Friday, September 14, 2007

A little help from my (bloggy) friends

Some of you have experience with this sort of thing, so I'll just throw it out here. What could be going on with a 2-year old child who presents with the following issues?

--fear of children in same age group; extreme fear of roughhousing or boisterous play
--high-pitched keening, crying, and shaking when distressed
--extreme sensitivity to and fear of loud noises
--tremendous separation anxiety from caregiver
--these problems come and go randomly as far as I can tell. I bet there's a trigger somewhere, but it's not blatant
--he used to have an obsession with lights and light switches and he used to flap his hands, but those behaviors have gone away

This little boy is fine when he's in my arms or in a back carrier, but that's not feasible when there are 4 other children to care for. His pediatrician says he looks great and dismissed his mother's concerns with the statement that "all 2-year olds are fearful and anxious from time to time." She's pressing the pediatrician on it again today after I had to call her for an early pickup; clearly he's not okay as he cried and shook every time one of the other kids looked at him.

This little boy is a wonderful kid and I want to care for him appropriately, but I can't figure out what's going on with him. Two coping strategies work fairly well some of the time: making him a cozy nest where he can observe, but not interact with, the other children, and helping him remember to cover his ears when loud noises occur. His mom gives him a pacifier and a lovey when things get tough, and they work sometimes as well.

I used to think this little one had Asperger's, but he doesn't have the hallmarks of that syndrome. Perhaps he has a different autism spectrum disorder. I have a call in to Early Intervention for him, so we'll see what happens on that front. In the meantime, if you recognize this child's behaviors as anything more than a random cluster of behaviors, would you please email me? Thanks. I really appreciate your help.



Anonymous Jenny PP said...

I wish I knew something. Poor little guy! I'm glad you and his mom are working on figuring it out. Good luck!

2:24 PM  
Blogger Shirky said...

hm, i was with you until you said it comes and goes. i happen to know a very sensitive and anxious child who acts that way...but all the time. I hope the doctor looks closer or finds another one who can. maybe a little video of the kid so the doctor doesn't think mom is exaggerating.

2:34 PM  
Blogger Gawdess said...

Sounds like my son, to a T.
He was dx'd with Aspergers Syndrome. But that doesn't mean that it is the right thing for your guy, but what might be good is simply to read up on the how to deal with the AS stuff.
It helped us a bunch. Picking up some of the books and getting a sense of what might be going on for my kid that I just couldn't figure out on my own.
I would email but I can't figure out what your's is.

3:29 PM  
Blogger Abigail said...

Honestly, many of my clients with autism fit these symptoms Clementine. That was my first thought- it's hard to get a full sense of him from a description, obviously, but a lot you are saying fits the autism spectrum- either Aspergers, autism, or PDD_NOS (Pervasive Developmental Disorder- not otherwise specified)-- which ends up showing a lot of symptoms on the spectrum, but not enough to classify as "autism".

However, another possibility when I take a step back could be a general Sensory Integration Dysfunction (SID). There is a list of symptoms here:

I also wanted to mention that most of my clients have had the experience that pediatricians had no idea what was wrong with their child and, in fact, told them things like, "he's just a late talker", or "he's just getting used to things"...etc. A developmental psychologist (particularly if they specialize in autism spectrum) would be qualified to diagnose, if that is in fact the issue.

I don't want to make it sound like he definitely does have one of these issues of course- I really have no idea, I just know that all of those symptoms could fit the spectrum, like gawdess mentioned, or maybe SID.

Good luck Clementine. He's lucky to have a caretaker who really cares.

10:39 AM  
Blogger Psycho Kitty said...

I was going to suggest SID, primarily because of the noise reactions. But you know I have extensive personal theories based around my Boy. I think some kids are hyper-sensitive, so their triggers and behaviors can come and go. But if I was the mom, I'd push for a good pediatric OT evaluation with an eye to SID and possible PDD_NOS.

11:27 AM  
Blogger lo said...

I'm with PDD NOS SID too.
Often these children remain 'undiagnosed' or misdiagnosed for several years. I have several students with Aspergers (highly intelligent) who were originally diagnosed with Austism before getting to SID and vice verse. It's definitely tricky but getting the right professional assessmentS is key.
Good luck

6:03 PM  
Blogger frog said...

Yep, my money's on SID of some degree.

7:28 PM  

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