Gifted Issues Discussion homepage Forums Twice Exceptional UPDATED - preschooler with severe anxiety?

I know there are quite a few parents here with kids with moderate or even severe form of anxiety. How did this show when they were 2-3 years old? Did things get better or did you end up medicating?

I am starting to see a lot of difference in how DS3 acts at home and outside. He is really starting to come out of his shell at home, starting to communicate more and more every day with ease but ask him to do something new or unexepected, especially outside of his familiar surrounding and that's when he gets in that autistic shut down / not cooperate / cry / freak out mode (for which he has been diagnosed with high functioning autism). He's a very sweet child at home who wants to spend time with me and his dad, tries to engage us in whatever he's doing, even the last week or so started basically provoking me with making faces at me to see if I'll copy him . Still very reserved, you can just see in his eyes how he's thinking everything through really deep, but he is pretty much 100% here with us with perfect eye contact. He is ok when we go visit friends, you can see he's careful about everything but paying full attention to what is going on and only shuts down when he seems to be threatened.
We just ended with early intervention therapy 4 weeks ago and took a 3 week break before his therapy through school district and private ST started and he was the happiest child ever. He likes the new private speech therapist and is fairly comfortable around her as long as she doesn't push too hard and she doesn't. Yesterday was our second day there and when we walked in, first thing he said was "I can't wait!" ... all happy and smiling . On Tuesday he had the first school speech and OT session and he just froze there. The second they wanted him to do something he just shut down and started screaming, crying, running away. 30 minutes later they finally let him just run around and explore (something new he's started doing couple weeks back. Until this point he tried to ignore new surroundings but now he's like a little 1.5 year old that wants to see everything and try everything). But the whole stress of this resulted in him not even wanting to go anywhere outside the home. Getting him into his carseat has been a serious fight since then (and he loves car rides otherwise)

now, back to my original question ... I really wonder if a lot of this could be caused by some sort of anxiety? Thinking back, I had real issues with it when I was little and still do to this point but have learned to live with it. I remember it like it was today when I was even still in preschool and remember the feeling of hearing my heartbeat and feeling like my heart will jump out. I was frozen with fear but never told any adults around me or did try but they just didn't understand me. I was clearly identified as gifted (135-145 depending on the tests) but still always feared not being good enough. And I too use a "shut down / ignore" mode to cope ... to this day.

I hate the thought of possibly medicating my little boy but I also don't want him to fight the battles I had to on a daily basis. Did you see anything similar in your kids? How did you work through this? Did you medicate? Did it help?

btw .... he is NOT a sheltered kid. We do not keep him just at home, he gets plenty of outside exposure and in general is just fine with it and enjoys it. It is more of a "performance anxiety" than fear of the surroundings if it makes sense?

We do want to get his IQ tested eventually but first need to work on the communication issues and overall just want to wait till he's older (around 5-6 years old ... he just turned 3) but given the things he has been doing and looking back at myself, I'd think his score would definitely be higher than mine .... 145+ if I was to take a guess.

I had a child psychologist telling me that I strongly needed to consider medication for my 5 year-old child's anxiety because he was "just wired differently, so the only way he wouldn't feel intense anxiety was through medication."

I knew he was having problems with gravitational insecurity, and had heard that there is a huge overlap between sensory processing issues and anxiety. I told her that given his known sensory issues and the overlap of sensory and anxiety issues that I wouldn't consider medication without first trying OT directed at sensory processing issues. We didn't even get to that point. Less than a month of gymnastics and swimming classes, which are GREAT for sensory kids, and the anxiety disappeared. In short, addressing sensory issues dissipated an anxiety level that had a professional crying "medication! There simply is no alternative!"

I would encourage you to consider an OT evaluation to see if your child might actually have sensory issues that are creating anxiety.

HTH

he has been in OT for sensory issues for about a year now but we're not really seeing improvements . Well, other than seeing how much he enjoys and needs deep pressure and how it does relax him for a few minutes. We are doing private speech therapy where we work on some new found tactile issues with his mouth affecting his eating and how he forms speech. But you are right. SPD is definitely playing a major role in all this just like it did with me.

Both my boys probably really are "wired differently" because my older one started being a lot less irritated and nervous when we stopped most of his therapy. But his issues were different. He was always a show off constantly in everyone's face. It's the quiet and calm situations that make him anxious. Compared to DS3 who has it all bottled up inside.

Things would be a lot easier if he didn't have such a good memory! One negative experience in any one place or with any one person makes him completely shut down in that place or for that person for months. (completely avoids one room at the therapy place where he was pushed beyond comfortable ... for both him and me ... almost a year ago; gets upset at a girl in a play gym we go to because last June she took a puzzle he was working on away from him; ... and things like that).

Mom2277 - reading about your experience just makes me wonder even more if we should even bother with the school therapy that's clearly geared towards the kids being compliant, able to sit in a chair or one designated spot for certain amount of time, etc. when that isn't even our concern at this point? He's still almost 2.5 years away from Kindergarten (if he's to go to K at all as we are considering homeschooling early years for both him and DS4.5) and perhaps we should shift more focus on physical activities? I am already "the parent" when it comes to dealing with the special ed director because I went against their advice of putting him into special ed preschool and went just with the outside therapy. But I really don't see the point in insisting the child does something that he doesn't need for another 2-3 years

OK, this may not be an issue at all, but fwiw - have you had his vision tested? Our dd who is now 11 had severe anxiety as a 3-4 year old when we took her to new places or to large rooms, or to noisy places, or to ... you get the point. We couldn't take her anywhere without extremely severe meltdowns, but she was a-ok happy at home with no obvious anxieties. We eventually consulted with a psychiatrist who attributed it to SPD who sent us on to OT for the SPD, dd went through listening therapy which seemed to help some, but she still was anxious starting school when she went to kindergarten, took most of the fall semester to adjust to being there, finally got the hang of it and seemed to be ok, then fell apart when she had to return after Christmas break. It wasn't until 2 years later, 2nd grade, when she was having a tough time learning to read and reading from the board that a neuropsychologist figured out the not-so-obvious for us - she couldn't see clearly!

Anyway, that doesn't mean your ds is having vision issues - but that there may be something physical going on that your ds has been able to become comfortable with at home and can compensate for but when he's in new situations, or places outside your home, he hasn't had time to be able to get comfy with them and figure out how to cope. Vision might be worth checking. A regular eye exam didn't catch our dd's challenge - she had 20/20 vision in each eye (individually) but her eyes didn't track together at all and most of the time she was either seeing double or one eye was completely shutting off to avoid double vision, which then meant she had no depth perception.

Best wishes,

polarbear

ps - one of the things our dd did as a toddler and preschooler was to avoid eye contact when people were speaking to her. She eventually would look directly at us (her parents) once we started teaching her explicitly to look at us. We had some concerns for awhile that some of her behaviors might be autistic, and she also appeared to be ADHD (with the H for hyperactive emphasized).... but the lack of eye contact and a lot of her fidgeting etc were actually due to the vision issues.

polarbear - I would not be surprised if vision was an issue. He has never had a formal check up. Just a picture of his eyes taken during special ed evaluation. I have to find a pediatric eye doctor that would be good with him (or any kids) because the eye doctor's office I took my older one to was horrible. I mean, good care, but for adults and people with plenty of patience. Not for kids. I do think he can see well when it comes to reading and everything right in his face but not so sure about how his vision is affected by everything further away. Even might be the reason why he's only climbing down the stairs and takes him a lot of planning. He can climb up on chairs, tables, anything else vertical but seeing the space in front of him and planning his way down the stairs or down from a slide is definitely an ordeal. Yet he can walk up the stairs better than DS4.5. He also a lot of times pushes on his eyes with his fingers. It is something I mentioned to the early intervention therapists but they just said it's because he was tired.

How did they detect the actual issue that your daughter was having? By dilating her eyes? Or some special test? Or does the child actually need to be old enough to cooperate and say what he can or cannot see?

Mk13,
I wish I could be more helpful. I'll share my thoughts and reactions in the hopes that they might assist or spark an idea or help clarify your thoughts/direction desired.

First, I'll affirm your sense that school-provided OT might not be optimal. I think school-based rehab provides (OT, ST, etc.) have a very strong incentive to minimize needs and to focus on skills that suit their belief of what is optimal for class success. I'm dumbfounded that we had evaluations at two separate school districts, and in both instances, the school-based therapist reached a vastly different conclusion than private providers. Of course, private providers, too, might have an incentive to say a child needs their services. For instance, the school-ST said my son was only having problems with one sound, so he didn't qualify for school-based speech. I was puzzled because I identified two sounds. A private ST confirmed that he indeed had difficulties with two sounds. I had a similar experience at another school district. They said no delay or issue whereas an OT affiliated with a teaching hospital saw significant OT needs. I think you are more likely to encounter the provider at school pronouncing your child no longer in need of their assistance when that may be in the school's best interest, but not your child's.

Also, I share your concern that school OT, in particular, is tailored closely to compliant classroom behavior, disregarding broader issues. If you can swing it, I would see a private provider.

I'm sorry you haven't had more success in sensory treatment, despite sensory issues being present. I don't know whether it's applicable or not, but our success with sensory treatment required lots of ME doing things, not relying on OT to resolve/aid the issue. As I mentioned earlier, getting my children into gymnastics and swim was a quick and dirty way to resolve a lot of sensory issues in a way that let them be with other kids.

I'll also add that I've experienced "sensory savvy" as something like a fad. My impression seeing different OTs in EI was that lots of OTs spoke of sensory issues, but not all really, really had the training and sophistication to effectively work with it. The difference I saw in the OTs at a major pediatric teaching hospital addressing my children's sensory issues was a landslide away from how some of the other EI OTs approached and treated my children. I obviously have no idea how skilled your OT is, but you may want to consider a different provider if you don't feel like your making progress that may be possible.

I hope this helps!

I'm here to update my post. It's been 4 weeks since I originally posted my questions and concerns about anxiety and at this point I am more than convinced that anxiety must be playing a huge role in all of DS3.2 struggles!

This week was the second week when the therapists took DS into their rooms alone without me. Until that point I was always there to at least make him feel somewhat comfortable. 5 weeks into school therapy and he's at a point where he's screaming and nervous just driving by the school, he's back to chewing on his security blanket, he's back to chewing on his clothes, he's back to hitting kids around him (we had an issue with this last year for couple months that we got under control in October and had no problems at all, he was perfectly calm around other kids since than, just not joining their play and now after a little incident during his therapy session last week he's aggressive towards any kid around him), he's even kicking and hitting adults when he feels threatened and to top it off, Tuesday this week when we got home from therapy he was so nervous he kept scratching one of his thumbs so hard he now has a huge bloody scab there not to mention how angry and unhappy he was that whole afternoon. Basically, a month ago I went in with a very happy boy and now I have a boy who's always on the edge and hardly ever happy . We are also doing private speech therapy 30 minutes a week and he is fine there. When the therapist took him into her little room he did start kicking towards her and swinging his little fists but she got the point right away (I told her he had school therapy the day before), we took him into their gym and just let him run and he relaxed and just became a much happier child. This therapist clearly gets him. I didn't have to tell her anything and she could see right away (even during past sessions) what would push him over the edge and what would make him feel better. Yay for a non-pushy therapist!

But OMG! What do I do with the school therapy? We have 3 weeks (that means 6 sessions) left and I feel like every extra week of therapy there doubles the stress that DS is going through! My gut is telling me to just put his IEP on hold and pull him out NOW. Not even wait for the school year to be over! We want our happy boy back!

We'll keep going to the private speech during the summer since he is handling that one so well and may look into private OT in the same place. But when it comes to school I really feel like it's causing more damage than anything else . Would you keep pushing through the school therapy if you knew how miserable your child was? Or would you pull out knowing he doesn't even really need to be there given he's still more than 2 years away from entering Kindergarten (if we'll even do Kindergarten with him).

My first instinct would absolutely be to pull him out. But interested to see responses from more parents who have dealt with similar issues.

I know, right? I've been trying to fight my first instinct for the last 3 weeks The therapists are using the usual "if we push hard enough, eventually he'll come around" approach but I just don't see it working in this case. It has never worked for him and I just don't see the point when it's all just making him feel worse?