Seeking diagnosis

Took both J and Sweet P to the doctor's office for the first time since J was 18 months and since Sweet P was 3 months...

Some of you may think I am horrible for not getting them there more regularly but I have my reasons to distrust traditional medicine and we haven't had insurance until just this year.

Thankfully the doctor said the strange bump on Sweet P's foot is nothing to be worried about, unless it gets bigger, then maybe get it checked again, but it should eventually shrink and disappear on it's own.

However as I discussed with him the different things we were noticing with J's development... The doctor's concern grew and he asked a lot of questions... Eventually he came down to two possibilities.

One, it could all just be hearing related.
Two, it could be autism.

I shudder.

I'm not sure I'm ready for this. I'm almost hoping that it is just a hearing issue, I think that would be easier for me to handle... We go in tomorrow for an hour long speech assessment and to schedule a hearing test.

But what if it isn't his hearing?

I decided to look up autism as soon as the munchkins were in bed tonight...
Here's some of my discovery:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002494/
Says:

Symptoms
Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is age 2. Children with autism typically have difficulties in:

Pretend play
Social interactions
Verbal and nonverbal communication

Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. This is called the regressive type of autism.

People with autism may:

Be overly sensitive in sight, hearing, touch, smell, or taste (for example, they may refuse to wear "itchy" clothes and become distressed if they are forced to wear the clothes)

Have unusual distress when routines are changed

Perform repeated body movements

Show unusual attachments to objects

The symptoms may vary from moderate to severe.

Communication problems may include:

Cannot start or maintain a social conversation

Communicates with gestures instead of words

Develops language slowly or not at all

Does not adjust gaze to look at objects that others are looking at

Does not refer to self correctly (for example, says "you want water" when the child means "I want water")

Does not point to direct others' attention to objects (occurs in the first 14 months of life)

Repeats words or memorized passages, such as commercials

Social interaction:

Does not make friends

Does not play interactive games

Is withdrawn

May not respond to eye contact or smiles, or may avoid eye contact

May treat others as if they are objects

Prefers to spend time alone, rather than with others

Shows a lack of empathy

Response to sensory information:

Does not startle at loud noises

Has heightened or low senses of sight, hearing, touch, smell, or taste

May find normal noises painful and hold hands over ears

May withdraw from physical contact because it is overstimulating or overwhelming

Rubs surfaces, mouths or licks objects

Seems to have a heightened or low response to pain

Play:

Doesn't imitate the actions of others

Prefers solitary or ritualistic play

Shows little pretend or imaginative play

Behaviors

"Acts up" with intense tantrums

Gets stuck on a single topic or task (perseveration)

Has a short attention span

Has very narrow interests

Is overactive or very passive

Shows aggression to others or self

Shows a strong need for sameness

Uses repetitive body movements

The things I have highlighted are things that stand out about J, but even some of those barely... To me some of these things seem typical for a 4 yr. old or I can remember doing things when I was even older.

Where I have highlighted mentions of sensitivity to hearing... We live next to the train and J LOVES it. He rarely puts his hands on his ears in his excitement to point and jabber about what he is seeing. But in other cases such as having the blender or the vacuum turned on, he will cover his ears and act worried. I remember being sensitive to the sudden loudness by comparison, when I was younger I would run from the vacuum or cover my ears while mom ran the blender and banged about the kitchen.

Unusual distress: It usually isn't that he is angry or against the idea of activities changing. He LOVES to go new places and will get SO excited. He will get whiny when we can't getting ready to leave fast enough and his anxiety overwhelms me. Just how abnormal is that though? Don't a lot of kids get excited about going out?

Attachment to objects: AGAIN, I think "Don't a lot of young children do this?" Occasionally J will have one toy that is his favorite and he wants to take it everywhere... But it doesn't usually turn into a major fit, momentary is sadness is forgotten when we move on to the next activity.

Maintain a social conversation: J can hold up his end! He will talk a blue-streak, though you may understand very few actual words out of his excited jabber. And if you ask him a question he may not answer it or you may not understand the answer. He has gotten better at this but still not great. 

Gestures instead of words: J can sometimes do this but it seems to me he is usually acting out the behavior of his baby brother and if we ask him to use his words, he can clearly and nicely say what he needs or wants, maybe requiring a little coaching.

Develops language slowly: This is, of course, the biggest concern that has brought me to think that some how I need help with J. Lately he is learning more and more words and I can catch more of what he is trying to jabber about but others rarely catch it because their ears are not familiar with his sound. And compared with others his age he still has a ways to go. He can count to three, but he doesn't recognize any letters.

Refer to self: For the longest time J would say "You" instead of "I." but recently he has changed that and said "I" or on the rare occasion he may say his own name to refer to himself.

Repeats words: This is perplexing... I mean, if his language is developing, don't I want him to repeat what I say? Isn't he supposed to try out the words for himself? He doesn't memorize a whole script to repeat later, but for example, today he started repeating the doctor (very clearly, I might add!)  as the doctor was talking to him and the doctor pointed it out as an example of something that wasn't normal.

Interactive games: J just doesn't seem to comprehend complex rules or taking turns. I have sincerely tried, when we have been out with other children, but really if the other child and parent will not insist on waiting, taking turns, J will run all over them. Toss the ball back and forth? No. Take the ball and play keep away....

At home with his baby brother he has started playing a game where they take turns chasing each other back and forth (I recently posted a video of this) and it wasn't something I taught them, they just do it... So is it something he just needs more experience with?

May treat others as if they are objects: Shows a lack of empathy: Shows aggression to others or self

Again this seems inconsistent, J can seem aggressive, he has been known to swing his arms around and end up knocking other children and show no sorrow when they cry. He lacks the concept of personal space or belongings. He will get very close, but he will make and maintain eye contact. It doesn't matter to him if you are uncomfortable with him climbing in your lap or going through your purse...

In some cases he is super possessive of his toys, yanking them from baby brother and hurting Sweet  P in the act. Years ago J would throw his head when we told him no, as a way of throwing a tantrum but our therapist said to put him in time out in his bed so he couldn't hurt himself too badly, and otherwise ignore it (because giving it attention was a reward). A little after that, the behavior stopped.

With his baby brother he has gotten better, asking "You okay?" or coming to me when he can hear Sweet P crying in his crib and be all concerned that I should go take care of Sweet P. So again, is it just a matter of time and more experience?

Rubs surfaces, mouths or licks objects

This one drives me crazy sometimes... J will put things in his mouth. Toys, magnets, blankets, it seems like everything he has ever held has been in his mouth. There is a stage where this is normal in child development and I have to admit: I remember being 8 years old and chewing on my pens or the neck of my t-shirts, etc... So, when does it go from a bad habit to a sign of autism? Maybe I have autism...

Gets stuck on a single topic: short attention span: narrow interests: overactive:

This is where issues I think are prevalent. J was go on unendingly about the train, Christmas, if you want him to talk about something specific he might say a few words and go right back to whatever is most fascinating to him.
He can do things for really long periods of time, watching a movie, playing with Duplo's, but if there are a lot of distractions/people around it is very hard for him to stick to a task. J has narrow interests but I'm not sure how much, again, that has to do with a lack of variety and experience he has had being only 4 yrs. old.


Hopefully we find out more tomorrow.