My older son just turned 4 two weeks ago and while he will not be on the highest end of the gifted spectrum, I'm pretty sure he'll be one of those top of the class kind of kids. He's great with math, I do think he'll have some sort of learning disability when it comes to reading / writing (he knows all the letters but gets things mixed up ... even when talking sometimes he switches syllables, etc.) ... he has been in all kinds of therapies since he was a baby (PT for tortcollis and muscle weakness, OT for severe Sensory problems, ST for being a very late talker ... the talking is no longer an issue as he won't keep his mouth shut! lol).

He's currently being evaluated by a pedi psychiatrist for possible ADHD/ADD/Asperger's but many of the behaviors we're concerned with could just as well be those often times mistaken for ADHD, Autism, etc. (can't sit still, can't focus, extreme sleep problems ... he is a much better child in terms of behavior with 6hrs of sleep or less, always asking questions, and on and on) ... but all these behaviors seem to come and go with no apparent cause.

now I'm getting to the point. He'll most likely be recommended a Special Ed pre-school class 2.5hrs / day .. 5 days a week because of the behavior and concerns over how he'll handle school in later years (no way you'd get him to sit in a circle of any kind or anything similar to that). Now, my question is ... knowing he's either gifted or way above average ... do I send him to Special Ed where he'll be learning colors, numbers, letters with kids who're in most cases behind academically, knowing he won't be challenged in that area at all just so he can learn to behave well at a school setting (and to work on his fine motor skills where he lacks) or do I forget about it and keep him home till it's time for K next year?

He's never been to preschool before, Montessori and like kind are out of our budget, park district pre-school are a waste of time/money (at least in our area) plus they wouldn't take him as we're still working on potty training and that's one of their major rules that a child has to be 100% potty trained and he has a severe allergy to eggs so we'd have to make sure he's really in a pre-school where they can keep him from any contact with eggs (kids' snacks, etc).

My gut tells me to stay away from Special Ed since after the first couple of weeks that will satisfy his curiosity he'll just get bored there and will act up even more! ... BUT he's basically BEGGING me to go to school! Every time we pass by any of the local schools he's asking if he can go, when can he go, I just feel bad for keeping him home when he wants school so much!

So, special ed for gifted (or possibly 2E ... won't know the diagnosis till later this month) or not?

NO way would I put a child with a severe food allergy into a school environment (of any kind) without having a 504 plan in place to address it.

If you've not had much experience with kid's programming, er, that allergy thing can really be a hassle. If your child has anaphylaxis history from really small exposures, this is not something to approach lightly. There are other ways of (more safely, if you'll pardon my bluntness here) getting that social experience. While a SpEd classroom might be a good fit for some reasons, it may well be a nightmare on the food front.


And really, there seems to be little point in doing that until you know more about what sort of second e you're dealing with.

I'd look at what it would take to get early interventions rolling in other ways, given that your child already has two exceptionalities that will be quite difficult to manage well even in a standard PreK setting, nevermind a SpEd one.

Basically, you have a 3e child, in all probability. Begin looking at "least worst" in terms of fit, because things are likely to be a series of compromises.

Full-time attendance at this point doesn't seem like a good way to do that. Not unless that third exceptionality is such that it needs VERY intensive, aggressive intervention, in which case that might take precedence. But you don't have that info yet, so no, I wouldn't enroll anyway until you have more info.

Maybe he's expressing a desire for more novel experiences when he's talking about going to school? Might be time for some enrichment options that you have a little more control over, I'm thinking. While pre-school through your parks dept might not be worth it, maybe they have other opportunities for preK enrichment? Dance class, art classes, that kind of thing? Those provide that formal sort of environment, but in smaller doses and with less food.

ETA:
ask how I know all of this... go ahead. Yeah. My daughter had a boatload of food allergies at this age, and we opted to avoid preschool entirely since our applications kept magically staying "on the waiting list" and equally magically, apparently we were always LAST on those waiting lists, since there were never-- and I do mean never-- any openings... SIGH. Almost all of her "school" experiences until she was about eight were Parks and Rec classes or enrichment via our public library, and mostly those required me to be in the room at all times. It doesn't seem to have hurt her any that I can see. Then again, she very definitely does not have ADD/ADHD/ASD, though at four, that picture was very much less clear. She did seem to have some unusual quirks that pointed in those directions at times, but they were always situational and transient. She also has sleep issues and always has, but we've finally come to realize that this is partly GT, and partly genetics "other." At four, though, we were worried about her; I do understand that.

Just know that "can't sit still" and "sleep problems" aren't necessarily pathology. Some of that is being four and being gifted.

I am getting all his allergies retested later this week and really hoping the egg allergy is going away but have nothing to support that hope other than in most children it does go away by the time they go to school. But his was getting worse as of last year. The last episode was last fall when he started getting all puffy just from breathing the air in the house on the second floor when on the first floor I made scrambled eggs for my husband! We never had to use the epi-pen but that's probably only because I have been very strict with him have absolutely zero contact with eggs in any shape and form or anyone who had eggs prior to contact. I know the public school is really the only place with procedures in place for allergic reactions but even there the system is so messed up (from what I've read in all the paperwork that we'd have to sign) that who knows how long it would be till someone would actually administer the shot should he have a reaction.

Allergies aside though ... right now he's getting OT and PT at a local therapy place and should be getting a 1hr ST through the school district (if we don't go with the pre-school plan). If he did go to the pre-school, he'd be getting all these services there, which is the only thing I like about it. Going to all these therapies means I have to take my 2-year old with us and keep him occupied the whole time while the 4-year old is getting his therapy. And he's not an easy child to keep entertained. He doesn't like being around other kids so in the waiting room for the most part I have to keep him in the stroller so he wouldn't keep pushing and grabbing everyone else (he's a very sweet kid but can't stand anyone in the radius of about 10 feet ... talk about sensory issues!). So while one kid is getting what he needs (and does he really???) the other kid is suffering through it. So the pre-school at first sounded good to me since it would had been a one-on-one time for me and my younger one while older son would get his needs met.

but the more I think about it, the more I realize that it really is probably a bad idea. I do take both boys to a local Stay2Play cafe / kids gym where they get plenty of socialization with other kids so I don't really need school for that but just can't figure out what's the right answer here. I guess both have it's good and bad but the allergy issues is probably the most determining factor

Mk13, have you gone to look? I would definitely not reject the SpEd preschool without serious consideration. The SpEd preschool by us is a dream school that does things regular preschools don't do (e.g. they have farmer-led gardening classes and horseback riding and a real gym teacher and art teacher).

Even if your kid is the brightest kid in the room, if he needs help learning to sit at circle, share, all of that, this sort of preschool can be a wonderful place to do that, with teachers who are specifically trained to not be frustrated or punitive with a child who's not naturally compliant. (As opposed to regular preschool, where they will not know what to do with such a child and are likely to throw up their hands in frustration.) They are likely to be able to work with both the food allergies and the potty training, which a regular preschool may not. Their teachers are likely to be far better trained than most preschool teachers. And you don't need academic content taught in preschool, anyway-- you need social skills, play skills, and classroom participation behaviors. Half days sound about right for this.

I would consider it far more important for long-term success to get the circle time behavior and that sort of thing in place before kindergarten, than to teach academic skills in preschool. He sounds like the kind of kid who will learn academics no matter where you put him. And sending a kid to kindergarten without that skill set makes everything harder.

DeeDee

DeeDee ... I haven't seen the pre-school yet but am planning on taking a look first. But we're just a relatively small school district so there is I believe only two morning classes of about 10 kids maximum and one afternoon class of max 10 kids and some years they open another afternoon class for kids who age out of Early Intervention by January for the second semester. It's at two of the local elementary schools so basically looks like a kindergarten class but will a lower student vs. teacher ratio.

Friend of mine has her daughter in the class and they both love it but I'm pretty sure my friend loves it mainly for the fact she gets 3 hours with only one crazy kid rather than two! lol

But now when I think about it, maybe since it IS in the actual school building, the teacher might be willing to give my son something more difficult to work on to keep him focused rather than the basic that he will refuse to do? I guess that's something worth asking about too!

oh and just to clarify ... it's not that I'm worried about the academics part of it because I'd expect them to teach him something new ... at this age I take it as my responsibility to give him the opportunity to learn and explore ... my worry is that unless he's challenged, he won't cooperate with them at all and will just run around trying to find something that would entertain him (like taking whatever mechanical thing he can find apart).

the friend whose daughter goes in showed me a picture ... a traced letter that the kids worked on for 30 minutes ... that's great but it will only entertain him the first 2 minutes he'll work on it and then he'll be off to find something "better" to do. Which is why I wonder if it wouldn't be counter-productive?

Have you have an IQ test done? I would want the preschool to know that he is gifted otherwise they may attribute some gifted behaviors to other diagnoses. I also would go and observe the preschool before considering letting your kid walk through the door. Ask yourself if this is an atmosphere where your child would thrive. Make sure that you ask how they would work with your kid on the issues that resulted in the placement/referral.

I agree with HK that preschool is a minefield for food-allergic kids. It seemed like every week there was at least one birthday party, one food-based school activity or some other "holiday" party that included food. My DS's preschool worked hard to make it a safe environment but even then, things fell through the cracks. For example, my DS ended up with red, swollen eczema-ridden hands from an egg carton caterpillar project. Obviously, there was some residual protein on the carton and it never occurred to the staff that this could be an issue. Thankfully, it did not trigger anaphylaxis.

You have a better shot at getting differentiation with that low student-teacher ratio than anywhere else, including kindergarten; they are likely to be able to adapt what books are available and so forth, and the business of SpEd is meeting individual needs.

In my experience, no matter how bright a kid is, if he can't pay attention to instruction, he is going to struggle mightily in the early grades; it is that kind of skill that they'd work on at the SpEd school. From your earlier post it sounds like that's what he might need, no matter what content he's ready for. If you understand the *skills* as the content he'd be learning, not the facts or materials, it may change your idea of what's happening in that environment. Only close observation will tell.

DeeDee

no IQ testing done yet. Honestly, until couple months ago, I didn't even think about him possibly being gifted until I realized our younger one is and then it hit me ... the whole time I had been thinking our friends' kids were behind when in fact DS4 was ahead! lol ... he did a lot of things differently since he was a baby but I just didn't think much of it until recently. We were on a 6 months waiting list (due to our insurance) to be seen by the psychiatrist and finally got in 2 weeks ago. He's had two sessions so far and will have at least one more next week and I am hoping I can get an IQ test at least basic one done by them. But if we have to go the private route, I'd wait till the spring to get a better picture. We're doing two languages at home and there are some thing that he does in one language or the other and it could influence the test so I want to give him more time to differentiate between the languages.

Not sure though if the school could maybe do testing? Can't really mention the gifted part to the school at this point because they give priority to the kids with major academic risk (mainly those behind in basic knowledge) so they would just say we'll worry about him when he goes to K next year. ... which is what they did last year when I wanted him in that same pre-school and after their evaluation they just said he's way ahead and they'll deal with the hyperactivity issue when he goes to school. But this time we might be going in with a diagnosis of some sort(or not)

good point to consider! ... I think this is something that was greatly overlooked with my step son when he was in elementary (he moved in with us when he was about 12) and no matter how hard I tried with him, we were never able to get him over that (he's 19 now). He turned into the very bright kid almost failing high school (and labeled lazy by most of his teachers).

I knew this would be the perfect place to ask about this!

Slightly off topic, but I was wondering since you said your 2 year old has sensory issues, is he in OT as well? I'm sure you know since you already have one in OT , but the younger they start, the better the results because habits are less ingrained into them. And if they went at the same time it would be a nice break for you rather than worrying about keeping him entertained. Just a thought.

My 2 year old is in OT for sensory and feeding issues and has made huge improvements. Her therapist keeps saying that it is good we got her in so young because if they don't start until school age, when issues are usually identified, they're already too old for therapy to be extremely effective.

Following Happy Chef's tangent, Mk: if you get a diagnosis for the 4-year-old, or maybe even if you don't, you might consider having the 2-year-old evaluated as well. Not wanting other people within 10 feet is pretty extreme.

It sounds like you are working darned hard as a parent trying to keep things together for your kids, and if there's something diagnosable going on it is so much easier to know at age 2 than at age 5 or 7, because that way you can get more early intervention help that makes it easier over the long haul.

Hang in there.
DeeDee

ETA: passing along one of the nicest things someone said to me at a dark hour: "Therapy works." It's true.

yes, the younger one gets OT as well but at home through Early Intervention so we don't have to go out for that. Once he's out out of EI when he turns 3 we could possibly look for outside therapy for him as well in the same place, which would solve the problem. ... another problem is when my younger one is getting his OT, ST and DT at home ... keeping DS4 away from DS2 and the therapist is next to impossible. He's been so used to that all appointments used to be for him that he just doesn't want to understand that sometimes his brother needs an alone time with people! lol

That said, I doubt we'll continue with therapies for the younger one. While I'm sure they'll be recommended on a continuous basis for the future, I know I can work on the sensory issues at home (doing that every day anyways) and the reasons he has ST and DT at this point I'm pretty sure is more of a misdiagnosis because he's developing very asynchronously. Just 4 months ago we were quite concerned with Asperger's / Autism spectrum but now it's becoming more and more obvious he's far from that.

I do agree that starting any therapy as early as possible is crucial ... but I also think it's all in the hands of the parents. If the parent recognizes the problem and has all the tools needed to work on it, than OT might become just another appointment that we have to make and overextends our schedule ... not sure if that makes sense?

Basically after spending almost 4 years in therapy, I don't really see DS4 (and even DS2 lately) making that much progress due to therapy but rather due to outgrowing a lot of the issues with age (while developing new ones) but fortunately for us, pretty much all problems DS4 has are identical to what I went through as a child so I can identify with him knowing ways of getting over those bumps that come and go.

It's also really important to have therapists who realize your child not only has whatever diagnosis but if they are gifted, they work differently from most kids and may need a different approach.

I'm just rambling here ... but maybe some other parents here who's children went through various therapies can identify with me? ... looking back at my childhood ... I don't wish I received any kind of therapy ... what I do regret is that nobody knew what SPD was back then and that I was looked at as the weird / lazy / kid with too many excuses by my family and everyone else and they had no idea what was going on in my mind. When I tried to explain, they wouldn't understand. So I'm just glad I can spare my kids having to go through any of that!

The issue with kids being around DS2 is a fairly new thing (last 3 months or so) ... It started around the time when his brain kicked in at high gear and he started doing all his crazy non-2 year old things. His Developmental therapist came along with us to a kids playroom / cafe we go to where his problem with kids seems to be most obvious and as we watched him, we both agreed that it's most likely because having these kids around is too much of a distraction for him. They interrupt his line of thought! lol ... He's usually very much into what he's doing (be it a puzzle, some toy, etc.), really focused on it and if they get near him, he turns into this "mad professor". He's still lacking in speech so isn't able to tell the kids to leave him alone and that's why he's probably more aggressive right now.

Mk, I'll just share briefly what happened to us with DS10 (2E, Asperger's). He was extremely difficult to parent, had a very difficult time participating appropriately in preschool and kindergarten, all the while showing tremendously precocious and unusual talents and interests. We sought help but were told that he was just gifted: the possibility of autism spectrum disorder was ignored, even though he was a classic case, because very real symptoms were being excused as part of his giftedness.

We were not able to start appropriate therapies until he was almost 6, because for years we couldn't get anyone to see what was really there. I regret those years: they were hard on us and we could have used them better if we had known what was going on.

The party line among gifted communities is that gifted kids can be overdiagnosed with things like Asperger's and ADHD, but in my experience they can also be underdiagnosed due to their giftedness, and that is in some ways worse, because the child does not get timely help. It's much harder to recoup skills at age 8 than at age 3 or 5.

That's not at all to say that this is what's going on with your kids, but just to say that this happens sometimes, even when parents are paying attention.
DeeDee

DeeDee ... I have been pushing for Asperger's evaluation for DS4 for 2.5 years now and all the therapists would always blow it off as SPD ... but I KNOW that's not it. He does have a really bad SPD but there's more to it and I need to know what. But I feel like even the Psychiatrist we've been seeing the last two weeks is very puzzled by him. He shows a lot of Asperger's traits but not always. He shows a lot of ADHD traits ... but again, not always. He gets a lot of small and bigger meltdowns but in most cases I can reason with him to snap him out of them.

I just feel like all the therapists have been doing with him is throwing different therapies at him to see if anything will work. I feel like that's not what we should be doing if we don't really know what causes it? If the Psychiatrist comes up with some sort of diagnoses (or rules them out) ... at least we can adjust the therapy plan based on that and not just experiment because he doesn't have the textbook responses to therapy. He LOVES to be out anywhere and just explore ... park, beach, store ... just ANYTHING new to him so sometimes I think why waste time at the therapist office when we can be out giving him the stimulation he needs? Why try to hold him back teaching him to sit still when maybe running as fast as he can is what he TRULY needs?

As for the 2-year old ... if you didn't know him your FIRST thought looking at him for 5 minutes would be "this child is Autistic" ...as in, not just mildly on the spectrum but probably moderate. He'll either sit somewhere in a corner play with something and pay zero attention to anything and anyone (if at home or other very familiar place) or you may see him spinning for minutes listening to music that catches his attention. That and speech delay were major red flags why I got him evaluated through Early Intervention. He's on the 6 months waiting list for the Psychiatrist eval as well but won't have the appointment till sometime in January. ... but then when you watch him closely, you realize he's not "out" or zoomed out ... he's just doing something that really caught his attention and wants to finish it. The spinning used to freak me out a little (he started doing that when he started walking) ... he'd spin, never lose balance, not once. He'd stop and then just walk away. We were thinking it was probably a sensory issue where he liked the sensation of how it felt and the visual part. But I've noticed he has a great ear for music and as I watched him couple times he's spinning and "analyzing" the music ... not sure it's the right word. I don't know how to explain it. He's humming the tones with a slight delay (especially when it's a new melody for him) very focused on getting it right and the last couple of days he's spinning and sometimes conducting with his arms at the same time. I was fascinated by it when I saw him do that. Imagine a orchestra conductor conducting with his right hand but in a 2-year old's body! lol ... the music stops and he immediately snaps out of it. But he only does these things when he feels like it. When you come to our house another time, you'll see a possibly ADHD little boy that's into everything, giggles at everything and wants you to play with him and do goofy things. it's really hard to explain but while at first sight he seems to be more "off" then DS4, we're a lot less concerned with his issues than our older one's. Not saying that won't change but only time will tell.

We didn't get good answers on DS until we went to the autism center of a major children's hospital, where they had seen enough kids on spectrum that they were able to figure out DS. Because the gifted ones often don't present with the standard-issue set of symptoms, or present the standard symptoms in nonstandard ways, it can be hard for a general psych to get a handle on.


Not to scare you, but mine is like that too. We spent a lot of time out of the house when he was little because his play skills were so poor, he just did not do as well at home, and he loved being in museums and gardens and places where he could learn things constantly at his pace.

The only problem is that school (and eventually, work) are not like that-- you don't GET constant stimulation (even in an awesome job or an awesome school, there are quite a few down moments), and you have to learn to manage and occupy yourself in those environments too.

I realized kind of late how much I was compensating for DS's missing skills in how I was running the family.


None of what you wrote rules out autism (and the spinning makes me suspicious)-- it just says to me that there's a lot of interesting stuff going on inside that kid. I'm glad you are investigating.

You sound like a very caring and on top of it parent.

DeeDee

master of none - last year when DS4 aged out of Early Intervention I did get him OT but denied anything else. He was supposed to get speech therapy through the school district but after the nightmare that ST was for him in EI I wasn't going to put us through that again. It wasn't just the therapist because he had a two different ones but it was the way ST is done that made his sensory problems even worse and while he got ST one day, he was impossible to deal with for another day or two. ... one of those times when I realized that less is more! I'm really at a point where I look at the therapy sessions as one hour block where I don't have to be the one answering all the questions and tending to all the needs. DS4 looks at it as his play dates and is happy. If I see he doesn't like it, I'm pulling him out. Which is what will most likely happen with his PT (really it's more like extra OT since it's mainly therapeutic play). The therapist is really knowledgeable and everyone things she's THE best, which she might be ... just not for my son. She is older, doesn't remember much and I think DS4 is extremely bored with her (unlike his main OT he's had for the last 12 months). This PT forgets what she did with him the week before (NOT a good thing with my son who remembers all they've ever done at ALL sessions! lol) ... does the therapy at a small 10 x 10 room with dimmed lights (while he needs to run ... can't really ask him to sit still on a couch for 60 minutes) ... so, overall I'm just getting really irritated and am trying to find a polite way to say we're done with that one! lol I'm thinking if I take him to a bounce gym where he can jump for 2 hours he'll get more PT from that than anything else

... on a side note. I have actually been considering going back to school to get an OT or ST degree (because I am really interested in the topic and because I see a lack of therapists who can think outside the box and not think that all children will respond to the mainstream therapies the same way) ... but having two business degrees, I would pretty much have to start from the very beginning and neither of these degrees can be done online, which is a huge deal breaker for me

DeeDee ... thanks for the tip about the Autism center! I am finding a lot more useful information about all of this here on this board than any doctor or therapist has ever been able to give me!

The Psychiatrist we're seeing is at the Children's hospital in Chicago but it's only an intern since seeing a REAL specialist would take even longer. But at this point I was willing to have just about anyone do a basic eval rather than wait any longer. Depending on what she comes up with the next time we see her, I might be pushing for more or will want a re-evaluation done in a few months because he's changes so much in very short intervals. One of the biggest ... well, THE biggest issue we have is sleep. DS4 was always horrible sleeper (I mentioned to his OT when he was close to 2 that he spends 2-4hours in his crib jumping up and down every night trying to get himself to sleep and she said it was all sensory ... I do NOT buy into that) ...his sleep got better last fall for about 3 months and since December it was all downhill. We went through couple months of him being up past 3am, sleeping 4hrs a day and when he'd fall asleep at a normal time around 8-9pm he'd be up two hours later and stay up all night! Pediatrician couldn't figure out anything other than along the lines of "wouldn't want to be you" ... we tried Melatonin, which didn't work at all, tried Hydroxyzine, which helped a little but not much (he was able to fall asleep around midnight instead of 3am) and he started getting very irritable so had to take him off of that. Then I tried Melatonin again 4 weeks ago and surprisingly it's working! ... for now! When I tried not giving it to him, he was up all night, when I tried lowering the dose, he woke up at 2am and was up till 10pm when he finally crashed. So, really the main reason for contacting the Psychiatrist was the sleep issues because it throws off everything and everyone in the house.

And now DS2 is starting to have sleep problems too! He's been up till 2am most nights the last 7 days! Went from needing 12-13hrs of sleep to needing about 8 maximum.

which brings me back to my original question about the pre-school. If DS4 goes back to his crazy sleep/no sleep ways, he'll be impossible to wake up in the morning for school. How do you wake up a child that was up all day and all night and finally crashed at 5am for school at 7am? (I have tried all kinds of routines, removing toys, rearranging room, painting room different colors ... just about everything there is to regulate one's sleep and none of that worked so thankful for Melatonin while it's working at the moment!)

MK13, you've already received great advice, and I don't have much to add - but here are a few thoughts for you:

* Re the SPED preschool - chances are there are kids in the program who are all over the ability map - I wouldn't automatically assume your ds will be the only intellectually gifted child in the program. It may sound counterintuitive, but sometimes in our school district in the very early preschool and school years gifted kids on the spectrum or with behavioral/social challenges are identified as gifted earlier than NT kids simply because they go through the SPED eligibility process which usually includes ability testing.

* As the parent of an EG kiddo who is also 2e (not ASD, other types of challenges) - when he was very little it was basically a default reaction for my dh and I to think that the areas where he wasn't exactly typically developing were due to being a high-IQ kid. There was no doubt he was really bright - when he talked. So when he didn't do other things on the same schedule as most kids do we just figured he was a quirky smart kid. Later on when he wasn't producing work at school we assumed he was bored. We thought he didn't want to write because he was a perfectionist. We knew all the long lists of traits of highly gifted kids and it was easy to find something that explained everything on them so we never thought twice about it - until he almost imploded emotionally in 2nd grade because he'd been struggling so long with his undiagnosed disability and he'd reached the point in school where he could no longer compensate for it.

* I don't know if you have one in your area, but where we live autism evals/diagnosis are most frequently done by a developmental pediatrician (here the dr is affiliated with a children's hospital).

* We've had varying success with the different therapies our kids have gone through - and for sure, if you're in a situation where an individual therapist just isn't a good fit, I'd try to change to a different therapist.

* What your children need now or will benefit from now in therapy may change over the years as they grow. My dd10 is a prime example of this.. I started to write her story out but it was going to be *way* too long! The brief version is: she went through multiple types of therapies at different times, and they all helped incrementally. In her case vision therapy made the biggest difference in her life, but the therapies she'd been through prior to that (sensory OT, listening therapy) were still things I would have taken her through again even though part of what they were trying to address was at least partly due to undiagnosed vision challenges.

* Dealing with so many therapy appointments and two children who have challenges is beyond exhausting. FWIW, for all it may be exhausting now, I suspect you'll be glad several years down the road that you actively sought out all the help while they were young - it may not be obvious now but it *will* make a huge difference in their lives, and it will make your life easier *eventually* once they are farther along in school.

* Last thought re sleeping at night - does your dr think there's any possibility that they may have chronic upset stomachs or is there possibly some kind of physical sensation that causes discomfort when they lay down (reflux etc?).

* And (I promise!) my last thought - always trust your instincts

Best wishes,

polarbear

polarbear, thank you!

the sleep issue is a very strange one. I don't think though that it's digestion related. The strange thing about it is that he has LESS issues with less sleep. He's moody, irritable, super sensitive, etc. when he gets full 10-11hrs of sleep at night ... yet he's fully alert, easy going, fewer tantrums when he only gets 5-6hrs of sleep (but at that point I'm ready to hang myself! ... not really but you get my point! lol). He seems to thrive with less sleep but it's very taxing on everyone around him. I wouldn't mind having him awake at night (he still has a gate up in his room so can only stay there) but he's VERY loud when he's awake .... playing or calling me. He actually sleeps on the floor in his room because that's the only place where he can stay asleep for more than two or three hours. I was considering a sleep study but it wouldn't really work right now because he won't fall asleep anywhere but at home (or in the car) not to mention he wouldn't tolerate any of the sensors. So we'll have to wait with that till sometime in the future.

I will ask about the Developmental Pediatrician next time we see the Psych. I am a part of local SPD parent support group and some of the parents have been to a Developmental Pedi but she has a huge waiting list as well and doesn't take our insurance. But since we're already seen by the Psychiatry dept. we might be able to get seen by others without having to be on the long waiting lists!

I think I mentioned in my original post that I believe DS4 does have some sort of learning disability ... I can already tell he's getting his letters mixed up and while he's great with math, when it's math on paper (or when he sees numbers) he sometimes transposes digits and such. This is a completely uncharted territory for me and hopefully the special ed teacher would be able to pick up on it?

I think I am somewhat biased against the special ed because our friends' daughter goes there and soon their son will too. They are great friends but I already limit our play dates to about twice a month because I don't want our boys learn from the friends' kids habits. There is a huge chance all three of them would be in the same class (and possibly next March when DS2 ages out of EI he'll be in there as well) and I am just not happy about that. I hope that doesn't make me a bad friend ... but that is the truth . And it's not that I would want to keep my kids away from other kids with other diagnosis ... I don't mean to say that my kids are better than other kids ... it's that I don't agree with some of their parenting choices and don't want my kids to do what the friends' kids are allowed to do.

IMHO, those transpositions and reversals sound age-appropriate - even the ones where he swaps syllables of spoken words.

It's true that all of this is age-appropriate and that's why it's often really tough to recognize LDs in kids who are this age. I can remember everyone under the sun telling us that when our ds reversed letters, switched #s etc it was all age-appropriate... and I can even remember several teachers telling us the reason he resisted writing was "he's a boy". Since our ds wasn't evaluated for LDs until he was in 2nd grade, I really don't know what a neuropsych for instance could determine at 4 re whether or not there is a disability... but I do think a mom's instinct when she has a gut feeling that something is up is worth investigating.

polarbear

Mk13, the sleep situation sounds terribly frustrating!! FWIW, our ds never slept more than 5 hours per night until he was in first grade and school finally started tiring him out. I have so many memories of him staying up until almost midnight then pouncing on dh and I at 5 in the morning letting us know "It's time to get up! It's time to get up!". He also didn't sleep in his bed - he usually crawled out of his bedroom and played in the hall until he fell asleep. The difference with him was he wasn't noisy - he has always been a kid who listens and observes rather than an active jumping up and down running all over kid. One thing ds was doing while he was wide awake late at night was listening to our tv downstairs - he could hear it up in his room. We had no idea he could hear it at first, until one week when dh had been away on business and I replayed an episode of one of our favorite tv shows for ds when he returned.... as a commercial came on dh mused "I wonder what happens next?" and from upstairs ds called out and told him exactly what was going to happen next (because he'd been listening when I watched it the previous week!).

I tried thinking about the sleep stuff a little bit, and one thing about our ds - he did start sleeping longer at night once he was in elementary school, but he was still a very light sleeper and he always wakes up in the middle of the night (our younger dd does too). Both ds and our younger dd are kids who worry a lot - that's there way of dealing with stress. Hindsight is all I have to guess with but I wonder in retrospect if perhaps part of the early childhood lack of sleep was related to anxiety also. Not sure! And at the time I was *way* too tired to have figured it out if it was

I understand about the preschool and the kids you know - I wonder though if they act the same way or the issues would be the same when they are in a school with close supervision and different expectations than at home.

polarbear - he's now a lot better once he's asleep than he used to be. His room is on the second floor the furthest away from the stairs and any noise and I still have a cd player in the hallway playing the same CD every night (classical lullabies we've played him since he was a baby and always wants them on) ... and we still had to till just recently tiptoe around the house anytime he was asleep ... even had to install an extra set of french doors down on the first floors in the hallway to block off enough noise so we could at least use the microwave when he was asleep! We couldn't even flush the toilet in the house without him waking up! lol ... the CD player blocks a lot of it out for him these days but those times were really trying!

as for the possible LD ... you're right ... I am going by my mother's instinct ... so far I have always been right. It actually seems to be getting worse as he's getting older. While he had no problems recognizing the alphabet and numbers way before he turned 3 ... now at age 4 he confuses W and M, or 6 and 9, etc. ... he has days when he can easily read sight words that he's learned from tv yet the next day he can hardly tell me the letters in that word in the right order. Same with math ... he can do a better job with a math problem in his head than if it's in front of him on the paper. It's just that feeling you have when he's looking at something that he's not seeing it right (and I am trying really hard NOT to compare him to DS2 whose first letter at 18 months was W and he has never once confused any letters or numbers ... as I know he's not the standard)

The allergy testing this morning showed DS4 still has a very strong egg allergy ... no improvements what so ever. I guess I will have to talk to the school about what exactly their plan of action will be should he have a reaction while in pre-school before we make any decisions.

On the positive note ... DS2 had another OT meeting with the coordinator from Early Intervention today and they said they will get us a diagnosis through Early Intervention rather than having to be on the 6 months waiting list for Pediatric Psychiatrist. Sounds good to me! I'd much rather confirm or rule out issues as early as possible than later!

Hi Mk13,

Any public school should be required to make a food allergy action plan-- not only "what if he has a reaction" with medications on site and teacher training about how to use them, but also prevention. Your kid shouldn't be the first egg-allergic they've had-- it's uncommon, but not *that* uncommon among kids this age. Legally, they have to keep him safe.

I'm glad you will be able to work through the second eval via EI. You sure do have a lot of balls in the air.

DeeDee

The worst part is, I'll be dealing with the same gifted in special ed preschool dilemma in March when DS2 ages out of Early Intervention! ... at least he doesn't have the egg allergy. Just a moderate corn allergy. But might end up with both of them in the same special ed class for couple months! lol

DeeDee - I emailed the Special Ed director to find out what is the official school allergy plan. Will see what she says.

More correctly, they have to keep him BOTH safe and INCLUDED. He's considered disabled if he has an epinephrine injector and anaphylaxis history.

In other words, it's not okay to send him to the office so that the class can do "green eggs and ham" for Dr. Suess day, or to have the child "watch" his or her classmates do science activities with eggshells, or color Easter eggs. (Ugh-- yes, really. That is perfectly okay under a health-care plan, though-- because it meets the goal of "safety" just fine. It just doesn't let the child participate to the same degree as his/her classmates, and socially, this has very definite consequences.)

This is why I mentioned Section 504. If the major reasons for the placement are social/emotional to begin with, then inclusion is really critical.

HowlerKarma - thank you for the info! We've never had to use the epi-pen (thankfully!) but that unfortunately doesn't mean we won't have to in the future. His allergy has been building up over the years rather than disappearing so we have no idea how bad it would be if he digested or got into direct contact with eggs if not closely supervised. Today just before they did the skin test, just a tiny bit of the testing solution from the little skin pricking thingy got on his finger as he kept fighting us and when he touched his forehead with that finger you could see immediately hives popping up. And that was a very VERY watered down egg protein. He wasn't allergic till after he turned one. Then one day he had eggs and his face got all swollen, couldn't see his eyes, spent about an hour throwing up nothing but clear fluid ... it was a mess. We were very lucky that as bad as it got, he did not end up having breathing problems that day but it was very scary even without that. And since then he's been testing more allergic than he did before. So the 504 plan definitely sounds like something we will need! I had no idea allergies could qualify under that!

Seems like a lot of helpful comments and I don't have a lot to add.

But wanted to chip in that my DS (now 5) was not a fan of circle time up to about 4.5. Still complains about it as his least favorite times of day, but obediently goes now and doesn't bother the other kids. In some earlier preschools he would sit okay for a minute or two and then exhibit what I personally think of as normal for an energetic little boy forced against his will to listen to adults with fake happy faces singing songs or talking yet again about the weather (a subject that adults seem to be more interested in than most kids): leaning into a neighbor or standing up or wandering away or laying down and making snow angels on the carpet, talking, singing, just anything at all he could think of to avoid the desperate tedium of sitting still and quiet in one spot.

DS has some social ineptness but not to the point of aspergers/asd spectrum, and looks ADHD sometimes but not others. His challenges are more he is easily frustrated and emotionally tense/intense. Can easily focus and remain reasonably still watching a great TV show, or pay good attention for long periods of time to someone talking about a subject he's interested in. As he's gotten older he's gotten more tolerant of doing what others ask for the sake of pleasing them, gotten more used to routines, etc.

The turn around with circle time for him came when we switched him to a montessori/free-play preschool last year, they happily let him not go to their circle times for the first couple months (they were fine with him playing quietly within eyesight of the group), later let him bring fidget type toys to circle time, slowly transitioned to expecting more from him.

If you don't go with the public preschool perhaps there's a play based type of preschool your DS (or both your kids) could attend part time for the socialization aspect. Perhaps just for the segment before snack time or before lunch, picking up early and in that way avoiding the worst of the food allergy risk. Sometimes the least "best" preschools can be gems.

Polly

well, here comes my update. We had our 3rd (last) session with the Pediatric psychiatrist and she said she doesn't believe he has ADHD ... I didn't think so either ... just some of this therapists did ... my opinion has always been it's "something else". She is recommending the Special Ed preschool and is saying PDD (forgetful me didn't ask if she actually means just PDD or PDD-NOS but I'll call her to make sure). Was saying she does believe he's on the spectrum though very highly functional as long as he has the right support (basically told me to continue doing what we're doing as it seems to be working for him) and she did say she'll refer us to a Developmental specialist if we want to find out more as to if it's Asperger's or other type of spectrum disorder ... they'd run all the tests, etc.
Anyone here with experience with developmental specialists / autism diagnosis .... would part of the developmental testing be IQ testing as well?

All in all, I am not surprised ... it's one of those mother's intuition things. Glad they are not agreeing on ADHD as I don't want the school to come a few years down the road and say we need to medicate our son because he's too much of a distraction but instead they'll have to work with us!

We're still waiting to do a speech evaluation (was supposed to have it done on Monday but the therapist had to reschedule for Saturday) to see if there's any issues with speech (there are a lot of times when I feel like he's not processing correctly what he's hearing)and then the psychiatrist will send an official letter to the school district with her recommendations.

But for now, it looks like we'll give the special ed preschool a try! If nothing else, it will make DS happy

Both my boys had partial WISC IV (I don't know why they didn't do the whole things) as part of an evaluation to see if they were ASD, although I know there are other/better tests for ASD that your specialist may use in conjunction with or instead of WISC. Others here will know more, I'm sure.

Oh my goodness - this made me laugh out loud. This is exactly how my son describes "circle time" Exactly ! He even mentioned the fake happy voice and big weird interest in the weather all of the time LOL. He wanted to know why no one else seems to notice how ridiculous it all is.

oh, I can totally see DS4 doing the same when the time comes! lol He lost any interest in the weather 2 years ago! And I highly doubt he'll be willing and able to sit even for 1 minute. Most likely he'll just tell them loud and clear that he's bored and will walk away

lol, doesn't get much better when you get older. I think I have a phobia of being trapped in conversations about the weather/random sport team/relatives medical conditions.

bit of a late night rambling thought... spectrum disorder stuff is disturbing to me, I'd self diagnose myself with ASD, ADD, and dyslexia based on 60% of the diagnostic symptoms of each.

If each of these disorders results from being out on the tail of a curve for like three or four traits/factors, then you can see a bunch of overlap symptoms without really being there.

Like:
A. Sensitivity 95%+
B. Detail oriented 95%+
C. Introversion 95%+
Might be an underlying mechanic set for ASD.

Imagine 20 common symptoms for identifying it. 3 of them exist related just to A, 3 just to B, 3 just to C. 2 when A&B are true, 2 when B&C are true, 2 when A&C are present, 5 when all three are present.

Then maybe dyslexia has
A. Sensitivity 90%+
B. Detail oriented <1% (i.e. abstract thinking)
etc.

Maybe 75% of gifted is at core:
A. Sensitivity 95%+ combined with one or more other extended traits

If the symptom matched to the right trait is matched to the right intervention, great. However, the risk of a spectrum diagnosis leading to a wrong intervention is disturbing (like giving stimulants to a gifted kid identified as having ADHD.)

Zen Scanner - I am taking the spectrum diagnosis with a grain of salt BUT ... there are couple red flags we have had for a long time that make me believe he is somewhere on the spectrum ... such as not being able to have eye contact. You can even hold his head, keep telling him to look at you and his eyes are all over the place but he can't look into your eyes. And a complete lack of empathy ... he can tell from the tone of voice when someone is sad or angry ... but just from a look of someone or their face he cannot tell anything. It's really hard to explain but it is very strange. If he thinks someone is angry or sad from their voice, he will ask about it "are you mad/sad mommy? I need to make you happy." ... he basically asks for reassurance either way because he can't tell himself and it is as if he has learned that people are supposed to be happy and mommy is not supposed to be sad or angry. But you can tell it's all learned behavior for him but he doesn't understand it at all. He just knows that is how it should be. It's really hard to explain. There's a lot more of these rather strange behaviors he has but these two are very noticeable. That's why I have to agree with the psychiatrist. Quite honestly, I think the most important difference will be with my husband who will most likely put more effort into being patient with our little guy!

DS2 on the other hand, I do believe he could very easily be misdiagnosed. So we'll have to be very careful with him when the time comes.

The thing that gets a bit annoying most teachers/schools don't realize that this stuff is indeed mundane and boring for some... They are immediately like your child has a "problem." In my more assertive days (before I started schooling in the art of passive agressive way of the upper class suburbanite), I had said "well he has a point this stuff is kind of insipid - every day" And they just look at me... like they never even remotely considered that perhaps it is indeed boring! Last year my son had a problem with the books they were making him read for 100 book challenge... the books were so so boring for him. The school was all like "Your DS thinks theses books are boring, there is something wrong with him!" I look at all the books and I am like they are boring - couldn't you do any better thant this? LOL.

Sorry I digress! I just really appreciate it when someone else's child also notices this stuff!

Yes. If you search my back posts, somewhere in there is the list of tests that were used to diagnose my DS at age 5. Included IQ and achievement testing, life-skills assessments, and a large variety of instruments that measured social and behavioral functioning. Make sure they do an ADOS. Make sure they have real expertise in autism. I highly recommend the follow-up, which will give you a detailed picture of strengths and weaknesses, so you know exactly what to target through therapies.

Sounds like you are making a great start on getting your DS the right learning opportunities! It can be so tricky to figure these guys out.

DeeDee

DeeDee - the psychiatrist said that it's a developmental pediatrician clinic at the Children's hospital (same as the psychiatrist office) and that they concentrate on testing for specific forms of autism. So I do believe going there is going the right direction. Hopefully their waiting list isn't as long as the psychiatrist's (6 months) ... but even if it is, the older he'll be, the more we'll know.

and OH DEAR! ... the sleep problems! He took a quick 40 minute nap on the way home from Chicago and it resulted in being still up till almost 5am! I was so tired ... and he needed something every 15 minutes. I can deal with everything else, but between these two boys, the lack of sleep in the last 4 years is really getting to me! lol

Mk13, that sounds like the way to go. I would expect them to have all the necessary expertise and be thorough in their work.

I hope you get some rest soon...

DeeDee

I'm curious on the eye contact, at what times you do get eye contact. I hope I don't come across as questioning of there being concern over ASD spectrum, I'm not at all (and the empathy issue must be concerning). I'm just plain curious as your DS sounds obviously bright and easily bored if there is a component of oppositionality or boredom. Ie do you get some good eye contact if you say something funny or unexpectedly novel, "Guess what I saw today, a dog with wings", or "how about fried bunny for dinner?".

Polly

he's very rarely making any eye contact at all. I'll have to try the tip you mentioned. The eye contact has been a real problem for good 2 years now. I really stress it that he looks at me and keeps his eyes focused on me when I'm talking to him but he just can't do it. His eyes wonder all over the place or he won't raise his head at all. It's very different from what he was like even as a baby ... from the day he was born he would look straight into my eyes anytime I'd hold him. He was born 3 weeks early via emergency c-section while my husband was on the road and when he came home 8 days later, first thing he noticed was that DS4 was looking at us like he was an adult and like he understood everything that was going on. He's still getting a speech assessment on Saturday ... I keep thinking if he has some sort of language processing issue, which could possibly be the reason behind the lack of eye contact?

... funny ... just now, I got the most eye contact in months from him ... he's zoning out on Melatonin! lol ... so, his brain working too fast and making it hard for him to make eye contact is also a possibility?

... still, that doesn't take away any of the other spectrum-like behaviors ... one other that stands out in my mind ... from about 9 months of age till maybe 3 years old he was fascinated by spinning wheels ... cars, strollers ... anything with wheels, he'd keep spinning them and looking at them for a very long time. One of the first odd behaviors we noticed.

I am not one of the people who believe vaccines can cause autism ... BUT when he was 4 months old, by mistake he was given 4 of the same vaccines he already received 4 weeks prior (the doctor's office forgot to update his records at the 3 months visit) ... and nobody realized it until I started asking questions about why is he getting the same vaccines he received at the previous visit. They all said it's no big deal, it happens, it doesn't cause any harm ... but at the back of my mind, I have been always worried WHAT IF? It was basically a vaccine overdose as they should be spaced further apart ... so, yes, I have always been scared will be dealing with some issues later on. But that is just a theory ... uncomfortable, to say the least ... but only a theory.

So maybe eye contact is best when he's relaxed and everything around is quiet or dim? A component of anxiety/stress/hyperarousal (from any cause, stress from trouble processing speech is one possible cause), or some sort of distractibility (visual, auditory overload, etc). (I'm just thinking aloud, I have no training whatsoever). I asked about the fried bunny as that's my tactic when DS (or DH) is preoccupied, turns out they are usually listening at some level to me.

DS4 has a really bad Sensory processing disorder. He seems to respond the best when he's in another room. I always joke about him needing to be around the corner to actually pay attention to me.

PDD makes sense but I do keep in mind it might be a misdiagnosis. Hopefully the further testing will give us more clear answers.

another update - DS4 had a speech evaluation done yesterday at the place where he gets OT and PT. The lady who did it is the main ST there (and one of the co-owners) and she came to the conclusion that he's not really having any speech issues (I was worried about him not processing verbal info correctly as a lot of times it's like talking to a Martian ... you give him a question and he answers something completely different ... and I don't even attempt to have a conversation with him as it turns into a long monologue from him) ... I always say he looks like his brain just can't stop and is always spinning ... and she basically supported my view on it. Said it's not that he doesn't understand the question ... but for him the simple "correct" answer isn't enough and he has a need to tell us a lot more. ... like ... she showed him pictures and asked "which boy is wet" ... and he showed the picture and added "this boy is wet because he got caught in the rain and didn't have an umbrella and now is standing there in a puddle!" (this is the kind of sentences he uses ... they just never end) ... she went on showing him other pictures and doing other problems with him and then said there's no need to test further. That he knows well beyond his age level and the one big problem she sees with him will come when he's in a group of more kids and he'll need to be quiet and let other talk ... SO, he's starting their small group Speech/Occupational therapy next week. I think we'll cut down or completely cut out his PT as he doesn't really need it at this point and just keep his OT every other week and add this group session instead. Whether he does end up going to the special-ed preschool or not, I really want to give this group approach a try since it will give us a better idea of how he'll do following directions while with other kids! (on a side note ... DS2 ... the one who can't stand other kids in a radius of 6-10 feet will be starting a group OT as well ... they just last week created one for his age group! I'm so excited!!!)

But, back to DS4 ... he was a riot during the testing! lol ... She'd show him another set of pics with kids standing, holding balloons and ask "which boy has the MOST balloons?" ... and he'd first point to the one with none and say "he doesn't have any" ... next one "this boy has one" ... next "this one has three balloons" ... and then pointed to the correct picture and say "this is ME! I have the most balloons!" ... the speech therapist ended the session just telling me that DS must be a lot of fun to be around (yea, try that 24/7 though!!! lol) and that she wouldn't worry about speech and speech processing itself but really only about how to get him to follow directions and be in a group rather than do his own thing.

So, I guess this is all good news!