Expert: Dr. Sharon A. Mitchell - 10/6/2007

Question
My son was developmentally delayed at the age of 3. Always very verbal. He did flap a little and did some echcoing. His pediatric neurologist said he would out grow it and he did. By the age of 5 he was thriving. Great sense of humor, huge imagination, bright, social. He was a typical kid. One month after his fifth birthday he got all of the side effects of an allergy medicine he was taking (Zyrtec). After one week of side effects, he stopped talking, stopped socializing, stopped using the potty, stopped eye contact, started to flap and jump. He is a totally different kid. He was seen for three days at a University Hospital and they have never seen this before. They said he seemed autistic. Nothing is physically wrong with him. He did not have seizures. Nothing genetic. His teachers and doctors are baffled. It has been five months since this has happened. He has shown improvement each month but is no where close to being himself. Have you heard of this type of regression? Will I get my five year old back? His pattern seems to be that he will have a few weeks of great improvement followed by a week of tantrums. I miss him so much and I am scared.

Answer
My heart goes out to you. It must be so difficult to witness the changes in your son.

No, I have never heard of circumstances quite like this, although I have heard of kids having allergic or sensitivities to substances that made their autistic symptoms more pronounced.

It sounds like you have good medical and educational support. I presume that they see the differences in your son as drastically you do.

I'm puzzled by what you said about your boy's early development. You mention that he was developmentally delayed at age three, with some possible autistic tendencies, although he was verbal. Then, these signs went away and he appeared typical by age five, as predicted by his pediatrician.

Do you think there was a chance that he was actually displaying mild autistic tendencies as a toddler? Sometimes, with the help from parents and other involved adults, a young child can learn so many good strategies that he can appear much less autistic, especially if the child is quite bright. Is there a chance that the early teaching he received helped your boy appear "normal" by age five so that he was able to fit in well with other five year olds?

Then, the physical trauma brought about by the allergic reactions to the drug might have worn down his defences
sufficiently that the autistic tendencies became more pronounced.

But, that's all just speculation on my part. I'd encourage you to continue working with your doctors and other
professionals as you search for explanations and solutions.

In the meantime, you have this little boy who is showing behaviors that are difficult for him and for those around
him. The label is not at the heart of the issue. What matters most is finding ways to help your child be
comfortable, happy and successful.

Whether or not your son actually has anything in the autism line, it would not hurt to try strategies with him that are usually effective with kids with autism. Many of these strategies are just good teaching and many children
benefit from having a structured, predictable home environment.

Are you able to pinpoint anything that might account for those weeks where he seems more like his former self or
those times when the tantrums come? Is he better when his life is more predictable and routine? Is he better when he
gets into the pattern of school but finds disruptions for holidays and weekends difficult? Do new people, new clothing or weather changes throw him off?

Are there sensory things that seem to bother him? An Occupational Therapist may be able to give you good advice on detecting some of the things that might trigger his bad periods and on what you can do to help him. A couple little
books you might find helpful by Brenda Smith-Myles are:

- Asperger Syndrome And Difficult Moments: Practical Solutions For Tantrums, Rage And Meltdowns (http://www.amazon.com/Asperger-Syndrome-Difficult-Moments-Practical/dp/193128270...
7890509?ie=UTF8&s=books&qid=1191722987&sr=8-1)

- Asperger's Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World (http://www.amazon.com/Aspergers-Syndrome-Sensory-Issues-Practical/dp/0967251486/...)

These books may give you ideas on ways to handle the tantrumming and help in understanding what may be behind them.

The other suggestions I'd make have more to do with the ways you let your son know what is going on in his world. A
visual schedule and visual instructions (as opposed to just telling him or assuming that he knows) are easy things to implement at home and at school yet can have a profound effect on a child's comfort level and therefore on his
behavior. A great site for getting started with visuals is http://www.do2learn.com

In addition to using visuals, social stories is another good way of preparing your boy for what is to come. You can
find information on using social stories, as well as some ready-made ones at sites like these:

http://autism.healingthresholds.com/therapy/social-stories#rowe

http://www.autisminspiration.com/public/department47.cfm

http://www.adders.org/socialstories.htm

All the best to you and your family.

Sharon A. Mitchell, B.A., B.Ed., M.A.
www.autismsite.ca