need opinions on my 4 year old please

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Thanks so much for your responses. I'm glad I came to this forum. Its nice to get some support and insight from all of you.
I have been feeling upset about this since we ended the appointment and I think its because I feel that they missed something. My mommy instincts tell me it goes beyond disruptive behaviors.
They asked a lot of different questions but seemed to focus more on things like her being irritable and argumentative. Which she is... but there is more going on. My gut feeling is she has certain issues, possibly sensory and/or ASD related but also some other stuff going on due to parenting problems. My husband and I don't always agree on parenting styles and I think this may be the cause of issues that the evaluator was more focused on.

I asked if any of the sensory stuff would be addressed and the evaluator said they would definitely be trying to look at everything and once we got into therapy, they could more easily tell what behaviors are chosen and what ones she can't help.
There is a chance the psychologist will pick up on something else when they go over the evaluation before they make a final report. I think it will be a week or so before we get the results.


DW a mom, to answer your question, yes some days I feel desperation and want answers for some of the problems that arise. Some days are much better than others though and I have already made changes in the way we do some things I order to accommodate certain needs she has.
I don't particularly want her to be labeled, my reason for seeking help is that there are certain things that are so difficult to navigate and I don't want to do more harm than good. My husband's reasons are probably more because she can be very uncooperative and he believes she refuses to control her behavior. This is where we differ in opinion. I am not convinced she has that much control over some things. I had hoped the evaluation would help us gain insight and give us a direction to go in.

I remember having to talk my husband into allowing me to try some "experiments" when it came to how to deal with my son's behavior.

I don't think you have to agree on causes or what the best thing to do would be, as long as you agree on how you WILL handle things.

If you are the one with her the most, get your husband to agree that consistency is paramount and, therefore, he will follow your decisions on boundaries and consequences. And agree that this is for months, not a few days. If he sees an overall improvement under this system, he will eventually come around.

One common way parents create problems with ASD kids: If your child is ASD, being careful with transitions will be HUGE. You can NOT say, "stop playing, come to the table." Instead, you give out timed transition warnings: "dinner will be ready in 5 minutes, please start wrapping up what you are doing!" Same at one minute, and then maybe a short song when it is time to come to the table. You also can NOT change a plan mid-course. I STILL regret telling my son we were going for ice cream when he was 3 and then allowing my husband to decide we were having some real food first. Of course my son couldn't sit still until the ice cream came; he thought we were going to sit down and order ice cream, not food, because that is what we had told him! That turned into a huge meltdown. Shoot, many of his meltdowns could be traced back to us changing our minds or not telling him straight what the plan was or having things go unexpected.

And remember to give instructions face to face, close by. She may not process your voice from behind her or from another room.

You also have to be very careful to say EXACTLY what you mean, and not be "vague." To someone with ASD, "did you wash your hands" is a vague question. Instead, ask, "have you washed your hands in the last five minutes?"

Finally, kids don't always know what is good for them. If there is a place or activity she loves, but that tends to be followed hours later by behavior issues, it may be more than she can process. Pay attention to the patterns.

Even if your daughter is not ASD, the above should be helpful. And if you already practice these, good. Took me a while to figure them out

As for your instinct that there is another layer they aren't seeing - TRUST YOUR INSTINCTS. No one knows her better than you do, and we've all been there with people telling us this or that and us not feeling sure, only to eventually discover that we were right all along. When the experts call it right, you will know it. Maybe not right off, but as you research what they've said, it will all click.

I agree with everything DW_a_Mom says. It is straight on, on point.

Another thing that I found helpful, especially after our PS school botched these so badly is to do my own FBA. (Functional behavior Analysis.) It really helped me get things in focus as opposed to having my thoughts all scattered around.

Something like this:

http://mfba.net/fbabip.pdf

Use it to get your thoughts in order, and to think about what strategies tend to mitigate behaviors and which don't. If ASD strategies work better than whatever types of things they suggest for ODD and CD, then you have an answer, and at any rate an actual diagnosis is less important than knowing how to help, with the caveat that the right label will be very important at school. If your kid has an ODD type label in school, the school will not be as accommodating and will definitely be doing the wrong things if your child is really something else.

P.S-- I also think that this disorder category is a dumping ground for things they cannot figure out, and also tends to be interpreted as your kid is just "bad." Be careful.

That sounds a lot like my son when he was 4. He is 9 now and he still bounces, picks his fingers until they bleed and many other things you mentioned. We had him tested over 4 times in 9 years. He has a diagnosis of PDD-NOS, ADHD, MIRLD. For us, the hardest thing is figuring out which behaviors match which diagnosis.

I have noise related sensory issues, when you said she likes loud music, I completely understand. I would rather listen to one loud song then 5 different noises that the same time. My brain has a hard time figuring out whats going on.

Did the psychologist perform the ADOS (autism diagnostic observation schedule)? If not, I would recommending finding some place where you can have it done.

The best cliff note version is on namihelps.org link. It is in a pdf file, and I'm on a mobile at the moment. The link is half way down the page.

It is grouped in with ODD and Conduct Disorders, which would raise the hairs on my neck.

I would not saddle my child, with that diagnosis at such a young age. It is a very, very serious mental heath diagnosis. This is the diagnosis of kids that start fires, hurt animals and people, read the sheets...

Was your daughter horrible during the evaluation? I can't picture them saddling a young girl, four year old girl with that.

There is such a huge gap between what you wrote and that diagnosis. I'm guessing they will suggest stuff like parenting classes and medication.

I have been going over and over this stuff in my mind.
I read about the disruptive behavior disorder. Some of it does make me think of my daughter. There are times when she is very argumentative and seems to pick fights intentionally.
Looking back, this kind of behavior became more common when my husband left his job and was home most of the time, for the last several months. His parenting style is very different from mine and he is easily frustrated when our daughter does not listen, doesn't do what she is told, talks back. It snowballs from there.
I believe there are definitely problems she is having due to parenting. But I feel that there were other issues there first, that we did not handle the right way. At the very least, my daughter has some sensory issues going on. Possibly something else.

I can't think of another way to explain her behavior when we take her out of the house. She doesnt seem to be able to control herself sometimes. An example would be taking her to a store. She starts out relatively calm. But things quickly escalate. She starts jumping around and running back and forth. I try to get her to hold hands. Holding hands, she will continue to jump and pull and crash into me. We have had full blown meltdowns as a result of trying to get her to stop running and jumping all over.

I asked her about this behavior and she told me that sometimes her head feels crazy, like when we go to stores. She said its like things in her head are going around and around really fast. Then she said when she plays by herself calmly her thought go more slowly and in reversed direction. She used to have a name for this, she used to tell us she felt "crazied up". Not sure if this is a sensory thing or a hyperactivity thing. It seems like something she cannot control though, and this is one of the issues she has had for a long time. Before the argumentative stuff began.

Maybe someone else can make sense of this? Either way, again, I'm so thankful for all the ideas and insight. I'm slightly familiar with the FBA so it was good to be reminded of that. I'm definitely going to print a few out and work on them.

Thanks again!

Oh, and I should add that although indo see some of my daughter's problems listed in the descriptions for the disruptive behavior, I'm not comfortable with settling for that diagnosis. My daughter was calm when we went to the evaluation. I don't believe a diagnosis like that can be made so easily. I will definitely question them if they put it in their final report, may see about getting another opinion too, if our insurance would allow it.

I'm not any sort of psych. professional. I'm just a high functioning autistic woman. I think you should get your daughter tested for autism. What you've described is a lot like how my mom would have described me when I was a little girl.

I also think you should check these out and see if anything rings true:
http://taniaannmarshall.wordpress.com/2 ... re-school/

http://taniaannmarshall.wordpress.com/2 ... -syndrome/

Best of luck with your daughter.

My son wasn't dxd until he was much older (almost 9) but we took note of behaviors and did a lot of what DW mentioned. In addition, we had to be very careful about punishment and about labeling him within earshot.

Once he was dxd, we also looked at diet, and that made the biggest difference in calming him and making him consistent. You mentioned that she seems to do things on purpose - probably a similar to being inconsistent. What we realized is that certain foods make my son extremely irritable, causing him to be inconsistent in behavior. His irritants are gluten, dairy, sugar, oats and quinoa. Oats is his biggest irritant (go figure!). Diet may be a difficult issue to tackle, but I will say it made the biggest difference for my son. Nowadays if he feels out of sorts, we can easily see the cause ... usually that he hasn't eaten in a while or he just had an intense class. We aren't so confused.

Edited to add: My son had about 80% of the behaviors you mentioned on your first post. He played with other kids appropriately and probably didn't bounce around so much, but the night terrors, transitions, mouth noises etc. - yeah. He was dxd Asperger's.

Come to think of it, I wasn't diagnosed until I was older, like the parents here have said. My mother had studied enough psychology in college to know something was up pretty early on. She took careful notes, and asked her doctor and nurse friends for advice. One of the early interventions they advised that really helped was getting me into horseback riding lessons. My parents supported my dinosaur obsession when I was young- they took me to every museum exhibit involving dinosaurs that they heard of, bought me lots of nonfiction books about dinosaurs, even bought me dinosaur sheets and watched specials on dinosaurs with me. At the same time, they tried to cultivate other interests.

They got me a voice teacher pretty early because I had perfect pitch. One of the ways I managed to socialize with others and make friends in HS and in college was vocal groups and theater. One of the scholarships I got for college was a voice scholarship. Theater was actually really great for me as well, though I didn't get very involved with that until later. That's a shame, really, in part for the socialization aspect, and in part for the inadvertent training I received in body awareness/facial expression. The directors didn't always know I was autistic, but they would always ask me/help me analyze what my character was feeling, what I should be portraying, and how I should be portraying it.

Just fyi.

Stores can be a big problem. For us the issues were/are:

1) Overstimuli--The lights,bright displays, special interest items, the noises, and off smells (seafood dept. especially back in the day.)
2) Understimuli ---Being bored, and having Mommy and Daddy talking about purchases and things instead of playing with and entertaining him the whole time.
3) Alternating between feelings of 1) or 2) being predominant, depending on what department we were in. He loved/loves the produce dept. especially the scales and hates the regular dry good aisles. This was awful because of the vacillation between one extreme and the other.
4) He is very tactile and loves to touch things and there is so much he cannot touch, but wants to.
5)if he was tired, sleepy, had a bad day or we had to take him to too many stores...forget about it.

It is much better now, and here is how we handle/handled it. I can't tell you if all/any of it worked or if he just outgrew a lot of it by being older and having better skills, and tolerences in general.

1)We kept him in the front part of the cart as long as we could--We loved those carts that had car front ends you could put a kid who was too big for the tiny baby part.

2)We never took him to the store with only one adult, until much later. I still try to avoid it, and only do it when a need a couple of things. Having a two adult-one child ration made it easier so one of us could do the active shopping (requiring a list and organization beforehand) and the other could hold his hand to keep the tactile business to a minimum.

3)We have a tactile sensory box, we let him use before we left, to try to get the tactile stuff satisfied to a point.

4)We let him help weigh things in produce, and yes, spin in wider aisles that were empty and had no glass, blocking him to make sure he would not crash into things and make a mess. (I know a lot of people would not allow that, but we were pretty desperate.)

5)We still reward him by letting him pick the juice when his behavior falls within liberally defined, acceptable parameters or he makes a good recovery from an earlier faux pas. He loves juice, so it is a bigger deal than it sounds like.

6)Basically we scaffold everything we have to and give more freedom once we see what he is consistently capable of.

Our main issues at 8, still are boredom and wanting to touch everything, (which reminds me we might want to go back to the tactile box (Just a box with differently textured things I have accumulated) as we haven't needed it, but maybe could use it again.)

He also wants to talk constantly now and brain dump, but the it is so much better than it once was. He also does not watch where he is going and I have to remind him to look where he is going so he doesn't get hit/crash into others' carts. It is a work in progress.

I agree with lots of what has been said here.
It's really hard when you are in the stage of knowing that something is up, but not knowing exactly what or more importantly what to do about it.

I suggest what some others said- try some strategies to deal with ASD type behaviours and try some approaches for sensory disorders. See what fits and what helps. It's a long road to start out on, but once you do and you see things start working and helping it can be a good journey and much better than being stalled in the same place.

For what it's worth your daughter sounds very similar to my boy who is 3.5 and was recently diagnosed as "high-functioning" autistic. Finding and filing his sensory needs has been our recent mission and we see a lot of improvement. Experimenting with his diet and trying out some supplements to find what works for him has also been really great for us.

Good luck! Your daughter sounds like a lovely girl.

3-6 year olds can act like total, willful little buttheads. Seriously. These are NT kids who will test the limits in preschool, kindergarten and 1st grade (around 7).

Some kids mature much more slowly, and all little kids have an interest in testing boundaries. Almost all the push your buttons behavior leaves around end of 1st/2nd grade. I had some kids that were in kindergarten, and I wonder how their parents didn't leave them by the side of the road on a bad day.

Then around the beginning of 2nd or 3rd, it really quiets down. The one boy, in my daughter's class was a total, attention seeking beast in 1st, 2nd and 3rd. This year, it's like he had a mind swap. Medication? What was the magic? His mom said, he just caught up emotionally. No medication. She did have a few parenting classes, but not much else. My jaw drops. This boy is actually a pleasure to be around.

Give you some examples between the Aspergers and ODD

Aspie meltdowns=sensory overloads
ODD tantrums=to wear you down/get control over the situation. They are fully aware what they are doing.

Aspies running=get away from a situation, sensory overload
ODD running=control (literally, I can and WILL do what I want), and make you crazy until you cave. My ODD student "Biff", ran into the middle of a six lane road, and stood still until a gravel hauler was almost on top of him. Ask his mom if she crapped her pants. He was 9. He climbed on the house roof and threatened to jump if his demands weren't met. His actions were scary.

Aspies trying to control a game/free play: they are socially behind. They aren't malicious. They want to be liked. Trying and not quite succeeding.
ODD control a game/free play: it's like playing a chess game. They want the best game piece, best position, best spot and are usually savvy enough to rough shod over everyone to get it. Or they have a full bore tantrum and "if I can't have it, none of you will". I can't count how many red rubber balls were kicked on the roof because Biff had a tantrum. "Alex", the Aspie had meltdowns, the ball would go flying, but I don't even think he knew he kicked the ball over the fence. "Biff" flat out knew and didn't care.

The general demeanor of the four Aspie boys in our care was very gentle, retiring, trying to please, unless some sensory issue came up. Then all hell broke loose. "Biff" was a whole other ball game. Had enough confidence for Kanye West, Michael Jordan and Barrack Obama combined. He rolled into after care and it was GAME ON. This is at age 8. Any slightest bit of displeasure, a slightly harsh look, a defensive stance by any adult was met with absolute total, unrelenting defiance. I'm talking, you could have water boarded this kid, and he wouldn't break. He'd break toilets off the wall because, why not? After care sucked. Your life should be miserable too. He run across the parking lot just to piss his mom off, and keep running into the subdivision and hide in a garage. For hours.

Teachers have a terrible time with ODD, because every thing, and I mean everything must be a positive spin or a choice. You don't say sit down. You say, would you like to sit in this chair, that chair or in the hallway? Special education teachers, who work with ODD kids are a different kind of human. If you don't do the positive spin or choice, then it's a fight to the death over putting the crayons away or not yanking stuff off the hallway walls while walking to gym. We could have no art work on the walls by his class room. He'd just pull it all off, like you would pull daisy petals off.

Why'd you do it? Because I can. Or why not. Or what's it to you. Or I wanted to go to the office so I wouldn't have to look at your barf inducing face. Oh "Biff", how you broke my heart. How I hope you are doing better and not in a residential setting. I loved your art work, the cool Legos you'd make, and your silly jokes. And "Buff", who was much milder, but still and ulcer inducing handful.

Anyway, I would not agree with the DBD diagnosis until she is around 7. Your daughter just doesn't ping my radar on that.

Just remember DBD is a mental health diagnosis. They do not give PT, OT, Speech therapy for DBD. Mental health diagnosis are not usually (never in my district) entitled to that. Autism is and they have to provide them when deemed necessary. Also kids with MI label can be shunted off to special school (holding pens) much more easily than a kid with Autism. MI diagnosis makes things easier for the school district.

Sorry I'm cynical, but I've seen kids and parents get burned big time with an ADHD/Bipolar/OCD/ODD (whatever alphabet soup you want) diagnosis combo, and in the end it was Autism. But not until late middle school or high school when not a lot can be done without a whole bunch of lawyering up.

Good Luck