Unusual hand posturing / rigid finger positions?

Discussion in 'General Parenting' started by pattyb, Feb 3, 2012.

  1. pattyb

    pattyb New Member

    Does this sound familiar to anyone? We have a 4-year-old son diagnosed with a mood disorder, with anxious features. Autism has been ruled out but one psychologist described the hand postures, finger twisting, rigid-type finger posturing, as 'autistic-like' even though she did not believe he is on the spectrum. We haven't seen this talked about as far as mood disorders but I am not sure. I am wondering if it sounds like a pediatric bipolar or mood disorder symptom? It's not repetitive, more of just rigid sometimes claw-like hand/knuckle positions he seems to do unknowingly. He also does strange hand postures right in front of his eyes, almost like making a glasses shape with his hands or just putting his hands in front of his face and seeming to stare through them, when he is calming down after a meltdown or sometimes while having a meltdown. Thanks for any info!
  2. TeDo

    TeDo Guest

    I would get a second opinion. What you are describing sounds VERY autism spectrum behavior. How is his eye contact with people an and outside his family? Does he have any sensory issues? How is his communication? How does he socialize with kids his own age? Older? Younger? Does he have topics he will talk about incessantly kind of like an obsession? Does he go to preschool? How does he handle touch? How does he handle changes in routines and changes in plans?

    Sorry for all the questions? It helps to have more information in order to better answer your questions. Others will be along, probably with more questions at first. Be patient since week-ends are sometimes a lot slower around here.

    Welcome to our little corner of the world.
  3. pattyb

    pattyb New Member

    Thanks for your quick reply and for the welcome!

    He's been evaluated for autism by a big health system around here and a local psychologist, and less formally by a developmental pedi and the school district. The developmental pedi. did not attempt to talk to him but from what I described, she was thinking autism and referred us to the health system who ultimately said they had no concerns with-him (it was the psychologist who said mood disorder). School district said they had no concerns but noticed some mild low tone and observed a couple intense meltdowns. He has not qualified for services. The psychologist he is seeing now saw the hand postures and said she would suspect high-functioning autism or asperger's based on that, but said everything else she has observed with him seems to contradict that.

    His eye contact is okay - not good though when coming out of a meltdown and sometimes not good when nervous/being shy around someone. He is GREAT with kids but a little shy to warm up - he'll often walk in to a room of kids playing and suddenly be doing the hand postures and tongue slightly out and sort of wide eyes/hard-blinking and a 'baby mode' voice that's hard to describe - like a regressive mode in certain social situations. Then 2 minutes into it he's talking normally and no hand postures. He loves babies and older kids - does great with a slightly older kid he knows, seems to take cues from him as far as acceptable behavior/not melting down - except when it comes time to leave a place, then he doesn't hold back. Loves imaginative play, sharing activities.

    Sensory issues - used to fall on his knees and cover his ears at the sound his brother screaming, but now the noise issue doesn't bother him. Sometimes in a meltdown he'll say to stop talking because he doesn't want to hear any noises - not sure if that's defiance or sensory. Once at a field trip he flipped out and insisted we leave, later telling me it was too loud. But lately that doesn't bother him. He used to try to hide under something, like a mattress, during a meltdown. But again not in the past several months.

    His communication is good - slight receptive language delay around 2-3 years old, brief period of speech therapy and no issue. Except he does love made-up words, but uses them in sort of a silly way or when he can't think of a real word to say. Uses made-up words to call names when angry. Had a few phases of stuttering/stammering, sometimes thoughts seem too fast and he can't get out what he wants to say the right way and gets frustrated with himself that he can't get it out. He'll start then say it wrong somehow, then shake his head angrily and start again, might hit his ears as he tries, gets frustrated if you don't maintain eye contact and wait and also meltsdown if someone interrupts him - only when in these certain modes though.

    He doesn't have any topics he cares about more than others. But the things he melts down over are sometimes obsessive - i.e. needing something to be a certain way or needing someone to do something - even something fun - in a certain way that is impossible for him to explain or impossible to do it to his satisfaction.

    Preschool - yes. Intense meltdowns when it's time to come in from outside play. Sometimes refuses to participate in certain activities. Otherwise does great.

    He doesn't mind touch. Doesn't mind changes in routine or plans. Well unless it's to something he doesn't want to do - but in general just changing something wouldn't bother him.

    The main issue he struggles with is emotional regulation - or not being able to regulate his emotions. Intense meltdowns, now as he gets older starting to involve a lot of aggression and throwing things, calling names, biting. Some behaviors seem attention-seeking (like he will escalate behavior during time-out seeming to try to get our attention). But no explanation for the intensity of the reaction - sometimes he's responding to seemingly insignificant things. And once the tantrum starts it's very difficult to break him out of it. Haven't found good tactic yet. Explosive Child methods not really working so far. He refuses to talk about these meltdowns and behaviors after they happen.

    Sorry for the novel!! Thanks again.

  4. susiestar

    susiestar Roll With It

    Welcome!! This is a great group and I am glad you are here, though sorry you needed to find us, Know what I mean?? There is a LOT of info here, and the abbreviations may take some time to get used to. If you put the cursor on an abbreviation you don't understand, a short definition will show up. If you can create a signature, like the one at the bottom of my post, it will help us keep the details straight and not have us asking you the same things over and over. PLEASE do not use your real names, and do not mention names of doctors, hospitals, clinics, etc.... This is a public forum and it is important to remember that anyone can read what you post. This is NOT meant to keep you from posting, just to maintain your and your child's privacy and safety. We also don't use photos of our children or post them for the same reasons.

    Has he had a private Occupational Therapist (OT) evaluation? I would have one done if at all possible because it could be a coordination problem. My boys both have had trouble using both hands at the same time and often they don't bend their fingers at the 2nd and 3rd knuckles. It is not conscious, they just have hand problems. It is part of a coordination disorder and of dysgraphia (learning disorder with writing, just as dyslexia is a learning disorder about reading).

    Have you had him tested by a neuropsychologist or a developmental pediatrician? Neuropsychs have special training in how the brain and behavior are related and a complete evaluation involves 8-12 hours of testing broken up into several appointments (might be a big shorter due to his age, but more comprehensive when he is older). Many of us have had excellent results from neuropsychologist testing. Dev peds have special training in how kids develop and problems that can occur at various stages. I had excellent help from ours. I strongly recommend having private evaluations done when possible because those who work for the schools, while usually having the BEST intentions and motives, are often limited to seeing how things affect the school day instead of the entire life.

    Does he have an sensory issues? Problems with certain clothing, tags, seams, smells, tastes, picky eater, noises, certain movements, watch tv sitting on his head, seeking or avoiding any kind of sensations? If so, those should be evaluated by an Occupational Therapist (OT) and may be a part of his problems. The great thing about sensory issues is that they can be helped and often NO medications are needed. Sensory issues exist because the brain is not handling sensory input in the normal way - there is a glitch somewhere. There is therapy for this and often it is FUN. They have PROVEN that some of the therapies, esp brushing and joint compressions, actually create new pathways in the brain - rewiring how the brain handles things!!!! You can cause huge problems if you don't do this the right way, so it MUST be taught by an Occupational Therapist (OT). Once taught, you do it at home. It is not long or painful and many kids like it. Our Occupational Therapist (OT) said that the odd hand posturing was related to the sensory integration disorder.

    You can learn more about sensory integration disorder by reading The Out of Sync Child and The Out of Sync Child Has Fun, both by Kranowitz. The Has Fun book is full of activities to provide the different sensory stimulation that the child needs (called a sensory diet) and has ways to make the activities inexpensive. We wore out our first copy of this book because the entire family enjoyed it. I also learned that by paying attention to what my child liked to do and providing ways to do those things and similar things, we were already providing many of the things he needed. in my opinion it helped that he was our 3rd and we were a LOT more relaxed about kids doing strange things like watching tv while sitting on his head instead of his tushie on the couch. The first title explains the disorder and ways to treat it and is very informative. I found it fascinating.

    Why do they say that he has bipolar? What medicines is he on and who diagnosed him? Is there a history of bipolar and/or substance abuse in either side of the family? I ask about sub abuse NOT to pass judgement, but because often it is an attempt to self medicate an undiagnosed problem or a problem that existed when there wasn't any treatment. I strongly recommend you get a copy of "The Bipolar Child" by Papalous and read it. It is an excellent tool for understanding childhood bipolar disease and for treating it.

    Right now there are a LOT of doctors who are prescribing antidepressants for bipolar disorder. This is scary because ad's have been proven to cause mood cycling, which is what treatment is supposed to prevent. The book describes the approved medication protocol for the disorder and if this is what they are treating your son for, I would insist they follow the protocol (devised NOT by parents or one doctor, but by the Amer Academy of Child and Adolescent Psychiatrists). It starts with 1 mood stabilizer and if needed an atypical antipsychotic and another mood stabilizer can be added. These are introduced slowly and gradually until a therapeutic level is reached - it can take 4-6 weeks at the therapeutic level to know if they are the right medication. It is a slow process and not an easy one, but if the diagnosis is correct, this is your son's best chance to get this under control. Often once the right medications are at the right level, most problems go away. Any remaining problems can be treated by carefully introducing other medications, but if those medications cause mood cycling then they have to be stopped.

    This is a lot of info, and I am only going to add one more thing. There are 2 books that most of us have found work with kids with any problem. The Explosive Child by Ross Greene is invaluable. It isn't a long read and the techniques may seem counter-intuitive but they work. They are NOT traditional parenting, but our kids don't respond to that anyway. What Your Explosive Child is Trying To Tell You by Dr. Doug Riley is amazing. These books give you help that you can use NOW, without waiting for appointments or to see if a medication will work. They help you see what your child is thinking and feeling, and that helps you figure out the best way to help him. Dr. Riley is a member of this forum and you can search for his name and find things he posted when the book came out. He has great ideas and info, in my opinion.

    Welcome and (((((hugs)))))

    Remember - Kids do well when they are able, NOT when they want to.
  5. pattyb

    pattyb New Member

    Thank you so much for your reply Susie! I just replied with some more info a min. ago just before you posted and I'll come back to this tomorrow but he's not on any medication. It was a psychologist who did a ton of testing and came up with the mood disorder diagnosis. He never said bipolar, in fact I wouldn't have even known the two are related if I didn't google it. I am still learning about what the differences are and what a mood disorder really means at this age. It's hard knowing we may not be clear on what the right diagnosis is until much later - it seems like that might be how it works with these things, is that correct? There is no history of bipolar in family that we know of and no substance abuse, but some history of depression and Obsessive Compulsive Disorder (OCD). I will come back again tomorrow but we had been thinking about Occupational Therapist (OT) - very interested to hear about your experience with the hand posturing issue. I have not found anything at all really that talks about this issue. Thanks!
  6. TeDo

    TeDo Guest

    pattyb, your second post with more details answering my questions........you just described my difficult child 1 to a "T". It took us 3 psychologists(therapist), 4 child psychiatrists(psychiatrist), and the wrong diagnosis's of ODD and bipolar before someone bothered to listen to me and look at the WHOLE picture. My son is ADHD (in our case it's co-morbid) and Autism Spectrum Disorders (ASD). His "behaviors" are a result of his increased anxiety in certain situations. At 13, he still uses made-up words when he can't think of the "right" one and baby-talk when he's in a NEW situations. Once he warms up, he's very social. All the rest of your description matches mine, too.

    You really need to find a neuropsychologist. Susie recommended my two "bibles" so I won't tell you the same thing. You are right to ask questions. I have also learned the HARD way (cost difficult child 1 a lot) not to trust professionals implicitly. They are human also with thoughts of their own, beliefs of their own, and mistakes of their own. difficult child 1 and I have survived MANY of those. You need to find someone that will listen carefully, ask lots of questions, take their time, and look at the WHOLE picture.
  7. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Agree with TeDo. Take this child to a neuropsychologist. Does not sound like just a mood disorder to me. Sounds like he has some serious Autism Spectrum Disorders (ASD) traits. Autism Spectrum Disorders (ASD) alone causes mood dysregulation, although many Autism Spectrum Disorders (ASD) kids can learn how to control their moods. Not saying he has it, just saying he should probably get checked out again. Psychologists (regular ones) aren't the best diagnosticians. Never had much luck with them for a correct diagnosis, either for myself or my son. The last thing you want for your child is what WE got for ours...a wrong diagnosis of bipolar and three years of seriously heavy medication and their side effects. He does NOT have bipolar...he is on the spectrum. Now he is eighteen and very able to control his moods. He never needed all those medications in his system...please be careful before committing to agree with anyone's diagnosis, especially if it includes heavy duty adult medication.

    Keep us posted and hang in there !
  8. buddy

    buddy New Member

    This is a common form of transition problem, therefore he does have problems with transitions... transitioning from a preferred activity to a less preferred activity.

    SO anyway, HI! smile... I just jumped in there and didn't even welcome you, so sorry... tee hee.

    My son could not discuss anything and those parts of Explosive child and other methods are only now starting to help at age fifteen. The parts that did work were to lower overall stress in the home by very carefully selecting my "battles" and priorities. I did not pay attention to the words he was saying for a long time in terms of reacting negatively that is (I didn't ignore because this, if not done right, for many kids can make things worse...ignoring is an obvious change in parental or adult behavior and that makes it so that really you are attending to the behavior when ignoring it. My son is triggered big time by people ignoring him and he will get very very hurt). So, making my list of A basket behaviors and sticking to that made a HUGE difference. He was overwhelmed with being corrected and in deep doo doo for so many things... once stress went down, in our case, then anxiety and behaviors went down.

    About attention seeking.... This is a good skill to have. The hardest kids to work with are the kids who are so withdrawn and impaired that they do not want interaction. Negative behaviors get attention and adults then assume that is WHY the child is doing it. When analyzed by professionals who have training beyond the basic functional assessment level know that this is the most common mistake in behavior analysis. Usually the child has underlying reasons for doing behaviors. They may escalate and be tying to get someone to stop what his happening or to come and reassure them etc... but it is not what usually STARTS the behavior so just with drawing the attention almost never works for those situations. (of course we all know times, especially for less intense issues when not attending or redirecting does work so not saying it would never work, just saying never to assume that). The trick is in part to distract to help them gain appropriate ways to get attention and then to figure out what skills or problems are driving the original behavior. (so much easier said than done but well worth the effort when you can get to the bottom of it.)

    The stereo typed movements and behaviors during stress do sound like characteristics of autism . If you can find a therapy center or child development center that specializes in autism you might get a better evaluation to rule this in our out.... they are better aware of the spectrum. Psychologists and psychiatrists tend to go to a mood diagnosis and let me give you a great example. My son has a well documented history of a brain injury and has been both medically and educationally labeled with Autism over and over since he was 4. He recently had to for the first time, be inpatient in a hospital for medication adjustment. Though it was clearly a medication reaction and he clearly has a neurological disability, he came out with a Mood disorder-not otherwise specified diagnosis. I didn't sweat it, it gets him the services he needed from them. It does not apply to his situation in real life though, just how he presented at that time. i would never put it on a history form for therapy etc... just not his deal, and no one who knows him thinks it is, not even our new consulting psychiatrist.

    One thing in your case I would add, you know best though, so take this as it fits...

    I would consider a pediatric neuro evaluation just to make sure there are not any motor or brain injury or even genetic conditions that may be causing some autistic like symptoms. There are a host of medical diagnosis that have autism like issues as symptoms of the bigger diagnosis. In real life we still need to work with the specific symptoms and behaviors but it is always nice to know if there is anything going on. I have a friend who has a son who had meltdowns, trouble sleeping, eating issues, some autistic and sensory issues.... Wasn't getting a diagnosis. We went to visit and about age 8 I said to her do you think he has CP? I was checking his tone and how he held things and just his general hand postures... sure enough he did. He also ultimately has this genetic condition that is causing ongoing illnesses and medical complications with seizures and breathing at night... NOT saying this is your son in any way... doesn't even sound close to what I saw...just saying that until they knew the bigger picture they couldn't really be prepared for what to look for. Just food for thought if you have nto already been there and done that.

    Sounds like along with neuropsychologist, Occupational Therapist (OT) would be important for both motor and sensory issues....(you already have Speech Language Pathologist (SLP) right?) .
  9. pattyb

    pattyb New Member

    Thanks everyone for your very thoughtful and thorough responses!! We will definitely seek a pediatric neurologist evaluation to try to rule out any medical issue, and look into Occupational Therapist (OT). No one has suggested medication so far and we don't plan to try anything anytime soon as we do wonder if it's the right diagnosis. What did your child's mood disorder symptoms look like around age 4? The psychologist who diagnosed him is apparently very respected, the specialists we've talked to since the diagnosis have all been like oh, good, he is great, when they find out who evaluated him. He is a PhD and 'clinical neuropsychologist.' We felt like he did take the time to really look at the whole picture, and he did watch a LOT of video we took. The only thing he said that we didn't necessarily think he understood completely about him was about the hand postures/finger twisting/rigid hand type stuff - we agree that it does seem to come on during times of more anxiety i.e. walking into a room full of kids, but it's also when he's running sometimes, and he compared it to someone rubbing their fingers together out of anxiety and that is more repetitive where this is seems different. Out of all the times he saw DS, he never did the hand thing in front of the psychologist at all, in fact every time he observed him he only saw DS being very engaged, happy, social, bright, flexible with switching activities etc. It's only in the videos that he saw any meltdowns or obsessiveness.

    TeDo, I am also so interested to hear that your child does the baby talk thing too. I haven't seen anyone else talk about that. Is that something I can help him with in some way?
  10. DaisyFace

    DaisyFace Love me...Love me not

    Hello and welcome!

    I would like to suggest you also make sure to rule out seizures. Especially since you described putting his hands in front of his face and staring during a meltdown or shortly thereafter...
  11. buddy

    buddy New Member

    He could very well have a mood disorder, but it is sounding to me like your mommy gut is saying you are not so sure and probably most of us here, I for sure am one, who can tell you that I wish I had been encouraged much more to go with my mommy gut when my son was younger. I was always right for these big picture things. (Not always right about all things, just when it felt sooo like something was missing--school issues, seizures, certain staff, growth issues, etc.. ---I was always right. I am much better and when my gut doesn't know (now a certain amount of that going on) I wont decide... I keep searching.

    If you have any autism specialists, autism clinics, intensive treatment programs.....maybe check for an evaluation there since that is a question, that could be a way to put your mind at ease. FOR NOW... unfortunately it is not always very easy for kids who are sort of on the spectrum... but not really...like kids they call Pervasive Developmental Disorder (PDD)-not otherwise specified (pervasive developmental disorder-which is for now what all of the medical autism diagnoses fall under---not otherwise specified.....the person does not meet criteria for any of them in full but something is going on).

    He is four, a little guy, so this will change and evolve over time. just keep doing what you are doing, searching for support for yourselves and him.....

    You are doing great so far.
  12. TeDo

    TeDo Guest

    The baby talk didn't start really until his anxiety level started going way up. I would very calmly tell him I don't have any babies at home anymore so I don't understand baby talk anymore, can he please use "big boy" words. Now that he is older, I just playfully ask him to talk like a 13 year old. The incidents of this happening anymore have gone way down...but then again.....so have the stressors that were causing the increased anxiety. For difficult child 1, when he was stressed or very uncomfortable, he reverted back to HIS reference point and that was toddler stage. Whatever you do, don't point it out in an authoritative tone or angrily tell him to stop talking like a baby. If he IS like difficult child 1, that will hit his self-esteem. GENTLY remind him to use appropriate language. It worked for us.
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Here is an online test you can do to see if your child (according to this test) is on the autism spectrum. Posters on an autism site I go to feel it is quite accurate, as long as you answer honestly. You may want to give it a look and see if it rings a bell.
  14. pattyb

    pattyb New Member

    Thanks again everyone. I don't know if I should make a new post for this question but we are so new to all this and trying to figure out the best sort of treatment to be looking for- as far as therapy. We have a behavior analyst working on a behavior plan that she will help implement and a psychologist who will do some sort of play-based therapy (and advising us) once a week. He's in preschool part time and no services. And we will start Occupational Therapist (OT) asap. Our biggest concern is the aggression and meltdowns over insignificant things or caused by being obsessive over something random. That can happen at any point during the day even if he's been in a great mood the second before it happens - something random will set him off and suddenly he's in full meltdown mode. If an acceptable solution is made he can snap right out of it, or if it's something we can't help him with (because we don't understand what it is he wants us to do or etc.) or that we can't let him do then it could last an hour. I hope that doesn't make it sound like it's just about not getting his way- I mean 'his way' could be something so random like the way we tell him something or word something or because someone is interrupting him when he's trying to say something real fast and can't seem to get out the words. We really aren't sure what type of therapy or intervention by us or a therapist would address something like that, does it exist? If we can't identify the triggers? Thanks again.
  15. buddy

    buddy New Member

    You may find that due to the underlying issues (autism, auditory processing, language and communication, not being able to read non verbal communication well, sensory integration issues and on and on... ) that doing a typical behavior program may only help for those things that he can change without so much support (as you said, may not be understanding so adding a sticker chart or giving a time out may just add to the frustration but there are times we have to do in the short run something for safety but then still plug on with the additional issues ) so, until you get hte full story... and then also check with Occupational Therapist (OT) and Speech Language Pathologist (SLP) you may not know what therapies. If you find that there is autism you will want more of an autism expert not a behavior expert who knows about autism or has met a kid with autism...someone who really has worked and trained specifically on the well researched forms of therapy for autism. If it is not that, you will try other things, again based on the underlying issues or also a bigger "umbrella" condition (like autism, versus mental health diagnosis versus a medical/health issue etc...)

    You said he is in preschool, I can't remember, is he in early childhood special education??? If not, start that process now.... let us know and if you are not in that, we can help you if you want help in how to get that going.
  16. TeDo

    TeDo Guest

    I REALLY HIGHLY suggest you read What Your Explosive Child Is Trying To Tell You by Dr. Doug Riley. "Typical" behavior programs don't work with our kids and in our case can do great harm. They caused difficult child 1's self-esteem plummet because he couldn't control his behavior and no one but me was willing to find out WHY he was acting that way and helping him find the right words and TEACH him to handle things in a more appropriate way. I am very nervous for your son in this regard. I REALLY REALLY, for his sake, hope they will work WITH him to find out what he's TRYING to say with his behavior and teach and not just punish when he doesn't do it right. THAT scares me.

    Crossing my fingers and all other body parts that you have some of the GOOD professionals we don't seem to have any of. Definitely get the Occupational Therapist (OT) going soon. Is speech therapy working on expressive speech including feelings? THAT is where difficult child 1 is severely lacking and are working on in speech therapy.
  17. pattyb

    pattyb New Member

    Thanks again for your very thoughtful responses! The behavior analyst is through the health system where we had the first autism evaluation-they mostly work with kids with autism, but she has worked with a few kids with a bipolar diagnosis, though they were a little bit older. I think they do a lot of ABA. Is that a good idea for a child with mood disorder, if that is the right diagnosis? We will see what she has in mind before we do anything different. It is important we are all on same page - everyone seems to have diff opinions re: how to handle meltdowns. We've been doing time outs and it clearly does not work for him. She said the behavior plan would not involve time-outs and would be based in positive reinforcement. We'll see. I will look into the other books you all mentioned. We have the Explosive Child but not the other one. The neuropsychologist's main recommendation re: intervention was the CPS technique, just has been difficult to use in some ways since he doesn't like to talk about it. I definitely want to do what it takes to understand what he is struggling with that causes him to have such extreme reactions.

    He's not in speech therapy anymore as he met all of his goals (he was there for receptive language delay-mild) but we are trying to get back in because I think it benefited him in other ways - I mean they worked on social skills too like greetings, etc.

    I just did that test as honestly as possible and it came back with 53-mild Pervasive Developmental Disorder (PDD).

    Also about school district- it has been a long, ridiculous process with the district. Multiple evaluations, meetings, them trying to say he doesn't qualify for anything. But then even after making progress with them, the environment there turned out to be very negative. We've worked with a Special Education advocate and now are in the process of moving to a different district anyway and we'll start that process again there. For now he's in a private play-based preschool where the staff is extremely patient and willing to work with him, work with us to find best ways to work with him, etc. Thanks again everyone for taking the time to offer so much info and advice!
  18. pattyb

    pattyb New Member

    Also yes this is exactly our concern with-the behavior plan, is yes we want to know the best way to respond to it and hopefully he'll learn the appropriate skills to deal with certain feelings, but why does he have those certain feelings or obsessive needs that upset him, why is it such a big deal if A, B or C does or doesn't happen in that way, how to intervene with those things too before it becomes a meltdown. Talking to him in that moment hasn't been really successful so far. So I do want help with behavior but I also want help finding out why he responds that way to the things that ultimately cause the behaviors, Know what I mean?.
  19. TeDo

    TeDo Guest

    The book I recommended in my last post will answer that for you. I found it VERY informative when dealing with difficult child 1. It also helped me get communication going with him.....WAY after the meltdown is over.

    It sounds like you have a really good plan and experienced people to work with. THAT is most of the battle. You also have a very level head on your shoulders and I can tell you'll all be just fine if you keep an open mind and are willing to try. Our favorite "mantra" here is TRUST YOUR MOMMY GUT. That is what most of us find the most difficult because....after all.....aren't the professionals supposed to know more than us?!? LOL
  20. SRL

    SRL Active Member

    Your description sounds a lot like my nephew who has Tourette's Syndrome. In his case the tics were mostly unnoticable until they suddenly kicked into high gear following an illness. His diagnosis was on the fence between PANDAS, Tic Disorder, and Tourette's until he was older and the tics became more pronounced. In addition to the tics, they see lots of behavioral stuff, mild sensory, some social skills deficits but not as pronounced as AS, and some anxiety.

    Tourette Syndrome "Plus" " Leslie E. Packer, PhD

    Has he been evaluated by a pediatric neurologist?