Should I seek a second opinion?

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You've already gotten some terrific advice. I'll just add that what stands out to me about your posts is that your gut is telling you there is something going on with your child. It may be hard to explain/define, but you, as a Mom, just know. That is absolutely what I experienced with my daughter. It took over a year and a variety of evaluations before we got an aspergers diagnosis. And even that dx was not a perfect fit. Every child is so different, and many don't fit neatly into any particular category. I had a neuropsychologist at a large well respected university tell me my child could not be on the spectrum because, "she does not talk about vacuum cleaners and fans all the time". I also got the suggestion of parenting classes for dealing with strong willed children. I kept trying to explain, but no one "got it".

Your son is still so young...when he enters preschool issues may become clearer. I had teachers pulling me aside almost every day to report what my daughter had or had not done. "We've never seen anything like her" they told me. If your son is still displaying the issues you describe in preschool, then you will get feedback and comments from teachers that can be helpful to pass on to any professional who may be evaluating your child. It certainly helped with my daughter. It wasn't just me the stay at home mom sounding alarm bells, it was teachers who had worked with many young children seeing issues too.

I wish you the best of luck and hope you can find the answers and help you need. Sometimes it just takes a while (longer than an anxious mom wants it to). It's a journey. Your son is lucky to have you!

Thanks so much for sharing your story. One of the things that was suggested to me by the psychologists was to place him in daycare/preschool as a way to "test" that the evidence that I'm giving them is actually happening across the board. This is where I get seriously wary... and perhaps I'm just seeing it in an overprotective way and I'd love for you to give me your perspective (I'm not trying to criticize or judge you at all, rather to express a real concern I personally had with this suggestion when made to me by the psychologists): I have a child who has made it clear across the board through countless interactions with other toddlers (cousins, the park, the library, our attempt at watching a little girl, mall and doctor play areas, etc.) that something does not work for him regarding other small children. He is not yet old enough to articulate why he behaves the way he does around them. As a parent, is it ethical, then, for me to place him in a situation where I can reasonably assume he will "fail", just for observational purposes? I don't know what happens inside him, but if other small children cause him stress/anxiety/sensory issues/etc., especially when I know that his most successful interactions with other children are with one child at a time, how can that be good for him day in and day out, when even in his own home, like I said, he is "happy" but not "content"? Knowing him and what works and doesn't work for him, it seems unfair to me to subject him to a situation where he could easily begin to identify himself, consciously or not, as a "bad" kid. He is an extraordinary pattern matcher, and if he is able to realize over time, "I get put in time out all the time and other kids don't. I make other kids cry. The teacher gets frustrated with me", etc., that's giving him a whole lot of information about himself in a time where he is just in the process of getting to know/building his own identity. I don't know... My brothers and my father were all difficult kids with their own mental health issues and being able to self-identify as that from a very early age only contributed to further problems with them until they became adults and realized that they had no choice but to be in control of their own destinies. I worry a lot that it's a very slippery slope. This is why I just wish the psychologist would take me, my husband, and my parents' anecdotal evidence more seriously. My mother is actually a Behavior Disorder teacher at the high school level with a Bachelor's in Psychology and a Master's in Special Education and she wholeheartedly thinks my son needs to be home with his family who understands (or is dedicated to learning how to) him and has the time and energy to learn how to raise him best. The idea of the alternative scares all four of us, honestly...

Last edited by sarag1989 on 25 Sep 2016, 5:06 pm, edited 1 time in total.

The thing that confuses me, though, is that it's not an angry aggression. It's an obsessive, reactionary, knee-jerk aggression. He always has a straight face and doesn't seem to do it ever out of a desire to harm, but rather to defend his own self. Or a sensory, always needing to touch others thing. Any ideas about that?

Actually, I have gotten the same message from the current psychologist, something along the lines of "he's not sitting around obsessing over washing machines and staring and his fingers as he drums them." My question, then, is, well, what if he's sprinting around while obsessing over that one Doc Martin character from three weeks ago who had a boat? Or about gorillas? Or wanting me to repeat in both English and Spanish all day long the exact same sequence of instructions for not biting the neighbor toddler's belly button? I guess I get confused as to where the line is drawn.

It's good to hear that others have been in a similar position to me. So, if you don't mind me asking, how did you learn to best support your daughter at home, as a parent?

Some thoughts for you. I get where you are coming from in terms of the fear of putting your son in an environment like preschool where he may struggle and come to feel like a "bad kid". Also, I get the ethics of - should we put him somewhere that he might hurt, bite, kick, other children as a kind of experiment as to how things will go. There is no easy answer. If you choose to put him in school it might trigger services and evaluations within the school system. This might in turn lead to school provided therapies or even a smaller special needs preschool where your son could get extra help and thrive. So I guess the question is, do you want to enter that system? It sounded like you were having your evaluation done privately. We never went into the public school system (just a personal choice and no judgement meant for anyone who chooses that route). We ended up doing speech and occupational therapy privately. As well as a social skills play group and working with a psychologist who specialized in helping children on the spectrum. I know not everyone wants to or can seek out and pay for their own therapies. We were very lucky to live in an area at the time our daughter was diagnosed that had lots of amazing services available. And we were doubly lucky to be able to afford them. You know your child best. If you think keeping him at home is the best thing to do, then that's okay. But unless you plan to homeschool you will eventually have to deal with how he behaves in a classroom setting. Maybe if you hold him out of school and give him more time he will mature and not have the problems you are seeing now. It's just so hard to know!

For our daughter preschool did help in confirming there were issues and help get a diagnosis that at least gave us a roadmap and general ideas of what to do to help her. One example; school showed her small motor problems with holding pencils, using scissors, etc. This led us to occupational therapy and an eventual diagnosis of dysgraphia. Anyway, I hope some of this helped a bit. I'm sure your son is a wonderful little boy. It's clear how much you love him. I totally remember the fear and panic of knowing there was something happening with my child and not understanding it or knowing how to help. It is tough! Again, sending all the best to you and your family.

Thank you, thank you, thank you I will muse on all of this. (As a side note, yes, I did plan on homeschooling all of my children. I know everyone has their opinions on this, but that aside: I would be seeking out therapy where I could be present and learning along with him. So, I'm assuming, private.)

I support homeschooling. Rather than bury students in a daily avalanche of paper instructions, educators should be having conversations with them. Homeschooled students have improved IQs.

Just saw your question of what we did - here's a (partial) list. Obviously, you'd tailor it to your own child and their needs. 1. Occupational therapy to address sensory issues and dysgraphia. Handwriting Without Tears program used (and, oh, there were still tears!). 2. Speech therapy - working on back and forth conversation, how to approach other children, ask to join play, etc. Use of "social stories" - to explain social situations. 3. Created an obstacle course in our garage. The OT recommended it to help our daughter regulate herself. She would do a specific sequence of actions - like jump on trampoline, walk a balance beam, throw a ball, you get the idea. She'd go through the course five time before school. It helped a lot, not sure why or how, but it did. 4. Working on emotional regulation with "How Does Your Engine Run" program and also had a visual of a thermometer with different colors. Calm was blue, red was angry, etc and would check in to what level she was at. Are you in the blue? 5. Social skills group weekly with about four other young girls on the spectrum. Led by a wonderful therapist who would guide them in play, talks, etc. Very helpful. 6. We did a lot of scaffolding where if we were going to a certain place would lay out what was going to happen, how she was expected to behave, what to do if she got upset. We would talk through it all before and this helped decrease anxiety.

Whew - that's a lot I know. And none of it may be the right thing for your particular child or set of circumstances. But there is so much help out there, and many great programs. Research, talk to other parents in your area, that helps too.

Thank you I tend to agree. Just as there are good and bad teachers, there are good and bad homeschoolers. As a gifted student in high school, I thrived with the good ones, but didn't have control over being assigned to them. I can control whether I will be a good or bad homeschooler. Hopefully a gift to my kids, in the long run.

No, actually, all of it sounds just right and just like a lot of the things I've already been trying to implement at home. We're always in the process of learning what does and doesn't work for him, and some things we've noticed are: 1) He does best with LOTS of physical activity. It just seems to soothe things. We were passed along a list by a father of a child with SPD that listed "heavy work activities" for kids at different ages; this has been very helpful. 2) Short-term social interactions with one child who is mild-mannered have helped to build some confidence and low-pressure practice interacting with others his age. 3) Working on emotional literacy ALL the time, like in conversation throughout the day all day. I do believe that is what made the church conversation I referred to at the beginning of the thread possible in the first place. 4) Lots of "scaffolding", as you call it. It's a term I've heard before but never knew what it meant. Now I do! It helps. It doesn't take away the anxiety for him so much as give him time to talk himself through what's coming so he feels better prepared and like he has tools. It's actually super interesting to watch the process take place in his head. 5) Preferred items have ended up helping quite a bit. We are currently taking a ball everywhere or for every undesirable task, and I don't know if that's the right thing to do, but it seems to help the anxiety and displeasure. 6) Talking to him like an "adult". The therapist actually said that is something I do to make myself feel better, and that he needs the opposite, but I staunchly disagree. I know my child, and I know that he prefers to be talked to that way. It just seems to work for him.

Thank you again so much for describing all this for me. You give me hope that I am on the right track! You sound like fantastic parents.

I think part of the problem in their mind is there are diagnostic questions that involve that the behavior exist in multiple environments, and so therefore they want confirmation in different environments. We had out assessment done by the school district (after he was too old for the zero to three thing) and apparently if they do not feel they have enough evidence or want to bust chops, they will insist on coming to your home to video the child in his own environment to make sure it is not just the fact that s/he is around new people in a new place. (After they assessed him they had no doubts so they did not ask to do that,but I was warned about it after I turned in the parental questionaires, so i think it is fairly routine to look at what the parent has to say with a grain of salt.)

That annoys me too.

When I first read this I surprised myself by thinking, oh he's so young, wait a year. But I know your frustration. I was told for years before my son's ASD diagnosis that my concerns were unfounded, that he was too young to tell, that he might change. It resulted in a healthy gap between the end of early intervention and start of therapy in school and on an outpatient basis. If I had to do it again I would have found a psychologist willing to do autism-specific testing sooner. I understand professionals' reluctance to misdiagnosis at a young age. But you know your son best. Unless they are offering an alternative (if not ASD, then what?), I would get a second opinion. Ask around to be sure you get a good one. Good luck.

My parents watch him about once a month for 3-5 days at a time. They live 4 hours away, so aren't a part of his daily routine. Would it help, do you think, if they took their own notes from their visits? Or is that not enough of a different environment?

Yes, this is the issue exactly, the insistence despite all the evidence I have provided, and despite the mixed messages I felt I was getting through the month of evaluation, that, in the end, he is a "normal" two-year-old. I kept saying things to them like, "You can't tell me that the consistency with which these behaviors are happening is normal", and they kept saying things like "Toddler boys are very different people." So I feel that if they aren't able to work outside that box of theirs, most toddler boys who come to see them aren't probably going to get the help they need...

I'm joining the "I haven't read through the other posts" crowd, so I'm sure I'm repeating some things.

Bless your soul. I can relate to much of what you are going through! My six year old son was diagnosed a month ago, but we've suspected there was something "different" about him.

There are similarities between your son and my own that had me chuckling over these bright minds. If I may, I just wanted to point them out, so you know he's in good company:

- Other kids: My son started talking at 12 mos. His first two-word sentences were "go car", which was used in any stressful social situation and "NO WAY!" (sounds like your son's "no people!!") which he would screech in the face of any child that came near him. I was mortified. He did this from ~ 18 mos to nearly 3 years old. As he learned more words, and got a little older/used to being around kids, he stopped saying "no way", but he had little interest playing with them and would get upset if they approached him. Today, he's definitely interested in playing with kids, so he's "outgrown" not wanting to interact, but he still needs to learn how to interact and play successfully. He still has the same triggers and meltdowns when things go awry.
- Toys/human characters: Anything like an action figure, or a Lego figure/Duplo figure would make my son flip out, shaking and crying. I think it was the faces, because he especially did it with Thomas the Train vehicles. I think he was around 3.5 or 4 when he moved past this. He still doesn't have any interests in playing with action figures or Lego minifigs. He prefers the wooden, plain peg dolls if he needs people in his play (although he rarely plays that way).
- Obsessive interests: My son's first big obsession was with EXIT signs. He was almost three when this started. We live in an apartment, so maybe it's because he started to recognize them as patterns? For over a year, our life was consumed with exit signs. And our walls and doors were covered with the signs we made. We cut out letters and we made countless signs. We got to the point where we hated going out, because he would HAVE to find the exit signs wherever we went. And that's all he wanted to do. I had to take my mom in for hip surgery, and I barely could restrain him from running off into the hospital hallways, chasing the exit signs. It wasn't charming, either, because he would FALL APART if we couldn't chase down every sign. We even begged bartenders a few times to just let us in for two seconds so he could see the sign. We stopped taking him to restaurants after that. I thought I'd lose my mind. But as annoying and stress inducing as it was, looking back I think that fixation was the springboard for reading. Once he realized he could read and spell the word EXIT, he asked us how to sound our words, asked about punctuation. By 4 years old, he was able to read or sound out anything put in front of him. He's a voracious reader now.
- Fears and the need to retell stories: Around three years old, he was afraid of flickering lights. If we had one outside in the hallway of our unit, we had to bribe him to leave. There was a particularly temperamental light above our parking spot in the garage. He was so frightened of it. But here's the similarity that is so striking: he would want us to "tell the story" again and again about the things he was afraid about. The example that sticks out the most was when my mom mentioned that her kitchen lights flickered. I kid you not, for the next month, every time she came over she had to tell the exact story over and over - in the same order - or he would meltdown. I think it was a way to integrate the story, and once I started treating it as such, it seemed to go away. Or maybe I had more compassion about it from that perspective? And he has seemed to get better about being fearful, once he turned 4.5 or 5, I'd say. Maybe he could reason a little better.
- Conversationalist, or lack thereof: my son has excellent language skills, at least in grammar and vocabulary. But, 90% of his communication is talking AT you. He doesn't start conversations with people. He begins in the middle, with perfect strangers on the street: "I have a book about blue kangaroos!" to someone all the way down the apartment hallway, so far away that he has to shout. He doesn't read body language, so we have to remind him to stop talking when someone is leaving the elevator. (I will say that he DOES learn, and can have polite conversations now, if he's calm enough to remember.) He gets very annoyed with questions that are not about his current obsession - which yes, he must discuss 20-25 times a day. He will say "No more questions, I have no answers!" His processing scores were quite low, as compared to his vocab and spatial reasoning skills, so I suspect his frustration is that when he's talking about a subject that isn't his own, he has to think - and he probably doesn't like the time it takes.
- Body slamming! Ugh, this is totally a sensory-seeking thing! Not only that, but I think it goes along with not understanding body language rules, personal space, etc. He slams into everyone, instead of hugging, or when he's trying to hug them. He claws at me with this maniacal look, but now I understand that he doesn't know how to express himself appropriately, physically. He's all worked up, and he wants to show affection and it all leaps out like the springy snake-in-a-can trick! It drives me I insane. I say that so you won't feel alone in that!
- Strengths: again, I chuckle over your comment about his attachment to the adults in your family, but not the cousins. My nephews are wonderfully "normal" boys, they are all within a few years of each other and of my son, and his experiences with them from his earliest memories are not pleasant! He didn't understand how to interact, he didn't like the noise and motion, etc. They always wanted the lights and sounds toys out and my son couldn't tolerate them - the toys or his cousins. He's just now starting to WANT to see them, but only after I remind him of the fun he had the last time (which he didn't want to go to also, until I reminded him... and so on! Ha!)
- Patterns: it is funny that you would use this word, discussing your son's strengths. When I talk about what specifically delights me about my son's personality and talents, I say it's his ability to see patterns and similarities between things that even I, as an adult, don't see. I'm literally inspired and even envious of this ability - it's like his mind is free of boundaries and it drives his inventiveness. It's really something to behold.

I'm still new to this, so don't have a lot of concrete advice, only my own experience. And just because there are similarities between our boys doesn't mean the are the same, to be sure. But still, I'm going to go out on a limb and say your son's behavior is not normal, or even a little bit more intensely normal for a toddler. There are distinct signals that stand out and I think your instinct about ASD/Asperger's is probably right. My son "got better" in regards to the meltdowns over his obsessions (he still has the interests!) and he has gotten less fearful with age. However, he's not grown out of the social issues and the lack of self-regulation. The only thing he's "grown out of" is not wanting to be around kids. He's so excited to start school, he always wants to play with kids at the park, etc. but he can't navigate social conflict and his own emotional turmoil. My son was never in daycare or preschool: I stayed at home and when he was old enough for preschool, we had potty training issues that prevented me from really trying to find anything. It wasn't until we put him in a daycare at the beginning of the year that we saw the problem: he couldn't cope with the unpredictable variables - waiting in line, squabbles over toys, sitting at the snack table while everyone finished, etc. He would seem to remember a few rules, but overall he just never caught on. We eventually had to remove him, they just weren't equipped to handle his needs. That was the big red flag, and we had him assessed a few months later. I used to think that if I'd only put him in daycare earlier, he would've grown out of these social problems. Now I see that had he gone earlier, we would've seen the same issues earlier.

And it's on that point that I'm being bold and saying you should to seek out a more formal and thorough assessment. Keep searching until you find someone you feel is really looking at the whole picture. He may still be on the edge of diagnosis, but at least you could have a road map to follow in the next few years. At the very, very least I think your son would benefit from a social skills class designed for kids with social delays and deficits, one that is facilitated by professionals. If I'd known there were groups like this when he was younger, I would sent him. Hopefully you can find some in your area. The groups I've learned about are usually part of a clinic that treats developmental disorders of one type or another.

We're now scrambling to get him ready for kindergarten, even though the school year has already started. Academically, he could teach the class. Socially? Well, I'll just mention that in his 15 min visit last week he smacked a kid for kneeling on his paper. And my son is not violent! He just needs to learn how to navigate the world.

That's another thing I wanted to stress: I think the emphasis on your son's aggression is misplaced. Of all the things you've described, the aggressive reactions stood out the least to me, as far as concerns go. In my mind, it totally makes sense that he says aggressive things: he's probably flooded and overwhelmed by all the input and doesn't know how to respond! You said something about his aggression not being an "angry aggression". I TOTALLY GET THAT. One of my son's biggest triggers is seeing other children cry. You can see it on his face that he is just flooded, he doesn't know how to cope. I don't know if it's the noise, or the emotions, but he loses it. Of course, his sister cries a lot, being a two year old! He loves her to pieces and they get along really well. But when she cries, he says he wants to kill her. It's very alarming. He doesn't watch TV hardly at all, or play video games so I don't know where he picked it up exactly. We've talked about it a lot, and I think he understands what that actually means b/c now he just says "I want to do something terrible to her." But he doesn't - he just wants her to stop, he doesn't want to feel the way he does when she cries. It would be misplaced to consider him violent in light of that. My son scratches and pulls at people's clothes when he's upset, but again, he's not doing it out of anger. He doesn't know how to properly convey how he feels and what he needs.

Please know that he is not a product of your parenting, no matter what anyone says! I felt the same way about my son, and it wasn't until my daughter was about 18 mos old (she's a little over two now) that I realized just HOW different he had been as a baby/toddler. There is no difference in their environment (we're even in the same apartment!) so it couldn't possibly be due to my influence alone.

I hope I didn't make this post seem like I was trying to make it about my son, and not yours. That's my way of saying "I totally understand what you're saying", but in about 500 more words than necessary. (Okay, maybe more like 1000. I have ADHD, and my editing skills suck!) anyhow, I have found so much relief from reading about other kids that are just like my son. It strengthen my resolve to support him however we need to.

Peace to you and your family. Feel free to ask me follow up questions if there's something more you want to know about, that I mentioned. I've done this with other people and it's really helpful!

I wanted to speak to this directly: I think both the psychologist's summation and your in-law's suggestion are crap.

To the first point, your son's particulars (the special interests, the fears, the sensory seeking/avoiding) are way too complex and specific to be simply about getting a rise out of you. My two year old daughter tries to get a rise out of me. And she's easy to distract and redirect. My son does as well - let's not forget, he is a living breathing six year old human boy - and in those cases, he's able to move past it, too. But his intensity and particularities have nothing to do with me or anyone else. He reacts intensely in words and sometimes actions (physically) to ANYONE who is an obstacle to his fixations: from his grandparents to the occupational therapist who showed him around the school last week. I think he comes across as rude and non-compliant b/c he is so strongly fixed on his beliefs, desires and interests. I have tried ignoring him in the past, to refuse reacting to him, and it only made him more desperate to get his point across. I can see it in his face when it's important to him, and hear it in his voice. I am not the object of his behavior; I'm the obstacle to his desire. He is receptive to compromise, if whatever he's wanting is not possible in the fashion he wants it to be. And we insist on respect. (Although we usually get it by saying "let's restate with respect", which is a good start.)

I've come to believe that he's truly mystified by my emotional outbursts or by my frustration with his actions. I thought we were in this push-pull dance of anger - and to be sure, we feed into each other - but the more I listen to him and watch him, I realize it's probably like I'm speaking a different language to him. So I'm trying to learn how to say things so he'll understand. I can't tell you how many times in his short little life that my husband and I have utter the phrase "THAT'S why he's been doing that!" I'm stuck for examples at the moment, but basically almost every one of his frustrating behavior or responses that we were just positive was defiant rebellion and disrespect (ok, that's mostly me - my husband is less emotional than that) has had some "reasonable" explanation. Oh, I just thought of one! The other day, he was restless and started saying "What are you gawking at, you freak?" My jaw dropped to the floor. I was dumbfounded. Turns out he read it in an old copy of Bambi. One of the blue jays shrieks it at Bambi, which totally makes sense if you've ever heard a blue jay. He didn't understand why it was mean, he just thought it was a funny line to say.

And as far as your in-laws go, if they think they can fix him, you should send him to live with them for a month. That should put an end to that. My in-laws, thankfully, are very supportive, but even they didn't realize how difficult he was to manage until they watched him when my daughter was born. I think that uninterrupted time, without us around, gave them insight into how complicated his world is.