amielynn38, it's really tough for most of us to know from a post here if your ds would benefit from an evaluation, simply because we don't know him personally and we don't know the degree to which challenges are impacting his life. I could read your description of him on the one hand as sounding like a fairly typical 4 year old stuck in perhaps a preschool that isn't a great fit (too much seat work and not enough play)… or I could read it as a child who isn't fitting in at preschool due to social challenges who would potentially benefit from an eval and possibly some type of therapy. My only recommendation there is to trust your gut feeling - if you feel there are challenges then yes, I'd go for an eval. I'd also put a bit of weight in what your ds' preschool teachers are saying - if they are telling you he's having difficulty with sitting or socializing that are beyond what they see as typical for his age, then I'd look for an eval.
I'll also add - it's not always straightforward knowing what type of eval to pursue or in catching what's up at your ds' age - but I don't see that as a reason for not pursuing answers when you have questions - just keep in mind that you might still be pursuing answers later on also.
What concerns me most is the sensory stuff. The screaming and uncontrollable crying when loud noises happen. Or total shut down when there are strangers or a large crowd. When his routine is off by just 15 mins, he looses it.
FWIW, I could have written this same paragraph describing my older dd when she was 4 years old. I was, quite honestly, worried I'd never get her into a kindergarten classroom when she was required to go to school the next year - her apparent sensory issues were that huge. We did take her for an eval and she did go through sensory OT - and it helped a huge amount, which was wonderful. It didn't, however, catch what was really going on - for her, it was a vision challenge (double-vision among other issues). We didn't catch that until 2nd grade. It was, however, worth the time invested in sensory OT, our insurance did cover it, and the OT was fun and did reduce her sensory reactions in new places etc.
I am not sure if it's needed and I don't want him to be labeled.
You only have your filter on whether or not it's needed at this point - you don't really know - and going to see your ped with your ds is nothing more than that, having a visit, asking for the ped's opinion. If the ped feels OT would be worthwhile (or some other therapy), you will still have to have an initial eval with that professional too - and again, that is just one professional's opinion that you can choose to either accept or reject and move forward as you see best fit. It's all really just collecting data and ideas and opinions from professionals with experience in seeing young children your ds' age at this point in time. If you visit and find out that there really isn't anything to be concerned about, that can be very reassuring in and of itself, and if you find out there's something to watch or something to get help with, that might be incredibly important to your ds to catch as early as possible.
Re labels - I have children with diagnoses. The diagnoses don't impact their lives at all in terms of being "labels" that cause negative consequences. The diagnoses give me an understanding of how to best help them, the diagnoses give my children an understanding of what the nature of their challenges are (prior to their diagnoses they formed an inner opinion on their own that something was "wrong" with them compared to other children), and the diagnoses give us a way to explain what's up with my kids to other people they interact with.
While a label may not seem like a "good" thing - what's really going to cause problems for any child long-term is having challenges that are ignored or not dealt with completely because a parent is overly worried about "labels".
Also, fwiw, labels given once don't necessarily last forever- an understanding of what is going on with a child may change as he/she grows and becomes more able to adequately express frustration and can explain to a parent or teacher or whoever what they are feeling or experiencing. My ds was diagnosed with ADHD at 7, and within a few years it became obvious that the ADHD-like symptoms he'd experienced at 7 really had nothing to do with ADHD. We had him re-evaluated by our pediatrician and he was officially "undiagnosed". His neuropsychologist followed up with another look at ADHD a few years later and again agreed, he does not have ADHD. So labels aren't necessarily for a lifetime - unless they fit the child.
I'm also not exactly sure if it's the sensory etc behaviors that you are seeking the ped's advice on or giftedness (based on your previous post). If you're primarily interested in testing for giftedness, honestly, I'd hold off on that at this point, and also not over-worry about academics until you have to. If that's what you're after, let us know and I'll add details about why I wouldn't pursue the testing now - or I'd at least be cautious about it.
Best wishes,
polarbear
