Sorry you're finding things so difficult, Dara. With Sammy still so young, it makes it even harder.
The token system, and any other system you're trying - if it's working, then that is fabulous. But if it's not working, for whatever reason, then there's no point trying it. To try and fail is far worse than not trying, when it comes to discipline and training. If you're trying something and it's being ignored or having no effect, then it is teaching him that nothing works; that he is going to always be frustrated by the people in his life.
At 3 or 4 years of age, this will keep happening over and over. It DOES get better but for now that's probably small comfort. It's NOW you want to be better and I don't blame you.
I think seeing a psychiatrist is a good idea, but a neuropsychologist is still likely to be vital.
I'm still thinking autism needs to be given serious consideration, and from what you say elective mutism should be looked at too.
what is the difference (from Sammy's point of view) between home and school? Often with things like elective mutism, it's at home where they talk and school where they don't. difficult child 3 would use the toilet perfectly well at home but would refuse away from home; if pushed, he would have a full-blown panic attack.
Whose idea was it to test Sammy at home as well as at school? That was a stroke of genius. Whoever it was, keep that person on your phone's speed dial. That sort of intuition is what you will need.
You've been told that something subtle in Sammy's environment at home or in how you do things, is causing the problems. It IS frustrating to not be able to instantly identify the problem, but that IS how it is for many people with their kids, PCs or difficult children. There is no blame or shame on you for not being able to instantly identify the problem and to fix it - you're not superhuman, even if sometimes you feel like you have to try to be. Don't beat yourself up. And don't let anyone else dump the guilt on you either. Guilt only slows people down, slows down reactions and gets in the way of effectiveness.
I remember when walking the floor with easy child as a new baby. easy child was crying, tired, hungry and I was so exhausted I couldn't think straight. I tried feeding her, but she didn't feed for more than a minute or two. I tried burping her but no result. I tried putting her to bed but she only screamed louder. I handed the baby to husband, went into another room and rang my mother to talk. My mother reminded me that I was experienced with babies thanks to my sisters using me as a babysitter so much over the years but told me that with your own baby sometimes you can be too close to see the problem. We talked, I felt better, then husband brought easy child into the room. My mother herd her and said, "She needs to be burped!"
"I've done that!" I told her, but Mum said, "Lie her across your knees, tummy down and rub her back firmly. Then put her back up on your shoulder with a cloth in place. You should remember that trick - I've seen you use that one with your sisters' babies."
And she was right. I should have remembered because tat was a favourite trick of mine to try to help a fractious young baby.
And it did the trick. easy child had a bubble of wind too far down for the usual burping techniques to shift and every time she tried to feed when she didn't need it, made her feel worse.
But I had been too tired to think of it, and my efforts were making easy child feel worse and making me feel more tired and more ineffectual. It took someone more remote and coming in fresh to hear the problem and suggest what should have been obvious to me.
I'm wondering if Sammy has something like this happening for him - and you. You're all tired (Sammy as well as you) and the more tired and frustrated you all get, the worse it is for both of you and the further away you feel you are from any good answers.
As for "once he is speaking his behaviour will get better" - clearly that's not the case. So it's time to re-think - his bad behaviour then is NOT connected to his not understanding. Something else is the cause, or at least part of the cause. Something in his environment at home which he is having a lot of difficulty with.
What if you go to school and observe? Is there any way you could watch how things are at school to help you see what could be different? And please, do not think that they are simply better at handling him - I don't think the answer is that simple. This ISN'T about you going to school to learn how to handle him the right way - it's about you observing, as a parent (and also a trained professional, which is a very useful advantage) what are the stimuli (or lack of them) in his environment and in his day to help your broader overview on his needs and his behaviour.
If your presence is going to distract too much then perhaps don't; but then again, if it means the school sees what you get at home, maybe that could be an advantage?
You are Sammy's mother. You are the most experienced in him. You see more of the various "incarnations" of Sammy. But you don't see absolutely everything so all other points of view are of value. But you may be at this moment a bit too tired and too upset to be seeing what you need to. It's a common problem, we all go through this. Some of us almost live permanently in a state of bewilderment!
Seriously though, if you can somehow get to see samples of the different behaviours as well as the different environments, you may get a better understanding.
While writing this, I'm thinking of Temple Grandin and cows. At the conference I saw her at in Sydney some years ago, she talked about how farmers were puzzled as to why cows going through a race were stalling at some points, causing pile-ups and bottlenecks. The farmers walked the chase and could find nothing wrong with the cows' environment. It seemed perfectly fine to them. Nothing hanging down, no distractions, nothing to "spook" them as far as they could see.
But when Temple Grandin walked through she could see it form the cow's point of view (a facet of how her autism manifests). She saw the things that would trigger a fear reaction in the cow - a corner as the chase changed direction, for example. A paint mark on the otherwise smooth wall. So her modified chase had smooth curves instead of corners (nothing with straight edges joined). All uniform in colour. Nothing hanging down. No sudden loud machinery noises on the other side of the chase. And so on. Sometimes it really was as simple as putting in a curve instead of a bend or joint. It could make a HUGE difference to how smoothly the cattle moved from one area to another. Smooth movement meant fewer injuries, fewer pauses, better working conditions, fewer staff needed - in general, better productivity.
The farmers worked with those cattle all their lives. They were skilled, caring, dedicated workmen. They lived cattle, they knew cattle. And they couldn't see it until it was pointed out. Whereas Temple Grandin can THINK like a cow and so understands from the cow's point of view better than any farmer could. Once she pointed out the problems to the farmers, they could see it. And they call her back all the time, here and everywhere, because they know she is good at what she does.
Something is happening for Sammy that is like those cattle in the chute.
I hope you can find some answers. But in the meantime, take time out for you, to de-stress. It actually might be the fastest way to find the answers for Sammy. Coming back fresh might help you see, if the answer is at all obvious. And if it's not - then there is absolutely no way you could be criticised for not instantly having Sammy's problem solved.
Marg