Behavioral Health

[SarahBear]

Violet has had various behavioral challenges. She just started Kindergarten last week, but these are things we have seen before. She had two days of school the first week and she's having a full week at this point. Her school is all day, starting at 8:15 and ending at 2:50 except for Fridays which end at 12:30. Her first day was perfect, but by the second day, she was throwing a crayon at a peer, kicking a peer on the carpet, and getting angry at the teacher for asking Violet to look at her. On Day 4, she elbowed multiple students, punched one, lunged at one, spit at another, and because of the physicality of her behavior, was written up and will likely be facing consequences today. One time she lashed out at a student because he was helping clean up an area they were both working in. Another time it was unprovoked and when asked, she stated that she didn't like the student. At home, she's making up for her mild toddler years with tantrums. I want to jump on this and have scheduled an appointment with her general practitioner and would like to see if there's anything diagnosable in terms of behavior as diagnoses lead to services. There is a lot that is just a bit off with Violet and it is becoming more apparent as she gets older. She has issues with emotional regulation as well as interpreting social situations and at times seems to lack empathy. She definitely has a lot of traits similar to high functioning Asperger's, but that doesn't quite fit either. This will be an interesting process and I just hope the school can handle it reasonably as I've heard some things that indicate this is not their strong suit.

 

[noon_child]

Sounds like a good idea to see if there is anything diagnosable - especially as if she is on the spectrum her school will be able to plan better (and hopefully stop demanding things she may find threatening, like eye contact). Good luck!

 

[SarahBear]

She's not on the spectrum. Her kinder teacher sounds like she's actually pretty good, but there are 27 students in her class and one aid... I talked to the teacher and we're on the same page about moving forward. The teacher will be taking data for the rest of the month and we'll look closer at how she's doing in October. In the meantime, I have an appointment scheduled for Monday that should kick off any referrals for assessments from the medical side of things. It will be a process, but the process is on track.

 

[morri]

Autism can look different on girls than it does on boys, but it may just be a period of readjustment. or adhd I guess can only talk about it and about deescalation tacticts. (like an anger ball or similar)I am glad class size is highly regulated here and class sizes are like 18-20 learners in one class. Nevertheless I am dreading it a bit too next year

 

[SarahBear]

I was pointing out all the characteristics to my husband that are similar to high functioning autism. I pulled out a screening tool that I provide to teachers when they are considering whether or not a student would qualify. There are certain areas that are bang on and others that just are not. People say it can look different in girls, and that is down to things like interests being more "typical" even if the quality is not typical. Or things like having rote understanding of social interactions such as looking at someone in the eyes and saying "hello," but then not being able to sustain or have a reciprocal conversation. I don't think it really "looks different in girls." Autism looks like a certain set of deficits and that looks different in every individual. In the past, I've also looked down checklists and rating scales and it just doesn't fit. I told my husband I would bring home an ADOS protocol on Tuesday (I won't be working or going to my office on Monday). It would be interesting to look through the scoring. Again, it doesn't quite fit. Some of her differences that are spectrumy have always been there, but are becoming more apparent as she gets older and other aspects are improving, but in the end, the whole picture of autism doesn't fit the whole picture of Violet.

 

[SarahBear]

I think there is a lot going on with her. The medical side, plus the medication can really complicate things and I think it all plays a role. There are definite spectrum-type characteristics that could complicate things, and then there are also mood disorders in her genetic history. Sometimes she is just fine and other times she is just not. All of yesterday was great! We cleaned up in the morning, sent her outside to play with her brother for some of that time, and then she had some down time before a friend came over to play. They played for about 2 hours and then we let her watch a movie (so that we could take a break). Then we had dinner. She hates Risotto, so not her best dinner, but she didn't have any big issues around it. Then after dinner, she and her brother wanted to make crafts with glue guns. We pulled out the stuff, set up, and things were going along fine. Then she started to make mistakes and hurt herself a few times (it's low temp, but still hurts). Her frustration was building and I could tell it was no longer safe for her to be working with the glue gun. So I had her be done, but she wouldn't comply. I unplugged the the glue gun and moved her away from the table. Ever since this summer, her tantrums have become aggressive. So, I had to hold a hand in each hand and pull them apart so that she couldn't hurt me. She screamed and tried to grab at me. I put her into her room where her anger briefly exploded. After hardly any time, she came out of the room, but having been removed from the situation, was ready to seek comfort in a hug, so I did give her a hug. She was still fuming, but under control. She sat down to write (a new interest of hers) and made a little letter for me, my husband, and Leo. She is just starting to write, so it just said "For mom & DAD Leo." It was really brief, but very intense at the same time. Hopefully things calm as she adjusts to kindergarten, but there are still certain things I don't expect to go away on their own.

 

[krissie328]

My son is 4 and this is his first year in preschool, but it's a very structured all day program much like kinder. He sounds exactly like your daughter! The only exception is he has a lot of articulation errors.

Autism doesn't quite fit but he does have some of those markers. It's not adhd. But I do think it's either (or both) anxiety and sensory issues. We have a referral in to a developmental pediatrician to evaluate him just to see if we can help him better.

So not much help, but you're not alone. It's so daunting at this phase but getting the early intervention help will hopefully head off future issues.

 

[morri]

while this is more about adults I still liked the article
https://standardissuemagazine.com/voices/see-not-get-life-female-autistic/ https://link.springer.com/article/10.1007%2Fs10803-017-3166-5
on the emotional outburst. I am an (autistic) adult when I am very tense or anxiety or other stress level is high I can have very sudden anger outbursts when I am usually a(outwardly) very mellow low key person.
I dont know if your daughter is a visual thinker but another poster on a different message board was sharing some visualisation to help visualise what happens when you have an impulsive outburst of anger .

 

[SarahBear]

She had an appointment with her pediatrician today. We are being referred to evaluations including an autism evaluation and we'll be contacting a behavioral therapist.

 

[SarahBear]

OK... I just observed her at a party with an autism evaluator perspective and read a description of asperger's... I could definitely see her as being diagnosable with asperger's... not that it's a real diagnosis anymore. Not sure she'd qualify under autism from a school eligibility perspective, but we'll see what others have to say about things. As long as we figure out the best way to support her, I don't care what they call it.

 

[morri]

The only difference is the name as in it will be autistic spectrum condition (as used by tony attwood and others)

 

[noon_child]

In my location, in the UK, Aspergers isn't used as a diagnosis anymore - as there is a whole spectrum, there's no point having a specific label for one small part of that spectrum. Instead the child would be classed as on the autistic spectrum and the help offered would be dependant on the specific needs of the child (sensory, social, verbal communication, emotional regulation etc.)

 

[whatwillbex]

Hi

I can’t remember but does Violet take medication for epilepsy?
My niece takes medication for it and it can effect her behaviour if it’s not quite right for her.
School is such a big change for them and that’s a lot of noise and children in one space to get used to and new rules. Maybe it’s just her way of adjusting. I hope you can get some answers soon. X

 

[SarahBear]

She has a neurology appointment in December. I will be asking about medication and behavior as I wonder about its role. Right now we just have to hang tight with it though.

 

[SarahBear]

So we had our first autism related appointment today. The doctor we were referred to is local, but not trained on evaluation at this age, so he did more of a screening and then referred us to a doctor further away. Looks like she has enough characteristics to warrant further investigation. Will be interesting to see where things go.