Need Advice-Special Education Preschool

My sympathies on this struggle you are going through. It's a journey to say the least, and can be extremely taxing on the parents, not to mention the child.

I have a son who is 9 and when he transitioned from special ed pre-K to Kindergarten, everything went haywire with his services. For over 4 years now I've been in charge of making sure he gets what he needs. At one point we had to hire a lawyer to sue the district, at another we gave up and moved to a different city. There are 3 things I've learned that are super important:
1) Follow your mother's intuition!
2) It's rare to get the correct diagnosis the 1st, 2nd, 3rd even 4th time out of the chute. If you don't believe me, follow rule #1.
3) The school is not going to give your child everything he needs. Look for alternative therapies that can help his brain function better.

That being said, I would highly recommend you read the book The Mislabeled Child. It goes through all the different kinds of issues, including sensory processing, ADD, visual processing, etc. It's a great primer and will probably help you figure out this puzzle way faster than many visits to many doctors.

Finally, your son seems to display symptoms of auditory processing disorder. He is too young to be evaluated, but you can read a list of symptoms here and see if they fit: http://apdus.org/Diagnosis/what-is-capd.html My son has this disorder, and I was the one who figured it out, and even after I said he should be evaluated, it took 9 months of fighting before I gave up and took him for a private evaluation. The fact that people keep asking you if his hearing has been checked is a huge indicator, also the fact that he doesn't answer questions and the speech delay. His social anxiety could stem from a lack of confidence in social situations. I'm not saying he has this, I'm suggesting you research it.

Many audiologists have little knowledge of this disorder, and they aren't going to mention it, let alone test for it. Your son needs to be at least 6 to be tested though, and even then there are few audiologists who can test so young. You can check out Carol Atkins in Laguna Beach, she specializes in testing younger children: http://www.capdsupport.org/Details/Carol-J.-Atkins-MA-CCC... She tested my son even though we lived 2 hours away.

If you want to know more about APD, I have a private Facebook group with a lot of parents willing to share/discuss: https://www.facebook.com/groups/213243298737362/

I hope this helps!
B.

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The first thing that you should do is have his eyes checked preferably by someone who does peds. Also, when you had his hearing checked did they do a tympanogram?? If not then the hearing test should be repeated....please. The school system does the bare minimum in the testing (trying to save money on services) so you have a couple of choices: call your regional center and or a developmental pediatrician, NOT a regular pediatrician! If you would like further suggestions please feel free to call and leave a message or send an email to the address below. You are your sons' ONLY advocate!

P. Amic CEO/Clinical Director
Special Beginnings, Inc.
An Early Intervention Network
____@____.com
###-###-####

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I suggest getting him evaluated by a Developmental Pediatrician as well to make sure nothing else is going on with him. You can get a referral from your regular Pediatrician.
Also if you can you may want to enroll him in a regular pre-school with typical kids in addition to the one he goes to for a few hours a week. It may help to be around regular kids as well and not just ones with delays in the special education pre-k.
All my best...

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In your son's preschool do they have peer models as well as the special ed students? Definitely have him evaluated by a developmental pediatrician. They are the best to give official diagnoses. As a mom to a child with autism who is nonverbal yet otherwise typical I would definitely make it a point to fully address your son's issues; finding a possible cause/diagnosis is just the start.

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Sounds like he might have some sensory issues or other issues that lie on the Autism spectrum. My daughter started out with speech with the pubic school system when she was 3 years old. The little school bus picked her up from daycare every day and took her to school--she loved that. At 4 years old she was in Early Childhood; the teachers asked me if they could do an evaluation, and they discovered she had hypotonia. She was with kids who needed extra help and kids who were "normal." She was in OT/PT from age 4 through grade 4. She is in the 6th grade now and she is still in speech.

We always knew there was something special about our daughter but it wasn't until she was 5 years old and we took her to see a Pediatric Specialist that we found out she has Sensory Processing Disorder--on the high end of the Autism Spectrum. (That diagnosis is "silent," or not in the charts, because at that time, they didn't have a diagnostic code for SPD; she was/is seen for anxiety and OCD.)

With all of the extra help we've been able to give her over the years, she's been doing wonderfully! She is a solid B student in school (and is working on getting some As), plays tenor sax in band, and has been in dance since she was 4 years old. She works extremely hard in learning how to deal with the areas that don't come so easily (like social/dealing with people).

My daughter exhibited almost all of your son's symptoms. Except the one where she didn't make eye contact, we got that one taken care of right away. She does the flight part of "fight or flight," and we STILL have to deal with/work with that one. We used the help from the school district (speech, OT/PT), we got some extra outside OT/PT help, we had a WONDERFUL childhood specialist who worked so well with her, for a while we had her going to a Wellness/Nutrition Service for Pediatrics (because of weight issues/fussy/picky eating), and just an extraordinary amount of work on the parent end of things.

I feel the more that can be done to help children as early in life as possible, the better the outcome will be for what they can achieve.

If you would like further info/talk more, please get in touch with me.

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I can only answer as the mom of a normally abled 5-1/2 year old. Your son is three - threes should not be doing any substantial amount of 'structured' activity. They learn by playing, by singing, by interacting in games with people and the environment.

My son would have squirmed in his chair if someone tried to make him sit there for long periods. Actually he is currently in a Montessori kindergarten and they DO NOT sit in chairs, do structured activities when they are told to. They get to pick which their 'preferred activities' are and do them. If the teacher finds they are doing all of one type (say math games to the exclusion of language, geography, etc), she will gently encourage the child to pick another activity after they finish the one they are doing.

Not allowing him to learn the things he is enjoying until he does an unpleasant task just seems to me to be setting him up to hate learning. I wouldn't do it. Identifying colors and shapes is something most children learn by interacting with the environment, not by rote. So you say 'look, a blue bird just landed on the green grass' or look, a STOP sign, it has eight sides, that makes it an octagon'.

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Hi Rr,

I'm going to respond to the question you posed in your follow up regarding care providers within a reasonable distance. You need to put in a call to your insurance carrier to find out what its policies are. Some carriers will allow you to go out of network if there are no providers within a 25mi radius of your location, others will insist upon a 50mi radius. Make sure you find out what the rate of coverage is. Ask the rep what alternatives are available if you go to the in network docs but they turn out to not be right for your situation. Most importantly, document, document, document! Make sure you keep a log of who you speak to, and the day and time. I have gotten conflicting information from my carrier from rep to rep, as well as from my own company's HR. It can be very frustrating.

Part 2 to this is, double check with the doctor's office to make sure they still accept your insurance (things tend to change around this time of year with open enrollment). Find out if they will bill the insurance directly, or if you have to pay up front and get reimbursed by the insurance. If the doctor requires additional testing, make sure it's covered by having the testing preauthorized.

If you don't have it already, demand a full explanation of benefits prospectus. This should be about 200 pages long. If you can get it as an electronic document, all the better, because you can search through it more easily using key words to find the information you need. Look for information on specialty care, developmental disability, etc.

If you can't find a developmental pediatrician who will meet your needs, check with your mental health benefits (if you have them) for a developmental psychologist. Also, check to see if there are options for care are colleges or universities that have specialty programs in early childhood development, especially pathological development. I know CSU Northridge has an excellent child development program, but this can be quite a drive, depending on where you are in L.A. (the 405 is NEVER a good drive IMHO!). These might not be covered by insurance, but often you can get services for a rate that is significantly reduced from the private sector, and is frequently more cutting-edge.

Good luck with your son -- I truly hope you can find services that will be of help to him (and you!). Here's a couple more spins, though.
1. How much fish is your child eating, especially tuna and farmed fish? The mercury levels in fish are quite high and mercury poisoning can cause the atypical neurological behavior you're observing. Not being able to look someone in the eye can actually be a sign of mercury poisoning, as can social anxiety. The "safe" FDA levels for mercury are actually several times greater than what research biologists have determined to be safe. If your son eats a lot of fish, try to cut it out from his diet 100% for a couple of months and see if there are any improvements (I woudn't delay seeking evaluation, though, and when you do, if there's reason to suspect it, you can ask the doctor to order a test for mercury levels).
2. Perhaps your son is not actually academically challenged, but simply marching to his own beat. Many intellectually gifted children can display the kinds of behavior you're describing. They do things in their own time, in their own way, and just don't want to do anything that's not of interest to them. True, this can be frustrating in its own right for the parent and teacher. My son was somewhat like what you describe throughout preschool and early elementary school, and even through high school just couldn't be bothered with anything he considered to be busy work, but would pursue his own interests with amazing focus. He would get 100% on every test (if he liked the topic), but refused to do homework, so usually earned B's and C's in school. Still, we and his teachers recognized that he has an incredibly bright and agile mind. At 22, he's finally getting himself on track -- a long haul, but better later than not at all!

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My son started with speech at age 3, was diagnosed with Aspergers/ADHD at age 5, and is now 9. The teachers ask him to do their tasks before his preferred activities(they call it first-then). They would also find activities to motivate him. He would collect stickers, tokens, or tickets for good behavior to get a reward at the end of the day. He's involved in choosing what reward he's working towards, whether it's getting to look at the thermostat in the utility closet or building an art project with stuff from the recycle bin. I didn't always agree with how they did it- one time they wouldn't let him eat lunch because he wouldn't write.

Have you tried having more of the lessons done with music and movements? Like singing the alphabet song, making letter shapes in the air with big arm motions, making lines in moon sand, and writing on a chalkboard while standing up. Or what about learning on a computer (or ipad) with programs that have music and cartoons as rewards for completing each lesson.

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This description fits my grandson in many ways. His main diagnosis has been speech and language delays. But he is also taking medication now for ADHD. He did not behave well in school tho he did in day care.

He too was evaluated thru the school by all the people you listed. He was in a therapeutic preschool and entered a special ed program in kindergarten and first grade. He didn't do well in that program and is now in a more specialized school. His class has 6 or less students with a teacher and 2 aides. He continues to get OT, PT, and speech therapy at school.

In addition to that, at the recommendation of the school counselor and his pediatrician he began seeing a developmental pediatrician. His insurance pays for this. This pediatrician is like a case manager. She keeps track of where my grandson is at developmentally and academically. She sees him every 3 months.

After the first appointment she referred him for more in depth evaluations which resulted in more in depth therapy paid for by his private insurance. We did see improvement after those therapies ended. He is still to receive added speech therapy but he refuses to work with the therapist.

He does continue to get all the therapies including speech at school. And, in the last several months is beginning to catch up academically. He's in the third grade by age but still in the latter first and early second grade academically.

We wish that we had gotten him started with private treatment much earlier. The developmental pediatrician is a big help and so has been the extra therapies. She changed his ADHD medication to one that is now working to keep him more calm and focused.

It has been decided that my grandson's inability to do tasks that aren't his preferred task is a combination of his disorder and behavior issues. He's probably somewhere on the autism spectrum scale. He not only refused to do anything in which he wasn't interested but he also was disruptive of the whole class and acted out in anger.

He's now 8 and is able to participate in class in a more consistent way. He is now well behaved in school and at home most of the time. I think his medication has been a help there but I also think that the consistent and firm discipline that his teacher and aides are able to provide in the small classroom is just as much a reason for success.

Early on in the program, when he was nearly 3, a social worker came to their home and taught his mother how to manage his behavior in a more effective way. Discipline is quite simple. There are just a few rules such as show respect which includes no hitting and do as you're told. When he doesn't follow the rules he's immediately sent to his room, not as a traditional time out, but as a way for him to regroup and start over. He can play, watch TV, listen to music, etc. When he's able to come out and say he's sorry and then do what he was told to do he can come out. Mom gives him a hug, repeats the lesson, and life begins over.

It did take a couple, three weeks, before he'd go to his room without assistance. Now, there are times he puts himself in his room.

I suggest that some of your son's behavior is due to his age and immaturity. Many 3 yos are still playing more parallel than together. Wanting to have his friends around only some of the time sounds normal to me. He could be an introvert whose basic personality is such that he likes his own company and doesn't need as much social interaction as us who are more extroverted.

I would recommend getting him in to see a developmental pediatrician and listen to her/his advice. They are trained in evaluation and treatment of the child who is different than the average child.

His not responding to conversation could be a part of his language delay and/or immaturity. This could also be an indication that he's somewhere on the autism spectrum scale. My grandson just began to have somewhat coherent conversations with us around 7.

In regards to having him do a not preferred activity before doing a preferred activity, this is usual in the therapeutic setting. He provides an incentive to do what the child doesn't want to do. With my grandson they eventually learned to do it the opposite way. He frequently is allowed to do the preferred activity with the promise that he'll do the not preferred one after that. This seems to work better.

What has been most helpful in providing treatment for my grandson is for the therapist/teacher/aide to be flexible enough to try different ways of approaching him. Yes, these children have much in common but are more sensitive to how things are done than the average child. They are not naturally compliant. They do march to a different drummer in many ways. It seems to me that their brain is wired differently in many ways.

My grandson has difficulty speaking and with using language because his brain doesn't get messages that help him do so. He needs lots of firm touches. Holding him frequently helps him calm down, even as he fights it, while in comparison his sister does not respond to holding when she's angry.

Have you asked the OT for suggestions on potty training? He is still young. Many children, especially boys train later than 3. But if he's physically mature and ready for training there may be ways to help him along.

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Wow. 3. 5 hours of structured activities a day? This is very troublesome to me. Young children need to play, and play hard. If he seems fine in certain situations, then put him in more of those situations.

There may be nothing wrong with him. If you poke and probe at a person, they will act weird and stop responding appropriately. The more I learn about our "therapies" on young children, the stronger I believe (and know) that we are breaking them.

And young kids only want to do what they want to do when they are in the right mood. It's normal.

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Is all your testing being done by the school? Yeah, you need private testing. The school does the BARE minimum.

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Hey Rr,
My own son showed some of these very same signs at 21 months and is now being evaluated for autism. He was very advanced in his gross motor activities, but really struggled with any form of communication be it verbal or nonverbal.
Our specialist put our son on a gluten free/casein free diet and we are noticing some big differences. He is now looking us in the eyes, is starting to sign again, and is seeming to now understand what we are saying. The doctor also ran a lot of tests and found that my son had some bizarre bacteria built up in his system that is typically found in autistic children.
This being said, you may want to visit either a pediatric neurologist or a DAN (defeat autism now) doctor. These types of doctors are more adequately equipped to identify these types of issues in children then a pediatrician. A special diet and some good probiotics may be all it takes to bring your son around.

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