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Forum Name: Pediatric Topics

Question: Autism or ADHD ?


 Avolon - Wed Mar 26, 2008 12:30 pm

My son is now 4 but he has been anything but easy to take care of. When he was a baby he had Jaundice so bad his skin was orange but nothing was ever done for it. He also had horrible colic for the first year of his life. When his grandfather would hold him he would turn his head to the left mostly and refused to look at him at all. When anyone else held him he prefred to look around instead of at faces but he would at times make eye contact especialy with me. He skiped crawling he prefered to roll and then started walking at 1. His language skills were delayed, he prefered to use his own language and his understanding wasnt the best. Now he talkes well enough but I think there might be some delay still. He's smart he can read some and he loves to say his numbers and ABC's. Teaching him is not easy though because he cant sit still for long, and his attention is always drifting. I've noticed that he has a hard time holding a pencil correctly and preferes to hold it in a fist. Also since he was 3years he started tip toeing off and on and now its something he does constantly. When we ask him to walk flat feet he does for a few seconds but obviously preferes tip toeing. He is not fully potty trained, he has bad days where he can never make it to the bathroom on time. When he is having too much fun doing something he will not go to the bathroom at all. He refuses to have a BM on the potty, but instead will take it out of his pants and place it into the potty. He is stuborn, willfully disobediant. Tests the boundarys of every rule every time all the time especialy when he isnt home. At home he is more behaved. He loves to play with other children, when he sees kids walking down the street he races off to follow them home. As he gets older he seems to be more and more behaved, listens better, goes to time out without being dragged. Yet he is still super HYPER, bouncing off walls. He has night terrors. talks in his sleep very loudly, thrashes at times. His father does the same things. For the last 2 years my father has been saying my son is autistic, strangers say he acts autistic. I've resurched autisum and its true he had a language delay and he tip toes but he talks very well now and his understanding is miles better than what it was. I'm thinking the delay might be my fault because he is the first born and I'm not much of a talker, since he started watching tv in the mornings his understanding and talking have improved ton's. I think he is more ADHD, my husband and I were both diagnosed with that when we were young. My son is a sweet lovable boy, who loves people and calls everyone his friend. I'm being pushed by family to get him treated for autism, but I don't think he is, and neither does my family doctor. What can I do?
 Debbie Miller, RN - Wed Mar 26, 2008 10:48 pm

User avatar Hello,
I can certainly empathize with your frustration. Parenting is hard work and not an exact science.

What makes it difficult to diagnose disorders such as ADHD and autism is that almost all the characteristics of the disorders can also be seen in neurotypical children. It takes a trained observer to get a good handle on this.

With autism, there is a broad spectrum of autistic disorders. In other words, you can be "a little autistic" or "severely autistic" and everywhere in between.

With ADHD, there is a timing issue. At age four and five your son's behavior is actually quite typical. I have seen children who appeared by all accounts to be very hyper and I suspected ADHD, only to have them enter kindergarten and have the teacher say, "this child is no worse than the others." So, at this age, you can expect a log of hyper behavior, difficulty sitting still, concentrating, staying on task and yes, even potty training and responding to adult expectations. For this reason, an actual diagnosis and treatment is usually delayed until the child is older. When in a few more years the child is standing out as quite different from his peers, they begin to think ADHD. Until then, it's kind of a stab in the dark.

Normal behavior also runs the gamut. Some children are more obedient and less obstinate or rebellious. Your child's personality has a lot to do with his behavior and you have to love the energy exhibited. Potty training can take quite a while. The fact that your child is aware and takes his stool to the toilet indicates good cognitive ability and it will probably be just a matter of time. Try to be patient and not draw too much attention to the behavior as this will reinforce it. Reward the times he does it right (only). Negative attention is still attention so try to extinguish the negative behavior by letting it die of starvation (for attention).

You may have some type of local service for preschool children where your son could be evaluated. This might be in conjunction with the school district or local health department if you are in the U.S. A trained professional might be able to identify behaviors that are consistent with autistic spectrum disorders and could suggest intervention if needed. You might also read some books on how to deal with autistic children because the skills are similar to what you would use with all children to encourage good behavior. If he does have Autism or Asperger's Syndrome, early intervention and education can help him to achieve. If he does not, there is little to be lost in learning parenting skills. Liane Holliday Willey has written some good books about Asperger's Syndrome, which is on the high functioning end of the autism spectrum. It is not so important to get a label right now as it is to find ways to help your child. Some services need a diagnosis so it can be helpful and knowing what you are dealing with can help you to learn what you need as well. To complicate things further, a child with Asperger's, for instance, can also have ADHD.

Elizabeth Pantley has written some excellent books on parenting in general that might help with some of your issues, including "No Cry Discipline Solution" and "No Cry Potty Training." You might also enjoy receiving an email newsletter about autism. There is a good specialist who does a weekly newsletter at http://conversationwithemily.blogspot.com/ and you might find this helpful as you work through the maze.

No matter what your child may be labeled with, remember that he is unique and both ADHD and Autism come with gifts as well as challenges. Find the good and the brilliant that is your child. Every child thrives on love so give plenty! Good luck.

Best wishes.
 Avolon - Sun Mar 30, 2008 4:58 pm

thank you so very much for taking the time to answer. I just have something to add. My son is in a class or school of sorts but it only meets once a week for 2 hours. I have peeked into his class and I've seen that he doesnt usualy sit, he makes lots of noise, he doesnt like to focus on what is being taught but would rather play. He gets taken out of his class for a time out just about every week for his disruptive behavior. Now there are days where he is really good but even then he has a hard time listening and sitting still. I'm worried that when he starts school he will be unable to learn because he cant focus or sit still! I do not want to put him on meds. I remember what happened to me when I was little, because I could not focus I was put into a dev. challenged class where the teacher thought it was ok to abuse the kids because they couldnt say anything or whatever her exuse was it wasnt right. I didnt stay in that class for very long because I wasnt delayed I was just ADHD... I was then put on meds that seemed to suck the life out of me. I lost all interest in friends and would rather be alone. I believe I was depressed, and even after they took me off the meds the damage was done and instead of being outgoing and full of energy I was withdrawn and prefered to be alone. I don't want to put my son on meds so I was hopeing that there were some tips or something I could do to help him with his hyper behavior and inablitity to sit still problems? He's a good boy and I don't want him to go though the same painful childhood I had...I will even home school him if that is what it takes! But I would rather he could go to school to make friends because he loves to play with other kids.
 Debbie Miller, RN - Wed Apr 02, 2008 8:12 pm

User avatar Hello,
Again, he is still very young to be overly concerned. Some children do have difficulties with behavior and time alone helps. Kindergarten teachers don't expect all the children to sit still for long periods of time - it is not developmentally appropriate to do so.

As for meds - if it reaches that point, they do have many more options now than they did in the past and if he actually needs them, there is likely to be something that won't have the negative effects you experienced. Also, they do not cause permanent, long-term damage. This is one of the advantages to treating ADHD. The meds either work or they don't and you can find out very quickly which it is.

This is such a growing problem that professionals are also much better able to handle the condition than in the past which children were labeled troublemakers and disrupters. Educators are taught how to better handle these variations in the classroom. I would also recommend a therapist if needed to help self-esteem issues.

Good luck.
 kabeebabee - Wed Apr 09, 2008 10:33 am

Wow! sounds just like my daughter. She was diagnosed at age 4 with adhd, I knew at the age of 18 months that she was adhd. I had a daycare so i knew that she was not like any of the other children. Finally at age 4 they diagnosed her, only because she ran out in the street adn was hit by a truck. She never sat still, bounced off the walls, did that tiptoeing things always. It got to where I was afraid of her when she got to close to me, I was afraid of her actions, she was so wild, I didnt know what to expect one moment to the next. I developed anxiety because of her hyperness. I totally understand and sympathize. If you have any questions I would be more than happy to answer them for you. I am not a docotr or nurse, just a parent who is dealing with an ADHD child.
 Debbie Miller, RN - Mon Dec 29, 2008 1:59 pm

User avatar Hello,
Both these conditions are very challenging. And when they co-exist, life can be trying. The rewards are great and these children have untapped abilities others lack. You can read lots of books and get help through your school system parent education centers and classes.

Good luck.

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