what could this be?

[jnpsmommy]

My son is 6 years old and in grade 1. I have known since he was 2 years old, maybe even younger, that he was "different" from other kids his age. Due to diferences of opinion between my hubby and I ( aka my hubby being in total denial that anything is wrong) we have just recently been in the process of trying to get him an evaluation. Lots of loooong waiting lists Some of the things we have noticed are a lot of sensory difficulties, cries over the slightest things, gets very upset by any change, especially if he isnt given prior time to get used to the change, wants desperately to make friends but dioesnt seem to know how and rather does irritating in your face things to get other kids attention, takes EVERYTHING literal, has a hard time controlling his emotions, is very irritible and quick to anger, has some odd interests, the latest being collecting capacitors from electronics  There are many more, but I could type all day.

The school occupational therapist recently wrote up a report based on the teacher and social workers observations and here is what it says:

J is in grade 1. When he first arrived in fall he presented with lots of anxiety but over the last couple months he has settled into routines. Of note during my observations he almost always is making noise at the carpet and when working at his desk.

J scored in the definite difference or much more than others in areas of auditory processing, movement processing and touch processing. Several concerns related to these areas of sensory processing include:

He appears unaware of what is going on around him and almost always misses oral direction.

In the area of movement processing he frequently rests his head, slouches and bumps into people or objects.

In the area of touch processing he is constantly fiddling with objects or touching people to the point of irritating others.

Registration- J scored much more than others in the area of registering sensory information. This means that he misses sensory input. Students who have difficulty with registration tend to appear uninterested, seem to have low energy levels and act as if they are overly tired all the time. They are often missing cues about what is going on.Sensory avoiders - He also scored in the more than others range in the area of avoiding sensory input. Behavior consistent with avoiding behavior is the child actively keeps sensory input away. They notice and are bothered by things more than others. He may at times isolate himself. Avoiders try to create ritual in their daily lives.

Overall J presents with difficulties related to school factor 4. He is both avoiding and not registering sensory input. Children with this sensory profile actively withdraw from being overwhelmed. With a registration pattern the student is failing to detect salient stimuli needed to participate in learning. At times they appear disinterested. J may need more input so he can notice what is going on. When he is overwhelmed he will need less sensory input so he can concentrate.

The noises j makes are generally not words. These noises are not disruptive to the class but are constant. I would discuss this with his physician.

I know that was a mouthful but if any of this sounds familiar to your childs diagnosis please help me out. I am pulling my hair out here and just want to know what is going on with my son!

thanks

[Emmeline II]

Yes, a lot of that is familiar. We just got the results of ds' evaluation with a developmental ped team at Center of Hope for Child Development.

These are the therapy referrals.

1.      Speech therapy with attention to pragmatics.

2.      Continue CBT (cognitive behavioral therapy) to address anxiety and behavior.

3.      CAPD evaluation (by audiologist to evaluate his problems with auditory processing).

4.      OT to address sensory concerns.

Ds also sees a psychiatrist who is treating his ADHD and we plan to bring up starting Intuitive to control his tics which are fairly significant (and predate his ADHD medication).

He appears unaware of what is going on around him and almost always misses oral direction.

This may be due to CAPD.

The noises would likely be identified as verbal tics.

If you are not already on a list to see a developmental pediatrician I would get on one. These are the people and areas ds was tested in:

MD                           Medical/physical

MA CCC-SLP            Speech/Language

PhD                          Cognitive/achievement

LMSW                      Psychosocial/adaptive

Quote:

The results (as transcribed from the Dr.’s teeny tiny handwriting)

1.      Average to high average ability (performance IQ – TONI 3 =117 > verbal SIT-R 94).

2.      Achievement commiserate with ability (WIAT II – word reading =140, reading comprehension =121, spelling =130, numerical operations =102).

One score somewhere was abnormally low; I think it was part of the verbal SIT-R, a section with “strange stories” where you identify what someone is feeling knowing that the feeling is not what they said (like a person who hates apple pies saying “thank you, it’s just what I wanted” when given an apple pie—why would they say that? because they didn’t want to hurt the giver’s feelings).

3.      Mild to moderate pragmatic language disorder.

4.      Social developmental delay; in part due to ADHD.

5.      ADHD combined.

6.      Disruptive behavior.

7.      Anxiety (performance and social anxiety)

8.      Chronic motor/vocal tics

9.      Possible CAPD.

10.    Hyperacusis/sensory concerns.

Therapy Referrals

1.      Speech therapy with attention to pragmatics.

2.      Continue CBT (cognitive behavioral therapy) to address anxiety and behavior.

3.      CAPD evaluation (by audiologist).

4.      OT to address sensory concerns.

Regarding Asperger’s, the Dr. said that he appears to meet the criteria but that he was a little young for diagnosis and that the ADHD complicates the picture (she went into a lot more detail than that; apparently the diagnostic team spent a lot of time debating this point). We will reevaluate in a year – added maturity and addressing some of his other issues may give us a clearer picture. The appointment took about 2 hrs.

[sbgrace]

Well, it sounds to me as if they are saying he is a sensory seeker in the proprioceptive and other areas. He's seeking input. They are saying he shows signs of a sensory processing disorder.

I think you've got markers for spectrum stuff based on your description honestly. You might try this and see if he scores in the possible range. If he does I'd seek a professional assessment. (he may not of course!) http://www.childbrain.com/pddassess.html

I also like this link because it puts the criteria in real world language with examples (note: not all categories in the right configuration would be met for a PDD-NOS dx--but you would have them in some form.)

It could just be sensory issues too of course.

[kme]

A lot of this sounds familiar to me.  I would definitely get him evaluated by a developmental pediatrcian, neuropsych or someone with knowledge of sensory/spectrum issues.  Several of your observations raise red flags for a spectrum diagnosis.  A lot of it sounds very sensory which may or may not go along with a spectrum diagnosis.  Whatever the diagnosis, there are therapies (like OT in particular) that can help.  Good luck!!