped.

3 months ago the anxiety returned ten fold, hes "scared" of being alone, will not be in a room alone and shadows me around the house. Its terribly frustrating. He wont fall asleep unless im "guarding" him, however tired i am i have to keep my eyes open till hes asleep or he says im not guarding him and he wont be safe. If he wakes he screams that he can hear things (I cant)and that things are getting him,it is a murderous scream.

He doesnt like new places and really plays up and has tantrums and hits me, he plays with his neices and nephews but doesnt seem to understand playing with other children and gets stroppy if he loses a game or something doesnt go his way and he cries and screams and takes it out on me. Its embarassing and frustrating and Im really losing my patience.

I took him to a friends party today and I knew how it would go. He would drag me around to play and not play with his preschool friends unless i really pushed him too. If i speak to anyone he says "im bored" and if i carry on speaking he starts hitting me. We played football, it was a soft play place, but when other children came in the enclosure he throws himself on the floor and cries. I knew this would happen and thats why i dont really take him anywhere.

Hes very blunt speaking (could be age i spose), he has no qualms about saying exactly what he thinks, again embarassing. He has an answer for everything that ive only just noticed over the last few days. What ever i say in conversation he will have an answer, like back chat.

Ive been off work for 2 weeks and got another sick note for next week as its taking its toll. My teenage son says he doesnt even like his little brother .

Anyway im waffling on.....had an assessment with a clinical nurse, where he went for me cause he said he was "bored", scratching, kicking etc. Nurse told him off and he kicked her too, shes referred him back to Gatland House near me which is the CAMHS main house I think. Upto 2months wait, just wondering what will happen next. She said she thinks he has Seperation Anxiety with underlying Attachment Disorder. I had to google this and its awful, she said because of the hospital treatment our bond has been disrupted. Im not so sure.

Playschool love him, they say he is insecure, needs routine or he gets frustrated and needs adult company. The manager is lovely but has herself met my sons aggression on one occasion, she didnt complain and just told me because she thought id want to know as she knows im concerned about him. The clinical nurse said he will be thrown out of school if he attacks a teacher, hes due to start at a tiny school in September.

Thankyou for reading my long winded post

oh and after being extremely stern today and telling him he had to stay in the bathroom while i nipped downstairs (he had a cat with him so apparently the cat will protect him), when i returned 2minutes later he had put the plugs in the plugholes and baracaded the door with himself and the cat scratching post. the plug hole thing has been going on for about a week and putting cushions down "gaps" of the sofa, bed so no one can get him, hes obsessed

I have no idea about separation anxiety but wanted to ensure you that all 4 yr old boys (no experience of girls) go through the back chat thing.

thanks crackfox, glad i havent got the only lippy 4 year old then, thats eased my concerns about that

Hi Brandy, sorry to hear of what a hard time you are having. My DD has a medical condition affecting hormones which means she is steroid dependant and needs hospitals stays and injections, she has a speech delay/disorder and one possible explanation the SALT gave was that she has had such a hard time with nasty procedures and being in hospital a lot. Is his condition well managed now? DD had bad sleep issues when she was on too high a dose and behaviour changes when she went from high to low.

Hi used3bthin, his condition is manageable but with difficulties as i never know when his meds are wearing off we could be out and he starting peeing/drinking for england. Hes missing the hormone that tells the kidneys to hold water in. Ive spoke online to adults about how they feel when their drugs wear off and they only really moan about the sudden urgent need to pee and the extreme thirst that follows. Im glad you have your daughters condition under control now, is she on cortisol as you mention steroids?

My mum thought it was his medical condition but hes been on the drugs for 3 years now and this anxiety and mood change has been on/off since last november. I have got outpatients in london with him next wednesday so will be having chats with the paed about his moods/anxiety but i think because they are endocrine paeds and his bloods were clear they wont be much help

thankyou for your reply

My DD is on hydrocortisone and fludrocortisone, her kidneys don't retain salt and her adrenal glands do't work so she needs hydro to deal with stress and illness etc. Sounds similar. I hope endocrine can help, my DD was getting tired very easily at certain times of day but they have got her on the right dose for now. She is 2.7 though and was diagnosed shortly after birth so it did take a while. We do blood spot profiles to keep track of it so less actual blood tests now thank goodness. Is your Ds condition genetic? I only ask because my DDs is and we have a brilliant support group which I was put in touch with through CLIMB which is a charity for children with inherited metabolic conditions.

Hi there, i dont think my sons condition is genetic, they have taken bloods just to check though. Wow, so your daughter is cortisol deficient. Now that is a worry! My son had a cortisol profile a few weeks ago and apparently his levels are within normal ranges so thank goodness for that. I read a lot about the endocrine problems and have met a few people in london with your daughters deficiences, im glad she was diagnosed so young, her conditon is a lot more serious than my sons. I used to stress about the meds and controlling it all the time, but his anxiety probs have overtaken that now

Yes she hardly produces any, I spent the first year or so in a blur of health issues for her and stress about whether she is ill or just tired etc etc but it has become easier to deal with now I know more about it. Did you meet people at endocrine clinic? Thats great if so, I have met a few people with DDs condition but through the support group. It is hard, always something eh? I am similar in that when I felt a bit better about her health I realised that I was really worried about her speech! Hope you get some practical help on here with his behaviour, it sounds very difficult for you both.

The clinical nurse sounds less that helpful!

Poor you and your ds. DS3 spent one night in hospital, he was not left alone, I was with him all night. He had no tests or procedures (wouldn't let anyone near him) And he took ages to get over that. A really long time, and it did make him clingy. He found it very difficult to handle.

However, he doesn't have attachment disorder or anything, he was just very anxious for a long time after one night and this translated into the sorts of behaviours you describe.

I'd recommend this book, the challenging child - it gives a different way of thinking abut why children can behave in these difficult ways. It did alter the way I thought about ds3, and the whole hospital stay (short though it was) sort of fitted in. He talks a lot about sensitive and anxious children and how that can translate into aggression or difficult behaviour.

lol, yes my son is still saying one week later that he didnt like the clincial nurse cause she was horrible to him, its a shame because he loves staying in hospital as the nurses there are so lovely to him and I never have a problem getting him there! Il have a look at that book saintly, sounds very interesting, thankyou

So...4.5 year old son, controlling, aggressive or loving, clingy behaviour,anxiety, shadowing around the house, "scared" of being alone, will not be in a room alone, obsessed with you guarding him to keep him safe, screams that he can hear things that you can't, doesnt like new places, wants to focus on you and know exactly what you're doing, when other children are in the enclosure throws himself on the floor and cries, very blunt speaking, kicks people, playschool say he is insecure, needs routine or he gets frustrated and needs adult company.

OK, I'm not any sort of general expert, but much of this fits with ASD behaviour.
Just suppose he really can hear things you can't. Our hearing is hypersensitive, and we can hear details you wouldn't believe - people next door or down the street, a dog barking miles off, things rustling in the undergrowth outside, the sound of our own blood rushing in our veins. To you, silence. To us, possibly scary monsters when we're young.

He needs a lot of routine, is obsessive, is very blunt, can't work out appropriate behaviour, can't cope with lots of children unless he knows them well and can predict what they're like, prefers adult company?

I wonder if they'll test for an ASD as part of this?

Large cup of tea needed for you, I think?

That's interesting Amber - I was thinking the same thing about ASD behaviours as I was reading Brandy's posts.

Brandy - you sound exhausted and in need of support yourself.

It sounds like the transition to school is going to be quite difficult for your ds because of the number of new situations and people, which in turn may escalate his behaviour at home. Is he going to a school attached to his nursery?

It will be really important to make his transition a high priority with CAMHS. Whether he has separation anxiety/attachment disorder or not, the nursery, school and you need to be working very closely together (possibly with the behaviour support team as well).

In case you wanted some more info about ASD - I've cut and pasted below from Teachernet. Amber would be able to comment further on this article.

Autistic Spectrum Disorder ? what it means
Autistic Spectrum Disorder (ASD) is a relatively new term that includes the subgroups within the spectrum of autism. There are differences between the subgroups within the spectrum and further work is required on defining the criteria, but all children with an ASD share a triad of impairments in their ability to:

Understand and use non-verbal and verbal communication
Understand social behaviour which affects their ability to interact with children and adults
Think and behave flexibly ? which may be shown in restricted, obsessional or repetitive activities.
Some children with an ASD have a different perception of sounds, sights, smell, touch and taste, which affects their response to these sensations. They may also have unusual sleep and behaviour patterns and behavioural problems. Children of all levels of ability can have an ASD. In recent years there has been an increase in the number of children and young people identified with autistic spectrum disorders.

The core areas affected in ASDs
There are several core areas affected in ASDs:

Non-verbal and verbal communication - Children and young people with an ASD have difficulty in understanding the communication and language of others and also in developing effective communication themselves. Many are delayed in learning to speak and some do not develop speech. Many children with speech have difficulties in using this to communicate effectively. It is likely that they will need to be taught the purpose of communication, a means to communicate (using pictures, photos, gestures, spoken or written words) and how to communicate.

Social understanding and social behaviour - A key characteristic of those with an ASD is their difficulty in understanding the social behaviour of others and in behaving in socially appropriate ways. Other children develop this understanding without being explicitly taught and do so fairly easily. Children with ASDs are very literal thinkers and interpreters of language, failing to understand its social context. For the child with an ASD, other people's opinions may have little or no influence on their behaviour and the child may say and do exactly as they want. Children with an ASD often find it hard to play and communicate effectively with other children who may be confused by their behaviour and may avoid or tease them. Adults who do not know the child or know about autism, may misunderstand the child's behaviour and view it as naughty, difficult or lazy, when, in fact, the child did not understand the situation or task or did not read the adult's intentions or mood correctly.

Thinking and behaving flexibly according to the situation ? Children with an ASD often do not play with toys in a conventional way, but instead spin or flap objects or watch moving parts of toys or machinery for long periods and with intense concentration. Their play tends to be isolated or alongside others rather than with others. Some children develop a special interest in a topic or activity which may be followed to extreme lengths. Any new skills tend to be tied to the situation which means that children with an ASD will need specific help to generalise skills. They will also have difficulty adapting to new situations and often prefer routine to change.

Sensory perception and responses ? From accounts of adults with an ASD, it is evident that some children are over-sensitive or 'under-sensitive' to certain sounds, sights and textures. This has implications for the child's home and school environment and may explain their response to changing clothes or food and their response to noise. In addition, the child may not make appropriate eye contact, looking too briefly or staring at others. In the past, there has been a focus on teaching the child to look when communicating but it may be that some children are unable to talk and look at the person at the same time.

morning amber, well when you put all the symptons together it does sound like ASD doesnt it. I must admit a teacher friend of mine (when at work i actually with special needs pupils), has been telling me she thinks he sounds ASD but then i have my mum telling him hes ok and will sort himself out. Mum is old school, bless her, and thinks these problems go away, she could be right of course but on the other hand.....

Thanks for the info Littlefish, thats easy reading, i find some internet documents such hard going to read. So do i mention this is a possiblity to the pyschologist? or see what they say, im not happy with the attachment disorder diagnosis by the nurse, although she did say that the CAMHS people may well come up with something totally different. A pyschologist went and "observed him from afar" at preschool last december and said "he played with another little boy so he communicates ok" and left it at that. I had told her about his difficulties with other children so thats why she observed him and to witness how he seperated from me, he was okish by then as we had spent 2/3months settling him in and he had formed an excellent trust/friendship with the manager.

Last night was a bad night, he woke every 2 hours, no hearing things last night (doesnt happen every night, just when hes extremely agitated and anxious)and told me i must guard him. If i get up for a wee hes straight out of bed and behind me in a flash, even if he appears to be asleep. I would absolutely hate to live a life full of anxiety about being alone and being scared, it must be truly horrific for him.

Anyway, ive had a star chart going for the aggression and its taken a week for him to get his stars but he got there in the end so we are going to town to spend his reward, hes still in a pushchair so at least he cant lash out at me if things dont go his way,lol. Thank you ever so much for your replies, i should have come back on here months ago really

As a p.s, my nearly 15 year old son is very "anti" his brother and doesnt really like him, because of his behaviour. Ive told my teen off this morning because he tells his brother he doesnt like him, which i can understand from a teens point of view is a valid point to make from living with a demanding, agro child BUT ive also told him this will add to his insecurities...im presuming. I think he should come to these meetings with me and his brother, i am single so its only the 3 of us. I thought it might make my eldest understand more about his brothers problems, does this sound a good idea. He has asked me to find him a support group but i cant find one

I'm glad you found the article useful Brandy - I was in two minds whether to cut and paste it because I didn't want you to think that I was trying to push it onto you. However, sometimes it's easier to have a look and see whether there are any traits you recognise, or whether it doesn't sound like your ds at all.

If there are some traits you recognise, then perhaps you could just say to CAHMS that you've been reading up a bit on both separation anxiety/attachment disorder and ASD and that you recognise that your ds has some of the indicators of ASD (if he does). At least it will open up the conversation.

The difficulty at school is that there is a lower adult/child ratio, so your ds could be in a ratio of 1 adult to 13 children, whereas at nursery, it could be as much as 1 adult to 6 children, meaning that it is easy to give him lots of adult attention at nursery, but far harder at school. I really can't stress enough how important it is to try and get some support/strategies in place for him for the start of the school year, rather than waiting until he is in school, and struggling. Push this with CAMHS as much as you can.

I'm really sorry, but I can't help with the issure of support groups for your older son. It must be very hard for him too.

Thanks littlefish, the school is not attached to the playschool but it is only about 200yards away. It is a tiny church school, i chose it because it only has 12 children in reception (under 80 kids in whole school) plus a support assistant as i was initially concerned about my sons medical condition/tablet taking being monitored BUT that has paled into insignificance now.

The playschool manageress has spoken to the SENCO and are waiting to hear off the specialist support teacher about arranging extra visits at the school for my son to become accustomed to it. Last year i spent the whole summer taking my son to the park where the preschool hall is, in the hope that it would make him more familiar, didnt really work though!

He will have his male cousin in his class and playschool friends but i dont think that will matter, if he doesnt feel in control he will lose it.

I think ive got used to his behaviour, this is the problem, ive got so used to it that it almost seems normal till someone points it out, like the clinical nurse did.

Just another example of his behaviour.... indoor fete arranged at playschool, entered the hall, its all set up different and obviously lots of adults etc. I found it really upsetting and embarassing again, as my son started saying "im bored" immediately and kicking me, managed to seat him opposite me at a table with my mother (who is extremely patient with him)and he continued to kick me under the table screaming full pelt for a solid hour. I wanted to leave but mum said to persevere with the bruised shins! all i kept saying to my mum was "look at all the other kids running around laughing and playing, thats how he should be", i said to mum that it was because the hall looked different. So i think i will mention ASD, even though he doesnt meet all the symptons. Thanks girls.xx

p.s if he does get physical with a teacher and is on the school SEN register, but not statmented, i presume this will protect him against being thrown out. that nurse said that if he hits a teacher he will be excluded immediately

brandy77, if he has a diagnosis, the school have to talk with experts about how to put in place enough help so that he doesn't injure anyone. If he then still assaults a member of staff, they can and will use measures to ensure he can't do it again, which might include safe restraint or exclusion. The safety of staff and pupils has to come first, so a child that is kicking or otherwise hurting others isn't allowed to do so in a school. It doesn't mean it has to be a permanent exclusion, though. They'll try to find ways to help. But if he absolutely can't or won't stop, then exclusion may well happen.

The knack will be finding out what causes him to do it, and working with him to stop it. I think you'd be wise to take all the help and advice you can to stop him as soon as you possibly can. He has to realise that kicking people hurts and is totally unacceptable. If it is an ASD, realising that it hurts someone can be totally beyond their understanding: They just know it makes the person do something if they do it often enough, and that's the 'reward'. Not hurting others is a lesson I had to learn as a young person with an ASD, and in my day that lesson was learned the painful way. There are good modern alternatives to physical punishment, thank goodness.

Not easy for you, least of all with bruised shins from all of this.

Brandy - Amber is right. Being on the SEN register or even having a statement will not protect him from being excluded temporarily. The school should, however, have lots of strategies in place to try and reduce the circumstances in which his aggression occurs. In my school, we have a number of children on part time timetables. I have 3 children in my class who have them. Two of them attend mornings only, and one attends for 2 hours a day. During this time, we implement all our strategies to ensure that their time is successful and meaningful so that their experience of school is positive. We gradually build this attendance up over time so that we can work on the triggers gradually.

Thank you! i thought i was the only one going through this. We have no medical intervention, Camhs gave us a parenting course that made the situation worse not better. GP is accusational and the best result we have had from a CAF meeting was that the school would dea with the situation in 4 months time when he starts in september. He doesn't respond to even the slightest change in routine. loud sudden noises results in hysterics for 30 mins plus and he is very violent in patches. The only thing that i have that works is a sensory box. It has things of different textures and materials, (eg velvety material, cold metal washers, fibre optic light, the bath tub). he is OCD with water and this is turned to our advantage when he gets violent - we stick him in the bath till he calms down. Mostly works.
Try the book "kids in the syndrome mix of ADHD, LD, Asperger's, Toyrette's, Bipolar, and more!" by Martin L. Kutscher ISBN 978-1-84310-811-5. The author says that most kids have certain aspects of many of the orders and gives strategies to tackle species traits. We have found it helpful in reducing some aspects of behaviour.

Dear all, my little one has developed really bad separtion anxiety when I take her to playschool,clinging and saying she doesn't want to go, I literally have to run out of the door. When I go to get her her she is fine and the helpers say she has been fine during the session. She attends two diff playschools and problem same at both. a couple of friends have same problem is it that she has just outgrown it ? Am worried at how she will react when she starts school in Sept, any tips or advice welcome x P.sShe will be 5 in October so one of the older ones at school.
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www.sibs.org.uk/
sibs is an organisation that offer support to the brothers and sisters of children with disabilities - it might interest your older son.

Although separation anxiety is his most dominant symptom, it does sound like there needs to be more work done to ensure the causes are clear. Having any chronic illness is known to have an impact on a child's mental health. Also it does sound like there are some behaviours which could lead to an asd diagnosis. I would write down your concerns as you have here to bring to next appointment with camhs or developmental paed.

Hello.

Some great advice on here (as usual!)

Just wanted to add that my ds1 (poss dx of asd - long story) used to shadow me everywhere and its exhausting I vivdly remember once being stricken with gastroenteritis and having to have ds1 sat on my lap whilst on the loo

Ds1 had lots of hospital appts as a very young baby and infant....I didnt really think that he would remember them and what happened when he was there, but who knows???

Ds1 does not shadow me much now (he is nearly 8) so it is a behaviour that can stop x

Have you tried the Carers Association? I am sure if they have one in your area they have groups for Siblings.

WOW! I posted this 2 years ago and lo and behold, son now 6.5years has been diagnosed with ASD and now on daily growth hormone injections