4.5 year old with significant motor skill delays impacting socialization, potty training, etc

[That Is Nice]

I'm hoping some of you in the special needs forum might have some ideas on this.

Thank you.

I have a 4.5 year old boy with diagnosed delays and special needs. He is ADHD and has major sensory processing issues, and significant motor skill delays (both gross and fine). Signficant.

He goes to full time daycare at an excellent facility, but it is not a daycare for special needs children. We did not get into that daycare and I wasn't sure I wanted to take him out of mainstream daycare anyway.

Lately, he's been making very obnoxious sounds and noises - loudly - which is very unnerving and distracting to his schoolmates, his teachers, and us, his parents.

It's repetive noises in a row, loud, and he makes them, I think, when he's over stimulated, over sugared, feeling socially out of place, or in need of proprioceptive input, which we do, but which they do not do at daycare.

The noises and sounds are starting to impact him socially at school, and other kids do not choose to play with him, which makes him amp up the sounds even more for attention perhaps.

Socially at school, he's not doing well.

His ADHD makes it a challenge for him to sit still during group time, not shout out, etc, so he is always getting reminders and removed from the group. His teachers actually do a pretty decent job of working with him and I've discussed all his needs and issues with them, and let them know his diagnoses and what his dev ped, OT, Sp Th have said.

With regard to the motor skills, the significant delays have / are starting to cause social problems. For example, at 4.5 years old he is still not potty trained. It is due to fine motor skills. When he is with me, he tells me he has to pee or poop and I help him with his pants/shorts/underwear/pull on.

At school, he often lets it go and doesn't say anything because he can't pull his elastic waist shorts up and down, and he can't pull the pull on/underwear up and down. His motor skills are that delayed at 4.5. I've noticed he is really starting to get comments from other kids on his delays about potty training and other things (like he's the only kid not able to pedal a bike or to hold a crayon or marker correctly). Many kids in his class are able to now write their names and my child can't even hold the implements correctly. He still uses a fist grasp. We've worked with him on it at length, but the motor skills imply aren't there.

He's been singled out as different now and kids don't want to play with him. Some kids are making fun of him now too.

So, I think he makes those noises to distract from the fact that he peed in his pants again and the teachers have to change his pull on with a group of 4.5 and 5 years old looking at him with disdain.

I'm thinking of putting him in a younger classroom perhaps so that his motor skills aren't quite so delayed.

Thoughts? Thank you for any help

[CarrieMF]

I would take him out of this school entirely. It doesn't sound like the school is doing anything to help his issues, especially the social ones. The kids making comments & making fun of him should have been stopped by the teacher(s) before it got to that point.

[romacox]

It always amazes me the insight mothers have about their own children. You mention several things that indicate you are probably right on target...sugar and stress being among them.

Scientific studies show that stress causes an increase in the toxic hormone (cortisol) which effects the brain. It causes a person's thinking to become impaired, and children, who's brains are still developing, are even less equipped to deal with this condition than adults are.

This hormone can cause many symptoms including ADD, temper tantrums, and other discipline problems. This book shows how diet, and how we deal with our children lowers the cortisol in the brain, and makes a tremendous difference. The book is at the top of the page on this site: http://www.educatorssite.com/

This book should be very helpful. But you may also want to find an educational system that understands what this book explains.

[LynnS6]

I think your son's behavior is saying in many ways that this is not the right environment for him. I know it's hard to come to terms with that, but it sounds to me like he needs a different environment, not the same one with younger kids.

While younger kids are more used to potty accidents, they also have less impulse control (and thus are more likely to say things that make your son feel bad, react badly when your son is verbally stimming because he's overwhelmed), fewer social skills (so your son won't be getting the kind of social skills modeling that he might need), and are less verbal. There's a real chance that because he's bigger, with less impulse control because of the ADHD, that he'll get labeled a bully/problem child and have real issues.

What is his current daycare doing to help him learn fine motor skills? Can he get OT? PT? It sounds like he needs both. Given his delays, he may well be eligible for Head Start.

What other options are available to you? Home day care? Nanny share? Trying the public schools again?

[That Is Nice]

Well, he didn't get in to the special needs school, for one. I've tried for two years. The wait list is long.

I'm tired of paying the application fees for schools. It adds up.

Yep, we did Early Intervention, and he went through OT and speech therapy for about two years until the cost-share program ended.

Our insurance does not cover OT and speech therapy, and he was not delayed enough for the school services, although that may have changed now, I'm not sure. We've had him tested annual, which costs quite a bit, and each time since phasing out of EIS he's been delayed but not enough for the free services.

The pre-school he does go to is very good (and quite pricey) and one of the best in our city. They do a fairly good job with him, but it is not a special needs school and his differences, particularly the verbal stimming and the ADHD behavior, are getting noticed and noted by the other kids. That's going to happen, most likely, in public school, too, so we just need better ways to handle it.

I don't think in-home daycare would be good...he really does need socialization and peer learning.

What I've noticed is that my son does so much better with a little daycare/preschool but I've increased my hours at work due to financial need and my husband's desire for me to work full time, and basically our special needs child gets overwhelmed more and has begun acting out.

[sbgrace]

It really sounds like he needs therapy in a major way and I agree with the others that this environment doesn't sound like the right place for him. Socialization that you're talking about isn't going to be a positive force for him. I'd put him in a private/smaller setting in a heartbeat if I could find one that was a better fit for his needs. One of those needs is that peers aren't looking at him with disdain. Gosh, I wish I could help him.
Now might be a good time to do another school evaluation? I can't imagine that a 4.5 year old with that degree of fine motor issues wouldn't qualify for school services.
Please re-think your ideas about the importance of large peer group situations for special needs kids. This is clearly not having the impact you would like for him.

[cchrissyy]

my boy is a little bit older (7.5) but does similar noises. we're not sure if he can control them or not. He has said that he can't help it - that he can stop for a while but they have to come out. So it could be a tic. However, his teacher had good success for part of the year asking him to "draw the sounds" instead of making them out loud. So try that.

He also has frequent potty accidents, and there has been some social backlash but not as bad as you describe. I definitely put that on the teachers - a class of 4-5 year olds has no business mocking a classmate as an ongoing problem.

I agree totally with whoever said not to use the lower classroom. Younger kids are harder to understand verbally, their play is less developed, they have less social skills to acomodate him, and he could look scary in comparison just by his size and developmental level.

edit: we've been involved in OT through EI, privately, and SpEd and yeah, the motor issues you describe are well within what the school should be giving OT for. If you're blowing you off, fight harder.