Expert: Jene Aviram - 2/17/2010

Question
I am a mother of 2. My oldest is 3, youngest 18 months. I have questioned my 3 year old son's behavior at different points. He seems a little quirky in a lot of different areas compared to other 3 year olds and even his youngers sister. "Andrew" seems to be scared of uncomfortable with a lot of new people or situations that occur outside of his home mainly. Some days are good, some bad. He doesn't like to go to preschool and he doesn't seek out play with other children hardly. At times, when he is 1 on 1, he will play good, but more than 1 child, he seems to become hyper almost or out of control with behaviors. Again, not always. He is a sensitive boy, and has seemed to have emotional outbursts that are just crying, but about little things, like not being able to get a toy open or cannot get something to work. Bright lights often make him squint or whine. His eating varies. When hungry, he seems to eat a lot of different textures and flavors, other times seems picky. Does not like anything "spicy". I have not gone to a doctor, because I don't want my son to be labeled so young, if there is really no problem. He talks very well, in fact his vocabulary is great for his age. Sometimes it is hard for him to answer questions or initiate conversation. Sometimes, he just does not want to talk and wants to be left alone, especially when I ask him about school. His eye contact is so so. He does not look me right in the eye for a long period of time. Maybe 3-4 seconds. When I am further away, I have better luck. When he is listening to other people talk to other people, I look at my son, and he is looking at their faces. Sometimes I think there are some sensory issues, especially when it comes to his play. The other day, he was around 4 other children in our home, and when the other kids would play with a toy, "Andrew" would come over and ram into or destroy something they were doing. That is not typical of Andrew's behavior but wondering why he would do that? Andrew likes to play with toys sometimes, other times would rather just rough play all day. He knows how to play with toys appropriately, but after about 5 minutes,will start to play with it in other ways, sometimes in my eyes inappropriate. He loves to be played with, and rarely will play by himself. He likes to be led by another person a lot. When I want to show him how to do something that is new to him such as coloring, drawing, shapes, numbers, letters,,,,, he gets upset or looks away and will not watch what I want to show him. He can recognize about 16 letters and know how to draw A and I, maybe a few others, but has to be guided most the time. Is this normal? Sometimes I feel I have pushed my son too hard, and he is refusing to listen to me. Some days, he loves to play catch for a few minutes, other times when we ask him to play, he will start to play and then start acting up or goofy or not playing how he should. I am worried about my little boy, I love him and want the best for him. I just don't know if a doctor would want to medicate him or what therapies he would benefit from. Do you see concerns for autism or any other disorder? Also, he is hyper. When he hears his name, he always looks up, usually for a quick 2 seconds, and will listen sometimes. Othertimes, I ask him or tell him something and I have to repeat it 30 times. I know some of these things seem like normal 3 year old behavior, but at what point do you get concerned? Overall, it hasn't effected our lifestyle, other than sometimes I can expect Andrew to get very shy, or sometimes cry when put in unfamiliar situations. At times, even with family members, it takes him about 20 minutes to warm up and associate. Please just give me some advice or thoughts. Sorry so long.
Nichole

Answer
Hi Nicki,

I can see that you are a very loving mom who is worried about her son.  Let me start by saying that your son has a lot of skills.  Among them he speaks well, he has play skills, he's responsive and he attends.

I do think that you have some valid concerns which does NOT mean that I think he has autism.  It sounds like your son definitely has issues with sensory defensiveness.  This explains some of his out of control behavior and sensitivity to light and different textures.  It can also explain his rigid behavior and wanting to do things on his own terms an in his own way.  The incident with the 4 children was probably sparked by his frustration at not knowing how to participate or join in appropriately. He clearly is not able to express himself in the way he would like and this is a skill that can be easily learned.

I know you are afraid about a label, however by not getting your son evaluated you would actually be doing a great dis-service to him.  Firstly, I don't actually think he will get a label but he would probably get some Occupational Therapy to help him through his sensory defensiveness as well as some additional services to help him express himself.  Your son sounds like one of those kids that will conquer all and you'll look back and smile at the days when you were worried.  But the trick is to catch it early.  Just think about yourself.  If you start biting your nails it's a lot easier to quit the habit after one month than after ten years.  The same goes for your son.  Everything we do becomes a habit, including our behaviors and way we deal with every day situations.

If I were in your shoes I would reach out to your pediatrician and ask him to refer you to someone that specializes in childhood disorders.  Make notes of all your concerns.  Take short videos of any other behaviors you're concerned about that you can show to a professional.  If your son requires services, now is the time to do it.  I'd also like you to read this article called "How do you know if your child has autism?"  I think it will give you some peace of mind.  You can download it here http://www.nlconcepts.com/autism-howdoyouknow.htm

I hope this has been of some help and I wish you great success.

Jene Aviram
http://www.nlconcepts.com