4 Year Old Behavior: Sensory Processing, SID, ASD, ADHD?

Updated on February 04, 2010
L.R. asks from Glenside, PA
13 answers

Hello Everyone,

I have a wonderful son who is 4. He has had sleeping issues since birth/trouble self soothing. He seemed on the late end of milestone markers, but still within range. Around 16 months he started toe walking/hand flapping/rocking. Running, diving and very active (gave me a few split lips) . Then close to 2 he was obsessed with light switches and doors and would play with them nonstop - he really did not seem to "play". Lined up toys, repeated words. Clothing became an issue ("scratchy","itchy",etc.). He never seemed to go with the flow and still has a hard time with transitions or not getting his way. We noticed quirky routines he needed. Social skills with other kids was hard too (hitting, head butting, not keeping hands to himself, etc.). Never sitting down, even to eat - there's more but I am trying to make this short and still give enough info. DH thought Autism. Neuropedi, PT, OT and Intervention did not see anything wrong. We kept going and they finally agreed to speech, OT and an itinerant but they said he was doing so well he did not need services anymore. I did more research and integrated sensory activities which seemed to help for a while. He is in preschool and doing well. He needs to work on an "inside voice" and not being so touchy. However he is only there 5 hours/week.

Today I would see him as sensory, still toe walks - rarely goes flat but can when running or requested, fully verbal, but tantrums/has issues coping, keeping hands to himself. Time out seems not to work. Smart and loving but goes through these periods where he is different...jumping, yelling/shouting, hard to control, poor listening, still runs away (thinks it is funny/a game), and so overly silly/laughing, "hooting"/ramped up that I can't get him to focus, etc. Please, I know he is only 4 - I do not expect him to be perfect - I am not so much concerned about one or two of these behaviors, but I am that so many are combined into one child.

Does anyone have kids with challenges who act differently in different settings? I have been told he cannot have a Dx unless the behavior is the same in more than one setting, so we are struggling with this alone. As much as we are not looking for something to be wrong, we also do not want to over look anything, as we know it is early intervention which helps the most if there is an issue.

Thanks in advance. :)

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answers from Pittsburgh on


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answers from Cleveland on

I agree with the previous responders, it really sounds to me like your son is on the Autism Spectrum or possibly Asbergers Syndrome. He would certainly be high functioning, so do panic at the possibility of it. I would definitely pursue it thru private practices. And remember, it is NOT the label that matters, it is the services that he gets to help with his issues. If one doc says ADD and the other says Autism, but they both recomment Occupatinal Therapy and Speech, run with the OT and Speech. My son is 6 and was diagnosed on the Autism Spectrum at 2 1/2 and is doing super in a normal class. Don't chase a label, chase the help he needs - every study shows, the earlier the better!



answers from Boise on

YOU NEED TO LOOKUP HEAVY METAL POISONING. http://www.helpyourautisticchild.com/chart

Doctors didn't see anything wrong? Are they blind? They clearly have no idea what they are dealing with. You should probably be at an autism specialist. Or a nutritionalist/naturopath.

I would recommend You research NCD zeolite. I just ordered this for my child with autism, haven't got it yet.But it looks so promising: http://zeoliteautismstudy.com/1-dr-p-clips-audio-420.htm

Mental illnesses like ADHD, bipolar, etc.. (as well as hyperexcitabiliy, compulsion, irritableness, aggression, insomnia, OCD) have long been associated with neronal magnesium deficiency. Drinkable magnesium citrate , or magnesium malate pills, plus rubbing magnesium oil on the skin, should help. Vit b liquid drops can help with nerves.

Nutrition, nutrition, nutrition. Clean up his body of poisons and metals, feed organic veggies, pull sugars and too many milks, add supplements.



answers from Washington DC on

I would get a second opinion on the testing that was done. My son has high functioning autism and does most of the things your son does (hopping/hand flapping/issues with clothing/sensitive to foods of certain textures). He is 6 now and in first grade. Here in VA (Fairfax county) we have a programme called child find , speak to your pediatrician about anything like this in your county and contact them , the sooner he is diagnosed and help put in place the better prepared he will be for school.



answers from San Antonio on

He does sound lilke he may be on the Spectrum. My son was different, and it took a long time to get a dx. We started with ADHD and Sensory Integration Disorder, but now he is more Aspergers. I want to correct a piece of advice. A psychologist can make a diagnosis, but cannot prescribe meds. A psychiatrist can diagnose and prescribe meds. I would try to get my son to a psychologist who has experience with autism spectrum and young children and have a complete evaluation done.



answers from Chicago on

If that's not Asperger's, PDD-NOS or high functioning autism then I don't know what is. You've basically described all the behaviors of someone on the spectrum. He may not be considered "autistic" if he didn't loose any previously acquired language skills, but there is definitely a problem. I would get him evaluated by a private OT (outside of school) and start sensory therapy right away. I would also get on the waiting list for a new developmental ped or ped psych for a new eval. My son is 5 and was diagnosed PDD-NOS last year and he has all your son's symptoms. Don't be afraid to get your own evals and treatment - you will find them useful when dealing with the school district.

Good Luck.



answers from Chicago on

I would look for an Occupational Therapist that is familiar with sensory integration disorder. All of the behaviors you are describing sound like it could be sid (my son is 6 and he has some slight sensory issues....he is in OT now).

SID is often mistaken for ADHD or ADD and these kids get treated for that and medicated and the real issues never get solved.

I would also recommend reading the book "The Out of Sync Child."

If you have any other questions (or need to vent to a mom who has been there), please send me a message.

Good Luck. I know how frustrating this can be. Be persistent.



answers from Philadelphia on

Seriously, you sound like you're describing my son when he was 4. He has ADD (ADHD at the time, he's grown out of the hyperactivity part), PDD-NOS (an autism spectrum disorder, aka high-functioning autism), sensory issues (which he's somewhat growing out of, but at 4 had quite a lot), and tics. He's 12 now, in 6th grade, working at grade level, still has some minor issues, but is doing really well. It's been a long road since he was doing all the stuff your boy is doing, but he's in a really great place right now. Definitely get a second and maybe third opinion because, not that I'm a doctor or anything, everything you're describing is raising red flags with me. BTW, at my son's 4yr check-up, his pediatrician said "nothing's wrong, he's just a very energetic child, don't worry"...yeah, right! Then a few years later (after he'd gotten the ADHD and autism diagnosis, but his tics suddenly started), the neurologist said "everything's basically fine, don't worry". If I hadn't worried, he'd never have gotten the OT and ST he needed. He would never have gotten the IEP he needed to get the support in school he needed. In short, he'd be nowhere near as good as he is now. You're the parent, if something doesn't feel right, keep looking into it. Good luck!!



answers from Philadelphia on

You may want to pick up a copy of Anthony Rao's "The Way of Boys" it may give you some insights into your sons behavior and help guide you as to where to seek help or more information.




answers from Washington DC on

I would suggest you to stop give your kid(s) food & beverage products contain High Fructose Corn Syrup. You can check out more information on the effects from HFCS on Google search engine.



answers from Santa Barbara on

When I read your story, I thought I was reading about my son. My son has severe ADHD. While he is easily distracted, his presents more as hyperactivity and lack of impulse control. When he was your son's age his behavior was similar. He was unable to keep his hands to himself, because even though he knew hitting resulted in consequences, he just was unable to stop himself. Even to this day (age 11) he does not adjust well to change and will work himself into an absolute melt down over the unknown. We are the "Loud Family", our neighbors even complained. The toe walking sounds like a habit. My son had thumb sucking to deal with. You said that the behavior is different in different situations, but it sounds to me that the "behavior" your dealing with is lack of any self-control. Talk to your Pediatrician and ask about ADHD. Consider alternative treatments before medication, because some kids respond amazingly well to these alternative treatments. Please feel free to message me privately if you need more info.



answers from Charlotte on




answers from Sacramento on

I would take him to a psychiatrist for an evaluation. Our son has ADHD and the signs were there as early as two. You have described many of our son's issues when he's not on medication (medication has been wonderful, by the way! Positive, positive, positive). You can get help at an early age. With ADHD, you will see the problems 24/7 ... it's definitely not just in one setting, although it can be worse in a school environment.

If you're only seeing issues in certain settings, it may be an entirely different condition. A psychiatrist is in a position to evaluate and make a medical diagnosis. There is a difference between an "active boy" and one who is dealing with ADHD or another condition. The behaviors you're describing are extreme and never discount your gut feelings as a mom. I KNEW from a very young age something wasn't quite right with our son and that the "active boy" claims just didn't cover the extent of what we were dealing with. Be your son's health advocate and seek the additional opinion from a psychiatrist.

Good luck!

P.S. A psychologist can't make a diagnosis but a psychiatrist can. (ETA: This may be just for ADHD, but the psychologists we met with were clear they couldn't diagnose and that had to wait until we met with a psychiatrist.]

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