Fighting Too Many Battles

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Hi. I'm new to the board; my 4 year old daughter was diagnosed as autistic last year. We found that our local school district has a good special ed program, and got her into ECE pre-school. It was rough at first; but she really improved over the course of the school year. This year, however, she does not want to go to school at all. Sometimes she starts telling me she doesn't want to go as soon as she gets up. Getting her ready can turn into a kicking screaming battle. I've tried to find out what's going on, but I can't get any kind of a clear answer from her. She has said variously that she "doesn't like the toys," "school is boring," and she feels sad. Her teacher and aide can't figure it out, either. (she has a new teacher this year, but the same aide as last year) She's missed several days of school because I just couldn't get her to go without her hurting herself or me.

As if that isn't enough, we're also having problems with her using the bathroom for the last couple weeks; I can't get her to go to the bathroom unless it's her idea. We have a lot of accidents now, while she was pretty reliably potty trained during the day. Her teacher noticed that she was itching her crotch a lot at school. We took her to her pediatrician; urine sample was normal, anti-fungal cream didn't help, anti-histamines for the itch didn't seem to help. We even treated her for pinworms, but she's still itching and tugging at her underwear. She won't wear pants at all, just dresses. Right now, I'm looking at it as a sensory issue and trying some new types of underwear.

She refuses to go anywhere in the car; the only way I can get her to go to school is to walk (we live about a block and a half from the school). I've tried to get her to go in the car to get ice cream, to the library, the toy store.... anywhere I think she might enjoy. She says she doesn't want to go anyplace. She says the car is "scary" and "there are bugs" in it.

Her meltdown behavior is escalating. She's been hitting at me and pinching me hard enough to leave bruises. I don't know how much more I can take, because nothing seems to work with her-- offering incentives, withholding privileges. I feel like I'm turning into a screaming witch; I try to stay calm, but I'm stressed to the breaking point. I don't like the way I feel. Sorry for the novel... thank you for reading.

Wow, that sounds really difficult, welcome to WP and I hope you find some help here. Do you have any other medical professionals in your world? Like a psychiatrist or psychologist, Occupational Therapist? Her fear of the car especially sounds like something that a mental health professional should be involved in. Her school refusal could be due to so many factors, flourescent lights in the classroom, over stimulation from the other children, tiredness, hunger, dificulty with transitions, lack of understanding the schedule for the day, inability to tell anyone what is bothering her...

My son hated the bathroom at pre-school because it was too loud and the consequences of that were multiple, not the least of which was refusal to wash his hands which just drove one of the teachers NUTS and that conflict I think contributed to some of his meltdowns.

As overwhelmed as you are right now, are there any other specialists at the school (OT, ST Sp Ed teacher) who can help you with trying to figure out her behavior? Sometimes it takes a lot of detective work and you aren't there all the time so it is hard for you to do it from the sidelines.

Also, have you tried any dietary changes with her? Some people have found that their children get some relief from the extreme sensory issues by eliminating things from the child's diet.

Maybe you could try using school as an incentive. Go four days and you get Friday off? If it's hard enough as it is to get her to go to school this may be an option..

It would really help if you could pinpoint the problem but it's hard when she can't or won't communicate properly. A therapist would probably observe your daughter in school and try and identify what upsets her.

What sort of privileges have you withheld, and for how long? How does your daughter respond? It may be a matter of persisting with it. Then again maybe not.

When there was something I didn't want to do my parents would lock me out of the house until I did it... I could resist for the entire day but it was very draining and my parents eventually gave up. There has to be some limit. Some point at which your daughter decides that the alternative is better...

Behavior is communication - from what has been described I don't think withholding priviledges at this point is going to do any good at all. It sounds like there are a lot of things troubling this child and her behavior is not likely to get any better until the source of some of the problems is discovered and alleviated. A 4 yo just doesn't typically refuse to get in the car because "there are bugs" in it, on a lark or willfully. Especially if a promise of a desireable reward is being offered.

I had the same "not wanting to go to school" issue with my daughter, but when that happened school was a nightmare for her: she did not have friends, the teacher was mean to her, kids made fun of her... obviously she did not want to go to school. Kids usually do not develop such strong "anti-school" feelings just because. Something should be happening and she cannot/do not want to tell you and the teachers do not know, either. Your kid is very young. Could yo volunteer at school a couple of days so you can try to figure out what is happening? I also think you need professional help. Sometimes our kids will not talk to us, but therapists have ways to find out whats happening (kids will talk to them or will enact it during therapy).

My daughter has an OT at pre-school; her suggestion was that we make a visual schedule so that my daughter knows what we expect of her at what time. We've only been doing this for a couple days, and so far have had mixed success. Sylvia (my daughter) loves Phineas & Ferb, so we made her a cut out of Major Monogram from the show that says "Hello, Agent S. Your mission is..." and then we put up the various schedule cards (eat breakfast, get dressed, play time, etc.) If her "mission" is positive (play time) or neutral (eat lunch), we don't have any problems. If it's something she doesn't like (bathroom, get dressed), Sylvia will get upset and take down those cards.

I spoke with Sylvia's teacher today about involving the special ed. program's psychologist in finding out what's bothering Sylvia about school. I'm also looking at other options for a psychologist/psychiatrist. We're in a DIR/floortime program through our local Easter Seals; I'm going to find out if they offer these services or can recommend someone.

We haven't tried modifying Sylvia's diet yet. I'm really reluctant to try cutting out gluten/ casein. The child practically lives on cheese sandwiches and pasta. We recently had some bloodwork done to see if we could pinpoint any physical reason for the changes in her. The dr. is checking her vitamin level; our Easter Seals therapist suggested Sylvia might be iron or B12 deficient. We're still waiting for the results.

Maybe she is suffering sensory overload at school and has developed an aversion to school.

When I was three in preschool, I had a meltdown every single morning before going to preschool. As soon as my mother picked up her purse, my brain knew that it was time to go to preschool, so it had a meltdown at that time, like clockwork.

I second the suggestion to go to school and observe her behavior there. If she appears totally unfocused and scatterbrained and much lower-functioning than at home, then she may be experiencing overloads and shutdowns at school.

Ask the teacher to note down problem behaviours at school. When they happen, what activity was going on, and specifically what your daughters complaint was if she communicates it. If there's a specific cause for the discomfort it may be possible to remove it, replace it or otherwise exclude your daughter from that activity.

Hi, this sounds very difficult.

I think observing her in school is the best idea, certainly.

I also want to note that most of the people who say their kids "practically live on " something end up being the ones whose children have food sensitivities the worst - it seems we are attracted to most what we are also most allergic to, at least in some cases, and especially for younger kids.

I hate to even bring up this possibility, but itching at her crotch....could that be some sign of some trauma that occurred in that area, maybe even abuse that occurred when you were not aware of it? It's probably not, but as they say behavior is language.... Maybe a play therapist could get something out of her ?

I wish you luck....

If possible, at least for a while, I would homeschool her for two reasons. First, she'll get some relief. Secondly, you will really get to understand her so that when she goes to school, you will much more intuitively understand what she's thinking. Third, as an older child, she might be able to accept school better.

It seems to me that there are way more things going on at school than she can handle and that's making her defiant and her development is regressing. For us, this young stage of life was quite confusing - way too many factors to figure out. We certainly made mistakes but I think being at school would have made him far worse. Keeping my son home helped, as well as a GFCF diet. He is taking homeopathic remedies for his intestines which has made a huge difference.

I really feel for you that she's hurting you. My son had a period when he was hurting his sister a lot and me somewhat. I had to see that he could be in control - he doesn't do that to others - and try to figure out what he was so mad about.

You have to throw away all the traditional parenting you have ever read, been taught, seen or experienced. It won't work.

You have to find the root of each problem and it may never be logical in the normal sense of how we understand logic.

You have to learn how to communicate with her. It isn't simple.

Don't ever scream at her. Ever. I am not criticizing you. Been there, done that, totally get it, but please please please don't do it.

Put all your effort into figuring out how she thinks, then you can help her.