Expert: Ettina - 8/26/2009

Question
I am hopeing to keep this short as possiable. My 4 yr old son has a severe speacelay, has had tubes in his ears at 15 months, and still is complaining about his ears. Has failed 3 hearing test in this past year. He has been diagnosed with Ausistic disorder with ADHD. Being that we are "Army" and are stationed in Korea there isnt services her for him. We leave here in Feb. 10 Since his diagnosises his behavior has been overwhelming with spitting and hitting me. also teachers at the child care center. He isnt recieveing services at this time bc school is out. My question is the doctor that diagosed him did it in 1 hr and had no previous knowledge of Jaden just went off what i said. I am aggurvated bc i have told People about what they dianosed him with and they are saying He is too friendly and loving to be Autistic. He is a loving child just when he is angery he is out of control. He has to be told alot of times to do soemthing. then he will just walk past it and say were is it. He is also a RUNNER.. He loves to play vidoe games. WII but gets too attatched to it and is very demanding. I just want to know if you can give me some guidence on what to do. No one will really help me they just through a label on him but since we are here no one can give him services.

Answer
Not all autistic kids are socially withdrawn, especially towards adults. It sounds to me like your child most likely is autistic, because he has language delay, outbursts and obsessions. It is possible to diagnose children with a disability like autism in only one visit, they'd only need a longer observation time if the diagnosis is uncertain (eg in a very mildly affected child, or one with features suggesting a different condition that must be ruled out).
I have a couple of suggestions for reducing meltdowns. Firstly, sensory overload is a common cause of meltdowns, so if you notice your child tends to get upset in certain situations involving lots of sensory information (eg in crowds) or a certain kind of sensory stimulation (eg when touched), then you can work on a) avoiding those situations, b) desensitizing the child gradually, and c) teaching him coping methods (for example, wearing a coat with a hood reduces noise and visual stimulation). Running away probably indicates that he can't cope with the situation and is trying to escape, so you could set up a 'time out spot' where he can run to and stay there alone until he's calmed down.
Secondly, you said that your son has a severe speech delay, which probably means that he doesn't have enough verbal skills to ensure that his needs are met. Not only does this mean that he can't tell you when he needs something in order to stay calm, but trying and failing to communicate is also extremely frustrating in general. This is one big reason why typical 2 year olds have tantrums so often. So if you focus on helping him communicate better, his behavior will probably improve quite a lot as well.
Speech therapy is often helpful, but at your son's level of communication ability, nonverbal communication methods are usually easier. The most basic thing you can do is notice how he is already communicating - for example, how does he act just before he has a meltdown? Does he act agitated or do a particular gesture or sound? Since he appears to have hearing problems, you might want to consider teaching him a few signs, such as 'more' (put fisted hands together) and 'finished' (hands to chest and then turn out). You could also see if he has any reading ability - many autistic kids learn to read earlier than usual, and this can provide an alternate method of communication. Lastly, you could try taking pictures of things he might want to say to you, and teaching him to give you a picture to ask for something (eg he gives you a picture of his favorite treat and you give him that treat). Some people are concerned that teaching other methods of communication will impede speech development, but usually the opposite occurs - it encourages the child to try to communicate through multiple methods, including speech.