4 yr old behaviour - disorder or "borderline" ?

[mollymalone]

I'm new to this forum, and after having read lots of messages with interest, I want to pick your brains about my 4 yr old daughter.

I don't want to take her to a doctor yet, as I don't want a wrong diagnosis, and more importantly don't want her to feel there is something wrong with her - when there isn't. I am conscious of the fact that maybe doctors diagnose and label young children too quickly when they're "borderline". But some of her behaviour has been troubling me for some time. I keep thinking that this could just be normal behaviour for more "hyper" kids - maybe she's "borderline" if you know what I mean.

So maybe someone can relate to what I'm saying, and maybe help me out.

First I'll point out the negative behaviours:

Started having major tantrums at 15 mths old.
Would throw herself on the floor banging her head. This would happen if things didn't go her way. She stopped this when she was about 2 yrs old. Her sister was then born. She was extremely jealous - would hit the baby. Hence I couldn't leave them in the same room for one second!

Shy when meeting new people - would sometimes shout when she felt uncomfortable in situations. Especially in big groups like playgroups or in a room where there's people she didn't know. I think this is the way she handled it - she couldn't manage her emotions. Now at 4 yrs old, she wouldn't do this as much, but would shout quietly to herself - like she was uncomfortable. However this wouldn't happen all the time.

Was very active since she started walking at 1 yr old - she would constantly climb the furniture, bang into everything. She still is active - she has a lot of energy - loves dancing.

I can't say that she has all the ADHD symptoms. I think she has a good attention span - she would sit down and play with her toys and loves to be read to. Some of the symptoms she would have like being hyperactive - but then it's not a daily pattern.

If she eats anything containing sugar, she's "wired to to the moon" - you can see the change in her movement and face. She goes absolutely beserk. Therefore I don't give her any sweets or chocolates - only a rare treat of children's Milk Button chocolates which don't contain too much sugar.

Now, these are the only negative behaviour, but when these happen, it's very worrying and embarrasing for me, especially in public.

Now the positive aspects:

Started talking at 2 yr old - few sentences.

She was always "advanced" for her age - I think she's very intelligent - she can read people's actions and minds very well, and then plays up on it.

She went to pre-school at 2 yr 9 mths, and at school, apparently she was perfect. She would behave quite normally. The teachers didn't voice any concerns. It's only when I was around that she would display these behaviours. The only thing that could have contributed is that maybe this could be jealousy towards her little sister, who had my attention.

Now at 4 yr old, she goes to pre-school everyday, but I haven't heard anything negative from the teachers. They say that she sometimes doesn't listen, but they didn't seem too concerned.

She has friends who she plays with and plays well, but when things don't go her way, she can get aggressive and shout a lot. She's not very nice and caring to her sister who's 2 yrs old - this is worrying. She can be perfect one minute, but then horrible the next.

Sorry this is so long, but I wonder whether there's an underlying problem - or just borderline? I don't want to talk about it to the other mums, as I don't want to isolate ourselves from people. But I also want some opinions and advice to this situation.

Hopefully someone can help me..... thanks.

 

[BusynMember]

I would be concerned. Not frantic, but definitely concerned. It's up to you what you do, but I'd take her for a neuropsychologist exam. She's too young to know you think there may be something "wrong" with her. Actually, I'm not thinking ADHD, but something else, however you have to take her in yourself and see. Borderline or not, it is not typical to get as angry as she does and hurt others or herself. Her early precociousness could mean something too (not bad, but could point to something). Have a few questions:

1/ Any psychiatric problems on the family tree? Mood disorders? Autistic spectrum/Aspergers? Substance abuse?

2/Does she make good eye contact? Play appropriately (this is sometimes hard to tell at such a young age). Can she transition well when she has to stop doing something or does that set her off? Did she have an early interest in letters and numbers? Is she obsessed with anything, such as an unusual interest in dinosaurs, the weather, a particular television show? Is she great one second and the devil herself the next? Does she show remorse? Any sensitivities to noise or texture? (Phew) :smile:

Do you live outside the US? If so you may want to say so that others from your country can route you towards services. If you're in the US, I highly recommend a neuropsychologist exam. NeuroPsychs are VERY thorough and spot what other professionals often miss.

Others will come along too.

 

[mollymalone]

MidwestMom - In answer to your questions:

1/ No psychiatric problems in the family

2/ She makes good eye contact with people. She has no problem transitioning. No early interest in numbers or alphabets. She's just started taking an interest in writing her name - but she's 4, so that's normal I think. No major obsession that I can pinpoint. She can be a bit of a Jekyll & Hyde - nice one minute and extremely angry and aggressive the next. One thing she might not be good at is empathy for others. For example, the other day she was on the swing and accidentally kicked another child who was too close to her - he started bleeding, but she continued swinging away until the teacher stopped her. She doesn't show much empathy in these situations when someone is hurt. But is this normal for a 4 yr old?

I don't live in the US. We're from the UK, but we live in the Caribbean at the moment.

What do you think? I did think ODD, but she doesn't display all of the symptons regularly. I am of course hoping that she doesn't have a problem, and that she may just be borderline. Am I in denial?

Anyway, I hope people can relate to me.....

 

[BusynMember]

I don't know. ODD rarely stands alone, and most kids here meet at least some criteria of it. But it is rarely diagnosed as a stand alone diagnosis in the US. I like NeuroPsychs and would go that route, however I don't know the dynamics in the Carribean. No, I don't think not showing empathy is ever normal. My kids were very sensitive to other hurt kids even before age two and would try to "hug" anyone who got hurt--except for my son on the autism spectrum. He seemed more oblivious, although he has since developed empathy (lots of it). He is 14. If it were me, I'd rather be safe than sorry.

 

[mollymalone]

Thanks for your response MidwestMom.

The thing is that deep down, I honestly don't think she fits into any of the labels, since she does not display most of the symptoms consistently. Also, when you look at her and compare her with all her friends, she looks just like them. Body language, facial expression, the way she talks and interacts most of the time. I've looked at every single neuro disorders, and the one you are probably thinking of is Autism Spectrum - Pervasive Developmental Disorder (PDD). I can say that the only persistent negative thing she does is shouting and having no empathy when people get hurt. Otherwise, she is a happy normal child who can play with others and is extremely articulate. If I can sum it up, during the day, she is a good girl 99% of the time. What makes it challenging is that the 1% she is bad, she is BAD. So I think the "badness" over-rides the "good", and I tend to forget how normal she could be. And this "bad" period is just so explosive that people might look at her and think, "what the....." if you know what I mean.

I know what you are thinking - why post here when I think there's nothing wrong with her. The answer is that I wanted to see if other mothers were in the same predicament as me - not knowing where to "draw the line" between completely normal and having a disorder. I wouldn't have posted on this board if I didn't have any concern, but I do need help in handling her behaviour. I ordered the book "Explosive Child", so I am looking forward to reading it.

Thanks for the advice and info, this board is really helpful.

 

[nvts]

Hi! Welcome to the crowd!

My oldest presented much like yours did at the beginning. He was diagnosed with Aspergers Syndrome a few years ago. The ODD and ADHD showed up earliest, but the Aspergers became more obvious as he got older. He makes great eye contact, but showed some of the other symptoms as he developed.

No one is going to think you shouldn't be on here because you think she's probably fine - better safe than sorry! :wink:

Keep your eyes open. If you have a gut feeling, it's probably right. No one knows your kids better than you do. Our pediatrician didn't think anything was wrong, but we kept pushing from 2 on to find out about it!

Again, welcome to the crowd!

Beth

 

[mollymalone]

nvts - your description of your youngest daughter:

"daughter - 6 - wicked anxiety - major tantrums in school - loving, but demanding"

sounds a bit like my girl, although she has tantrums everywhere else BUT school, which in a way is a relief. She doesn't have daily tantrums anymore - a couple a week maybe. How is she now? Does she sound like my daughter?

Did your son only show one or two symptoms at an early age, rather than the whole lot, like my daughter? It's just that my daughter doesn't show all of the symptoms for all these disorders - as I said earlier, she only has some social issues occasionally - not all the time - it's probably anxiety - and the lack of empathy. Other than that, she is normal. I am thinking whether she's just a highly-strung individual with no neuro disorder. This is ofcourse what I am hoping deep down, obviously. I don't want to take her to a doctor unnecessarily, and bring on problems to the family. by the way my husband think she's completely normal - he thinks I'M nuts!! lol... his family all said that he was a "difficult" child until he was 14, and now he is the most laid back person you can meet, and is a great guy. So in a sense, I am thinking that this may be hereditary - and that she will grow out of it eventually. This is what my husband keeps saying.

I'm a worrier, so maybe I'm "reading" too much into this.....

 

[nvts]

Hi! Unfortunately, difficult child 3 is still a bundle of nerves and a difficult child. I'll be transfering her from her school in the next couple of weeks.

Listen: kids are different. from what you've described, your daughter sounds like she tends to "outgrow" the less desireable traits that she tries out. If you see that she's chosen a poor course of action and doesn't seem to learn from her mistakes OR seems to develop more difficulties as time moves on, then take her for a neuropsychologist. Actually, these appointments take months and months to get into, so as soon as you suspect a problem, make the call right away.

If you feel she doesn't need it, cancel!

Keep coming back, bounce your questions around the crowd. We're all here to gain knowledge, give knowledge and to lend an ear and a shoulder to cry on. You can't ask for a better crowd!

Beth

 

[BusynMember]

You have to remember that NO kids exhibit every symptom of the disorders they may have. That doesn't mean they don't have them and don't need help. I"m still in favor of early help rather than waiting. You can't get back those years you "waited." Kids on the Spectrum tend to improve, even without help, but they really reach their max potential with interventions. It's a confusing world for them. Pervasive Developmental Disorder (PDD)-not otherwise specified (atypical autism) is very different than classical autism and Aspergers. These kids appear much friendlier, but, as I can attest to, have just as many issues as they grow up.

 

[susiestar]

I am not sure if you are asking if you can be a "little bit" adhd or bipolar or anxiety ridden. The answer is of course yes - and no.

It can take many months to get into a specialist. At least it can here. A specialist is going to listen to you. They are going to see you wouldlike to know what is going on, but don't necessarily want medicine. We had my youngest evaluated very early. Mostly to get a baseline, so that when things changed we would have a place to go from.

Things did change, but we did not, so far, need to go back to the psychiatrist. We did, and do, need the services of an occupational therapist for sensory integration disorder. His brain does not process what his body sends as far as sensory input. And there are things we do that helps that, quite a LOT.

You clearly have something nagging your instincts about this. The only cardinal rule for mommyhood is to follow your instincts. Most of us will tell you that the times we made the biggest mistakes were the times our instincts said we were doing something wrong. We listened to the so-called experts, whoever they were, instead of our mommy instincts.

I think an an evaluation might give valuable information. REading hte lists of disorders and trying to fit your child into one or the other is a recipe for heartbreak. Diagnosing miental illness is an art as much as a science. It depends on so many nuances, and we just are not trained in this.

It is also important to know that as kids grow they change. Their diagnosis may change, probably will. What they show at age 2 is different than what they show at 4 and at 7 and at every other age. This is true in almost every facet of their lives. That is another reason why it is important to let someone who has more knowledge of the disorders evaluate things.

As far as no caring toward her sister, that is a HUGE red flag to me. But we had some very real and dangerous problems with my oldest. I would at the VERY least be careful not to leave them alone in a room if I could help it. With our family, we ended up taking one child to the restroom when we went. I took daughter, husband took oldest. It was truly the only way to keep daughter safe.

ODD is not something that exists by itself, or so more and more of the articles and research I am seeing indicates. It could be different elsewhere though.

If you want to take a very cautious route, you might want to look into Sensory Integration Disorder. There is an excellent book called Teh Out of Sync Child, and it's partner book, The Out of Sync Child Has Fun. The first explains what Sensory Integration Disorder (SID) is, and what is going on in the brain when things happen. It explains ways to help. The second is affordable fun things to do to help kids with Sensory Integration Disorder (SID), for the different ways this manifests. They are written by Carol Kranowitz.

I am not sure what the health care system is like where you are. HEre an Occupational Therapist (OT) evaluates this.

Susie

 

[Sharon1974]

I was once where you stand. From the time my son was 2 I wondered if something was different about him. I kept telling myself that I was over reacting, that he was fine. I was reading things in that were not there. This wasted 4 years of his life!

I would go ahead and make an appointment with a neuro-psyc. They may tell you that your daughter is fine and give you some peace of mind, or not. Either way you have found what you were looking for and you won't be wishing you did things differently later.