Expert: Valerie Herskowitz - 1/30/2011

Question
Hi Valerie,
I have a 31/2 yr old who has been in special ed;self contained 12.1.1 class for almost a yr-EI since 2.  He had 5 words at 2 and v.self directed. The school evaluated him at 2 and was on the fence w/pddnos. I had him seen by an outside neuro at the same time and she said no to pddnos but mixed expressive and receptive language disorder.  Fast forward, he has come along way with his language.  Is he behind yes..but he is talking in short sentences and communicating his needs-yes.  The problem is this.. Placement and new behaviors.  The school says he is not socializing with the kids too much.  He still is at the parallel play level;will greet & ask to play but not enough to stay interested. He is answering wh questions w/between 60-90% accuracy. He reached 3/5 goals-sorting colors,shapes, sitting for circle,transitioning but not his social ones-verbalizing requests from adults.  One on one w/his therapists he is great.  So i took him BACK to the neuro and of course he was great.  He played ball, played with his brothers and sisters, broght me things, asked me for things and he appeared comfortable w/us. He is bright-showed her he knows all his letters, colors, shapes, spells his name,etc.. She said no to pddnos again. It was almost as if she felt i was looking for one to get more services. She understood the political issues but made it a point to keep telling me he is not autistic. I tried to explain that he is different in the classroom and had her read the report- she wants him in a longer program w/services which is just another fight way too long for this post & the school isn't budging as of yet.

Anyways, this is my issue w/his behavior. All of a sudden,he doesn't want to get on the bus anymore.  He waits by the door, and sometimes i will take him outside to play with the snow and when he sees the bus its like a game-he runs, i get him, walk him to the bus, gets on and he starts to cry, sits downs and yells for me telling me he wants to stay hom. 5 straight days this week.  He is so stubborn and self directed.  He will come into a room and say turn the channel.  If my other kids tell him no he cries and carrys on saying "i want turn the channel"  I explain to him he has to take turns. I always always have to stay firm, either raise my voice, put him on the step, or let him cry.  he gets over it but when HE wants his way we always go through the same routine-some are easier than others but he's strong willed.  I keep thinking-"Is the neuro right" and i just have a self directed, expressively slow, smart, child.  He is great if he gets his way but if he doesn't he's difficult. His testing is going on now.  She called me friday and said she is confused by him too.  He scored like a 99% on some visual test--off the charts.  Then he sat in circle w/a mug on his face.  She was asking the kids what they ate for breakfast.  He said spaghetti and meatballs.  Then she had a bag of winter clothers.  She asked him where do you put your hat when you go outside?  He said feet.  She said its like he is looking at her as if she is stupid but she's not sure. I knew he knew the answers-but he gets you stumped up.

That night my husband asked him all the questions about clothers, food at the dinner table and he answered them all b/c my husband made it a game-it was fun!! Maybe its that he doesn't like to conform to rules in the classroom if he doesn't like what they are doing?  He passed his transition goal though?

Put on your thinking cap... I am at another crossroads.  Placement-they won't give me integrated and/or extend his day. I am afraid to put him in a regular preschool w/SEIT but they keep saying that when i push for integrated for him w/support for socialization.  I think he is v.aware that he can't express as fast as others even though he knows what he wants to do and that frustrates him. How do i help him?  This i think is his biggest challenge. Patience is what he needs but too little to understand yet smart enough to be aware.  This equals frustration.

Answer
Hi Cetta
I hear your frustration. Your son is obviously having a lot of issues, but since he exhibits some nice skills in other ares, your professionals are reluctant to give him a diagnosis. The visual skill doesn't mean he doesn't have PDD-NOS though it does say that he appears to be very bright in that area which people on the spectrum often are.

It's obvious that he is having some processing issues none the less. So maybe for now you should concentrate on that. If you want to do a formal consult with me, I could recommend so specifics. Just let me know