Expert: Dr Billy Levin - 2/26/2010

Question
There was a post on here with this same basic question, but my situation not quite the same.

My son is currently 5 years old.  When he was about 6 months old, maybe younger, I noticed him lining up his cars all the time, not only in lines but my color.  It seemed odd to me being so young, but he showed no other "obvious" signs.  He was a little delayed in speech, but not in a way I've seen as a concern except for a small lisp I feel will be better addressed when he starts kindergarten.  He was an only child until almost 3, so he wasn't around other children very often.  But when he is around other children or in social situations he just seems to "shine."  He's very outgoing and follows directions well only in these social situations away from family.

He's always seemed lazy as far as independence.  He refuses to do simple tasks such as looking for things.  He just looks around , barely, and say's "I can't find it."  Most of our problems with him are him refuses to do things.  He loves learning such as words and writing his name all over the place and coloring.  But the more physical learning he’s had problems with.  Such as he refuses to learn to tie his shoes, and not with just me or my husband, but with anyone.  It seems much more than stubbornness.  He just says “I can’t do it,” without even trying like he is afraid to try.  He was slow when it came to learning to dressing himself.  We often run into problems to this day with him dressing himself.  At times he is fine, but most of the time, such as getting ready to go out, he gives us trouble to fully get dressed without assistance.    

He is extremely particular and this is where it gets confusing, because this doesn’t seem to fit in with ADHD.  He hates to get dirty.  At the beach he freaks out when sand gets on his hands.  Always has.  He won’t play on the grass in such ways other children will.  Like roll down a small hill, even when others will do it.  If he gets his hands dirty in any way he demands to wash his hands.   It I prepare a snack and put it on one plate for the two boys to share, he freaks out about sharing the plate.  He won’t touch sticky things such as peanut butter without needing a napkin immediately.  If his food is not on a plate or bowl he wants, such as the color, he freaks out in a tantrum, or even if the food is on a portion of the plate he doesn’t want.  

Our household diet is unstable due to lack of finances and falling through the crack of assistance due to our household income being too large because with currently life with my mother.  But we always give vitamins to help balance when he refuses to eat.  Diabetes and hypoglycemia runs in my family as I am hypoglycemic myself.  But he doesn’t seem to have these same issues I have with sugar as I do, but I didn’t have problems with my blood sugar until I became an adult.

He has the worst time trying food at all.  He won’t try anything new and just says “I don’t like it.”  I try to get him to just take a bite and he acts terrified at the idea of trying it at all.  Other times he eats wonderfully with no problems.

When it comes to his energy he is non-stop except when he passes out or goes to sleep.  He constantly interrupts and refuses to be patient.  We ask him to wait a moment because of finishing a quick task, conversation or even for the preparation of food, and he freaks out when we don’t immediately respond to his requests.  It’s not like we just ignore him.  And especially if he asks for something appropriately I say nicely “Okay sweetheart, just wait a moment and I’ll get that food or drink for you.”  But it’s like it’s not good enough and freaks out because we don’t drop everything for his immediate request.  

Sometimes he is just so loud I can’t think.  We get him to calm down but then a moment later it’s like he forgets and starts it up all over again.

It seems like maybe sometimes we are being overdramatic and need to just work on our parenting skills, but other times it seems beyond our control, like something is just “Not right” with his behavior no matter what we do.

In addition he has a disposition to bi-polar from his natural father.  Although his did not seem to be bi-polar in extreme until he did drugs that brought it out.  I really don’t think my son is bi-polar so much because I did have experience with his father who is a 1000% times worse that my son.  But it is something I felt I should point out.  In addition anxiety and depression run on my side of the family as I have had anxiety issues.  

Sometimes when he throws his tantrums he gets himself so worked up it seems like he’s going to give himself an anxiety attack.  Not many times, but there have been a few times where he will start coughing, seemingly on purpose, to the point of him gagging.  Twice he threw up following this fit.  And it just terrified me.  Last year I seemed to get these scary tantrums under control, by putting him in a cold shower to “wake him up”  then I dry him off and he calms down and is okay again.  These tantrums don’t happen as often but are still present.  I haven’t had to use the shower for quite some time nor do I want to because I don’t want him to be afraid of the shower more than he already was.  On this note, he hates to get his face wet.  Always has.  He will sometimes scream when he gets water in his eyes.  Not soap, just water.

He fights with his younger brother al the time and tries to boss him around all the time.  He hits and pushes him when his brother gets in his way or has a toy he wants.  Boys being boys?  I hope it’s just that.

We are no way perfect parents.  But I just have this “gut feeling” that something else is going one here.  The idea of medicating him for anything terrifies me and is the last thing I want to do if there does lie a problem with his behavior.  As any parent I just want him to grow up happy and healthy and balanced.  And right now he just doesn’t seem balanced.  And it seeming is getting worse the older he is gets.

His doctor tells me he is fine.  But my doctor tells me the same thing and he is wrong for I’ve had other doctors listen to me.  I’m working on getting a new doctor for myself.  I just have a hard time trusting some doctors.  When I expressed my concern with the shots he just backs the CDC like a textbook.  I never learned about the issues with the shots until I was pregnant with my second son and have spread out the shots to hopefully prevent any possible issues.  So Ezra had all his shots as they recommended and I pray that I didn’t hurt my son in doing so.  

I know this is long but I feel the more information the better you can address my situation.  My 2 year old seems normal in most ways much more than my 5 year old.  So now that I have a comparison I don’t know whether to be concerned and look for a better doctor or to just relax and keep working on being the best parent I can.

Any input would be appreciated; I’m just tired of being ignored when I would like to know which direction to go in helping my son.

Thank you so much.

Answer
Firstly your long description clearly suggests a neuro developmental problem that should not be ignored. Unfortunately some problemes are complicated and not just a simple singular convential diagnosis like ADHD. He has possible  traits of ADHD, Autism and Obsessive Complusive Disorder and excessive tactile sensetivity, all togerther if this is possible. My advice is to seek help from a Neuro-developemental Pediatrician who would establish where to start sorting out your son's complicated problems. The treatment would include medication, parental guidence and various therapies all most likely on a long term basis. You should not delay seeking help.