DS (aged 2) behaviour issues - now being referred to psych

[OatcakeCravings]

I wrote a while back about my son who has behavioural issues and was being referred to a paed - www.mumsnet.com/Talk/special_needs/970927-DS-2-behaviour-issues-being-referred-to-a-paediatrician you don't want to read this it's too long! Crux of the matter is that he is a very aggressive toddler (been like this from the get go) and hits, scratches, throws things at, and pulls hair of other kids and adults (but less so).

Anyway we saw a paed who has ruled out Autism, Aspergers and ADHD which is great but still leaves me with his behaviour, so the paed has referred DS for a psych assessment, initially it will be a one hour assessemnt but may lead to a full week with a multi-disciplinary team.

I really now feel that I don't know what to do. there is a 4 month wait for the initial assessment and DS behaviour is not improving - though it hasn't got any worse over the last few weeks. Does anyone know what might be wrong? If I had an inkling of what the problem might be I could read up about it and at least feel that I was getting somewhere.

Thanks to everyone for 'listening' again. I dont know of anyone in RL who has a child like mine!

Hi there,

She quite specifically said not autism etc. We were in her office for a good hour and she said that he was very bright, has very good imaginative play, excellent language development - he has 4-5 word sentences and is 2.2, prolonged eye contact, can follow instructions, can count to 10, knows all his colours and shapes etc. She said that it was just his behaviour that was a concern and because of this she was refering him for a psych assessment.

No just a normal paed.

However I have been mulling this over since your first post and maybe she didn't rule out autism, she definately said it wasn't aspergers or adhd which the HV thought it might be but she definately didn't say that it could be autism she just said his agressive behaviour was a concern and she would refere to psych.

I guess I should do some reading on autism - I thought that autism had a speech delay and poor eye contact and delayed pointing and things which my son doesn't have.

HI Oatcake, I would push for the multi disciplinary assessment mie thye can be very good at getting to the crux of a problem.
In the meantime cna your local surestart centre offer any support or advice regarding specific strategies that may offer some help until you find out whats going on.
Without understanding the triggers for behaviour its difficult to offer solutions.

I think two years old is a very young age for a Paed to be categorically ruling things out.

I do sympathise - my DS was a bright but aggressive toddler and it was exhausting and confusing knowing how best to deal with him. He was diagnosed with Asperger's earlier this year (he is 5). I am not for a moment diagnosing your child, btw! It really does sound like a multi-disciplinary assessment is the way to go here.

FYI - Asperger's is an autistic spectrum condition. AS children have average or, in many cases, above average intelligence and (crucially) no significant speech delay. They can often appear simply as 'difficult' in toddlerhood, before it is really clear what is going on - sometimes aggressive and domineering (or in other cases, the total opposite: aloof and introverted). Anxiety and control are generally big issues for AS children. Social situations can provoke anxiety in them, and they seek to control their environment in order to reduce that stress - sometimes by hitting out and dominating, or for other children, by retreating into their shells and avoiding social situations.

Paeds are often wary of diagnosing AS early on (and usually, wary of ruling it out!).
It can be tricky to properly identify until later on, when social situations (ie. school) really highlight the social communication issues AS children invariably have.

Good luck and hope you get an appointment soon. keep in mind that if you things get too hard, a bit of badgering (emails, phonecalls) can sometimes bump you up the waiting list, in my experience

Hey, My child is POSSIBLE aspergers and he is very bright with good imaginative play...it just became evident as e grew older that although his imagination was excellent, he couldn't distinguish between make believe and reality...he thought he was actually a lion and doesnt understand why you shout at him for bitig 'but it was the lion mummy not me'

hi so sorry you are having a bad time

i dont know your son personlly but in your mind dont rule out autism.
when ds1 was nearly 3 his paed rulled out autism and we went through the multi disaplinary asessmaent and 6 months later they diagnosed ds1 with autism.

untill he has been assessed dont rule it out as we were set for a fall, trusted what the paed said so when diagnosed with ASD was a wreck.

also bear in mind we have just had ds2 diagnosed he was 3 in june he was diagnosed in march but they actually said they didnt feel comfy putting a label on him as he was inder 3. I on the otherhand gave them a bollocking and pointed out what else can it be ds1 is autistic they are sublings and has all the traits.

so it might be as well to do with his age.

It really sucks they have us jumping through all these hoops for feck all

siblings not sublings

and to make it clear they agreed with me and gave ds2 his diagnosis

does your son like books? I bought a few good behaiour books to help mine... 'hands are not for hitting' and 'feet are not for kicking'are good for toddlers. 'how do dinosaurs go to school' bt thats for older children. Carol Grey does some good social stories for children on the autistic spectrum

I read your other post and was reminded of my son at 2 ( except ds had no language and had clear delays) . Now with the benefit of hindsight I can see that he could not (still cannot) see things from another point of view or understand others emotions or had the social imagination to think things through. He did not understand that hitting another hurt (afterall it did not hurt him). He also had very poor understanding of facial expressions and noises others make ( the difference between happy and hurt sounds and faces!).
It is clear now that my son has sensory issues - liking pressure/ whirling/ speed constant movement.
I was also told by the paed that my busy interested eye contacting child who never sat still could not have autism or ADHD. He made eye contact (stared you out!) - he wants to interact(hit the paed) ! How could he have asd?
Once he got to see the psych team he got a dx of ADHD and severe asd and LD. I am not saying your bright chatty child is the same - of course he is different but they should be looking at everything incase there is a sutle difference. Perhaps he has sensory issues, perhaps social understanding issues I don't know, but these may be areas to read up on.
I slowly taught my son to understand by using exagerated body and facial movements to show cross, sad, happy. Making a fuss of injuries. I espect you do the same.
You have my sympathy! it is mortifying to have your prescious child hurt another.