Preschool, take-2

Over the summer we continued working with G-man, using the tips the psychologist gave us and what we’d learned from the book The Chal.lenging Child.  We organized playdates with our friends children so he could practice playing with other children.  His language exploded and he started expressing himself to us.  He loved playing the imaginary games that his friends invented.  He was still socially awkward at times but he had improved so much I was just sure the next school year would be so much better!

 In August we went for his checkup and his pediatrician was concerned that he still walked on his toes.  Both dh and I walked on our toes as children so we had never thought anything of it, figuring he’d outgrow it on his own.  And I was fighting so many battles with his behavior that I was unwilling to take on another so I had let it go.  We did an MRI to rule out tethered cord syndrome and were told to ask his school about physical therapy. 

 On the first day of school we asked about physical therapy and they referred us to a county program going on in a couple weeks where they assess preschoolers in all kinds of areas to catch the kids that have unknown developmental problems.  One of the stations would be with the physical therapist we were told that was the easiest way to get in touch.   So we made our appointment and sent G off to school.  I was sure they were going to be amazed at the changes from last year!  Turns out I was the one who was amazed.  In the first week G had a doozy of a day where he knocked kids down, pushed one off a slide, and bit a child.  Our options were to bring the psychologist back in or leave the program.  So a call was put in to the psychologist and arrangements were made for her to spend more time observing G in class.

 Next, dh took G to childfind to see about pt.  He took G around to all the different stations, dental screening, cognitive development, pt, hearing, etc.  The pt determined that G didn’t have tight heel cords and didn’t really warrant therapy.  But the combo of that with all the other stations resulted in G being flagged for possible autism. 

This started us on a whole new slew of evaluations and screenings.  The psychologist observed G at school.  She came to our house for a home visit.  Based on seeing how G interacted with us at home vs his peers at school, she suspected Aspergers.  She left us with a stack of questionnaires to fill out and arranged for a formal observation of G in school by a team comprised of herself, an OT, a speech pathologist, and the elementary school psychologist.  (we had a personal conflict with the pt so she was not on the team)  The team was/is not certified in the ADOS system yet, which I’m told by Leslie Stahl on 60 minutes is the gold standard of diagnostic tools, but will be in April.  So G’s evaluation was to determine if he qualified for services without a formal diagnosis.  They will re-evaluate in April after they’re certified.  We moved forward with the evaluation and found that G ‘qualified for services.’

We called our pediatrician and she endorsed this path.  She could refer us to a developmental pediatrician who would put together a team to do the same observation and evaluations.  But the appt wait is long and the evaluation process would take awhile, so the soonest we would get an answer would be in the spring as well.  Going through the school system, g will be getting speech therapy to work on his expressive language delays and ot to work on his sensory seeking behaviors.  The psychologist comes to his class once a week to help him develop his social skills and works with the teacher to develop strategies.  And we get all these great services without needing a formal label.  This is a great relief to us right now because the preschool is part of a private school.  The handbook specifically states that the school is not capable of accommodating special needs.  His teacher adores him and is an advocate for keeping him in her class – the director, not so much.  I don’t blame the director, G is definitely challenging and I’m sure she hears complaints regarding his behavior from the other parents.  But if G is weak on social skills, then he needs consistent peer interaction.  None of the other preschools have space available, there are only 3 preschools in our small town and I’ve called them all, so I am determined to keep him in his current class.  A formal label of Aspergers would make that impossible.

Since the first week, G has settled down.  His behavior is much better.  He still has a bad day here and there, but the outbursts are on par with that of any other 4 year old.  He starts his ot and speech therapy after Thanksgiving.  We’ve met with his ot and she made lots of recommendations for us to do at home so we’re buying therapy brushes, chewing bracelets and lots of spinny things.  The psychologist still suspects Aspergers but the OT thinks it is Sensory Processing Dysfunction.  My gut agrees with Aspergers but my heart yearns for SPD because it seems like that can be fixed with therapy vs being a life long challenge.  I’m just going to have to be patient and content with the knowledge that we’re doing everything we can to help G at this point in time.

 This is our story, and the beginning of our journey to understand our son.

Is this thing on?

So here I am, blogging.  I’ve never been a diary or journal writer so this is entirely new ground for me.  But I find myself with so many swirling thoughts and questions lately that I need to find a mechanism to lay it all out.  Hopefully by taking a look at it I can start to make sense of it all.

You see, I am the mother of a 4 year old that may have Aspergers.  Then again, he may have sensory integration dysfunction.  Or he just has some communication delays, is sensory seeking, he’s high energy, he is just a boy, he’s just plain quirky.  I’ve heard all these theories in the past few months.   I have no objection to any of them, really.  I just want to understand my son so I can help others understand him too.

We’ve always known that the G-man is different from other kids.  From an infant he was constantly moving.  He wouldn’t sleep unless we were bouncing, swinging, rocking or walking him.  As he got older he would put himself to sleep by picking up his legs and slamming him down on his mattress over and over, like a whale splashing it’s tail in the ocean.  At 2 I gave up trying to stop him from jumping on the sofa and instead bought him an exercise trampoline to redirect him.  It became his favorite activity and spent hours each day bouncing.  The grandparents quickly bought trampolines for their homes so G could channel his energy when we visited.  His language development was always within a few months of normal in that he developed the proper amount of words and articulated them in an age appropriate way.  He hit his major milestones, he showed affection and made eye contact when prompted. 

But at the playgroup we were in from birth - 3 he rarely made many attempts to play with the other kids, instead choosing an independent activity that he could sit quietly and focus on for the 2 hours each week.  He preferred flipping a toy over to figure out how it worked rather than playing with it in it’s intended manner.  He had a short fuse and would strike out at the other children if they wanted to play with his toy.  He rarely expressed himself verbally or initiated conversation.  The only way we could get him to talk was to quiz him on things he knew.  He is a very fact oriented kind of kid – we thought he’d grow up to be an engineer or scientist.

Knowing that he needed help with his social skills, we enrolled him in preschool.  We even went so far as to move to a nearby town because they have an incredible Mont.essori preschool.   We picked that program specifically because they have long work cycles – G gets frustrated when he has to move to another activity before he is ready – and they emphasize getting along and cooperating with peers.  They don’t hold a child to a specific cirriculum, instead they let a child learn at their own pace.  G was, and still is, incredibly smart.  He knew his upper and lower case letters before he turned 3, shortly after he turned 3 he started recognizing sight words and by 4 he understood phonetics and could sound out words and read on his own.  His comprehension of what he read was incredible too.  He could count well over 100 and could add simple numbers.  We thought the preschool would be a great way to supplement what we were trying to teach him at home.

  But it didn’t go as well as I had hoped, and my expectations were pretty low.  He did great with the routine and structure of the program, did well with picking an activity and working on it throughout the morning, was fantastic with the academic lessons and loved the songs they sang.  He didn’t do very well with the social aspects and often got in trouble for hitting or pushing and had problems with being clumsy with the kids, for example, bumping into other children during circle time or when lining up.  He had no sense of personal space and upset the other children by leaning into their faces.  His teacher, who is wonderful, was frustrated because she could never anticipate when G was going to get physical with the other kids.  The Monte.ssori philosophy is heavy on empathizing with children so when G would get in trouble they’d go through the routine of trying to get him to understand why what he did was wrong.  He’d say all the right things, but it was as if he was reciting a script.  It seemed he had no innate sense of empathy.

Finally we had all exhausted what we knew to do and the teacher suggested calling in the school system psychologist.  She came in and observed G a couple of times, made some suggestions for getting him to interact with other kids and suggested a Stanley Greenspan book to us.  This was near the end of the school year though so there wasn’t a ton that could be done by this point.  But we read the book and worked hard over the summer to implement the strategies and I truly thought we were making lots of progress.