Normal high range or ODD?

[piraterose]

I have a 5 year old daughter, who is an only child, who will be going to kindergarten in the fall. She has been attending full time daycare since she was 4 months old - So lots of socialization and her daycare teachers and other students are like family to her.

When she's in a good mood she is a bright (I've had more than one teacher at school call her "super smart" and usually in the top two of her class), focused (playing board games since she was two and can play the same game over and over again for an hour if allowed) and helpful.

But then there are her bad moods and meltdowns. She is a very intense child and when she has her mind made up there is no changing it. So many people have told me to stay consistent and don't give in and she will eventual break down. HA!! Not my daughter - she will scream herself to sleep before she gives in.

Example of a normal situation with my daughter: My best friend (one of the biggest advocates of not giving in) babysat my daughter overnight this weekend. I guess she felt the need to prove her point and made Elisabeth sit at the table until she ate her zucchini (Elisabeth never had it before) and the rest of her dinner - apparently they put her to bed at 9:30 directly from sitting at the table. When I picked her up the next morning, Elisabeth ran right to me cling for all it's worth. And I was informed that I have "the most stubborn child" she had ever met.

I was like - tell me something I don't know. (And I felt a little validated after all these years).

It's like Elisabeth goes over a mountain - once she's hit the peak, there is no coming back from a meltdown. It pains me to say it, but it's like she reverts to a feral animal.

1) She doesn't go on the offense (what I would consider - biting others, hitting other's, obscenities) she goes on what I consider the defensive (no eye contact, no answering questions, no big girl words, sometimes just grunts, scrambling to get out of your arms, hides her face in the couch cushions)

2) Like I mentioned in #1 - once she's over the edge - limited communication - no eye contact - there is no talking her down until she's ready.

3) Regular time outs, taking away toys or privileges, or spankings do not work in the least.

4) I have had limited success with lap time outs including counting and deep breathing. Sometimes they work, but afterwards - if I still need her to do what caused the issue (brush her teeth or stay in bed) it starts all over again.

5) She never seems to learn her lessons either - it's always the same thing over and over. I definitely pick my battles. The battles I pick are what I consider being part of being a big girl/family rules - brushing her teeth, eating the dinner that is served to her, no major bad attitude, staying in bed.

I know you'll ask about other issues Elisabeth may have.

1) I think she has a problem with anxiety. While she is social and happy at school and home, she doesn't talk to people she doesn't know well. She's always been one slow to warm up. I don't think she's ever voluntarily spoken to her doctor or dentist. She is also a lip biter - to the point where she leaves bruises and chapping under her lower lip.

2) Speech delay - I think this might be a possibility, but not exactly sure - we can't get her to talk to the doctor (see above), so it hasn't come up. She does still have a thing with using some baby words (especially when she's upset). Also she has a bit of an issue wrapping her mind around something she's trying to say (she can't "spit it out"). When I try to have serious conversations with her, it seems she can't/won't answer questions posed to her (lots of shoulder shrugging/ I don't know).

But it's never come up as a issue at school.

3) Elisabeth was finally offically diagnosed with Asthma when she was three (though she had it all along). We need to get her in to test for allergies.

4) She seems sensitive to sounds (can't deal with the vacuum - runs to other rooms) and tastes (picky eater, took a year to find toothpaste she could deal with).

As for family history - both myself and my father have been treated with medicine for depression in the past. And though nothing official - I have my own anxiety issues. I firmly believe that my mom might be something a kin to bi polar - but she's under the assumption that there is something wrong with the rest of the word - not her.

I really don't want to label her, but she's been like this since she was an infant (at 11 months it took 2 or 3 people to change her diaper when she didn't want to lie down). I used to joke that Elisabeth started her terrible twos at 11 months and never grew out of it. But in reality I know this is her personality.

I worried about the transition to the new school and kindergarten - what if she refuses to talk to her teacher? We've decided to keep sending her to her daycare center for afterschool to help the transition. But I'm still worried that the transition will only intensify her issues.

Any advice? How can i convince the doctor that this is not normal (if it is not?) We're on a HMO so all referrals need to come from him.

 

[SRL]

We're only parents here--not diagnosticians--but as I was reading through your description some things did jump out at me. If this were my child I would want a thorough evaluation done on her, including for Autistic Spectrum Disorders. Autism Spectrum Disorders (ASD)'s can be easy to miss on young children (especially if they're on the fence or atypical diagnostically) and since you're seeing some speech irregularities, behavioral problems, and some possible indications of a hypersensitive sensory system (foods and sounds), I think it's important that you have some professionals take a look beyond for behavioral help. It's not uncommon to have to travel to a larger city to a Children's or University hospital but I promise you it's worth taking a hard look up front and not just trying to go about addressing the behaviors without having a grasp on what's contributing to the behaviors.

I'm going to give you the links we typically give parents whose children show some red flags for Autism Spectrum Disorders (ASD)'s--again, this is for you to research because we obviously aren't in any position to diagnose. As you read through the info keep in mind that most kids won't fit the description or have all of the traits listed. For example, some kids will be more social, while others more verbal, etc.

Is she lining up toys or other household objects into straight lines or formations?

Oasis-AS
http://www.aspergersyndrome.org/

Here's an article on how to approach your pediatrician to ask for an evaluation. Parents here have found developmental pediatricians, pediatric neuropsychologists, and Autism Clinics to overall be more reliable in diagnosing Autism Spectrum Disorders (ASD)'s than others. You would also want an evaluation in the areas of audiology, speech/language, and pediatric occupational therapy.

Please note: while this info is specific to Autism Spectrum Disorders (ASD)'s, the same basic evaluation process will be helpful in digging up info no matter what you're dealing with.
http://oreilly.com/medical/autism/news/getting_diag.html

You will want to read up on Sensory Integration Dysfunction If this article below rings a bell at all then check out the book "The Out of Sync Child" by Carol Kranowitz.
https://web.archive.org/web/20100820130047/http://www.tsbvi.edu/Outreach/seehear/fall97/sensory.htm

The speech difference you are mentioning (having trouble wrapping her mind around an idea) or having trouble participating in reciprocal conversation even when they have the vocabulary are speech delays but not in the way you would usually think (ie not articulation problems). Often they fall in the areas of auditory and language processing. For instance, the child might have a thought formulated but it gets lost on the way to spitting it out. You also might observe carefully to see what's happening when you ask her questions. ie Can she answer all of the W-H's) who, what, where, when, why and how types of questions? Kids who are bright and good compensators with these issues often do very well with speech when they are younger but hit road blocks later on when speech demands get harder.

While you're doing your homework and waiting for an evaluation if you decide to move forward with this, I would strongly urge you not to push issues like foods and make sure others who are caring for her do likewise. Oftentimes what looks like a stubborn child who "won't" turns out to be a child with issues who "can't". It's best to lay low until you know for sure. Keep her safe and keep others around her safe. You will find that things will go easier if you keep your eye on the goal. Fox example, it's important that she gets something fairly nutritious into her but it's not critical she eats what you serve the family or eats when the clock says she should be hungry. Kids like this usually do far better with flexible handling but it takes relearning on the part of the parent.

Two more book suggestions:

What Your Explosive Child Is Trying to Tell You: Discovering the Pathway from Symptoms to Solutions by Dr. Douglas Riley

The Explosive Child by Ross Greene

Hope this helps, SRL

 

[BusynMember]

I thought "Autistic Spectrum Disorder" right away. She has tons of red flags, including her "stubborness." Sounds like maybe Aspergers. The way she can play board games over and over again is another red flag. As are sensitivities to noise. I'd take her to a neuropsychologist.

 

[Rannveig]

I mostly lurk but wanted to weigh in. I totally respect what MWM and SRL have said, and I see the validity of it, but to me much of the behavior you describe sounds like normal kid stuff. I would worry more about an adult who forces a child to stay at the table for hours over some zucchini than I would worry about a child who refuses to eat a new food served by someone other than her parents. And five is very young -- it's not surprising that sometimes Elisabeth doesn't know how to articulate things or to conform to adult notions of how a "big girl" behaves.

I sympathize with what it's like to have one's concerns about one's child's development not taken seriously, and I'm sure you're seeing a lot more than what you've been able to put in your post, but I just wanted to offer some encouragement that maybe you're just dealing with a bright, high-strung, strong-willed (in the everyday sense, not as a euphemism for ODD) child. Is there an older person in your life, someone with extensive child-rearing experience, who could spend some time with your daughter and reassure you (or not) that her behavior is in the normal range? When you've never been through a developmental stage before as a parent, what's normal can actually look pretty scary, in my experience. I've felt versions of what you do at various times about all my children. But I think that stage of fighting hard not to be diapered, for example, is actually totally normal.

As Elisabeth sounds a bit like my Dagny, whom I've been trying to convince myself will do fine in Kindergarten in the fall, I'll be interested to see what the other moms (and dads?) here say!

All the best, Ranny

 

[TerryJ2]

PirateRose,

I agree with-everyone here, and am glad that Ranny weighed in as well.
Your daughter sounds a bit like me when I was little (artistic temperament )
but the difference is the duration and intensity of her behaviors.

My son is a very high functioning aspie, and every one of his behaviors could be attributed to "just being a boy." But when you put them all together, every moment of every day, and multiply them by a million, that's an aspie.

I agree, that no matter what her diagnosis ends up being, do not force her to sit at a table to eat whatever it is. Set a timer to train her to sit there for a certain length of time, say, 15 min, while the rest of you are eating, to make sure she learns what family meal time is. Then let her go off on her own while everyone else talks.
I wish I had done that when my son was younger. I would have avoided so many meltdowns!

One of the red flags I noticed on your list was that your daughter never seems to learn lessons and repeats the same mistakes over and over. If she is truly aspie, she doesn't "get" why she's supposed to be doing or not doing something, so you have to just train her by rote.

Another red flag is that she isn't social, but is okay at home. Again, that could just be shyness, but if it's very pronounced, it could be aspie.
My son HATES meeting new people and will yank on my shirtsleeve and physically hurt me, trying to get out the door so he doesn't have to meet people. He still does this and he's 12. Once he gets to know people, he's fine.
Yes, there is an anxiety component. It's hard to say if it's a chicken-and-egg thing, but if your daughter is aspie, anxiety comes with-it. Than can be handled with-training and medications.

In the meantime, get a good diagnosis (I had to go back 2 yrs later and redo our tests because the dr was a flake and my son was not a textbook case) so don't give up!

 

[jbrain]

Hi,
I'm coming late to this, just wanted to say that I was a easy child child yet I was scared of trying new foods. I think your friend was cruel to make a 5 yr old kid sit there all that time just to eat zucchini. I would not have eaten it either at that age and I would have been very anxious to have some other adult than my mother trying to give me a food I didn't want. Seems like your friend was determined to be in a power struggle--not a good idea with a difficult child kid, you will never win.

Sounds like you have gotten really good advice from the other people here, just wanted to chime in and say even a "regular" kid can be stubborn about food. I am glad my mother didn't make me eat foods I was afraid of and didn't make a big deal out of it either. By the time I was about 17 I was eating just about anything.

Jane