Concerned about my 11yo son. Does this sound like a disorder of some type? Developmental?

[Anonymous]

He’s always been very quiet and timid. At one point, around age 6, he was evaluated for selective mutism and deemed slow to warm instead.

Over the years his personality/temperament remained the same. In a classroom setting he was allowed to work in small groups and teachers would notice he would only engage in those groups and with those friends. In an effort to keep him progressing socially, even when he tested out of say a reading level small group, they allowed him to stay and used it for socializing.

He’s now going into middle school and small group socializing is still happening but one on one instead with the teachers and that is where they say he is most social.

I’ll notice when he’s asked to do something he seems unable to do it physically. He was to cut the icing packet on toaster strudel the other day and seemed to not know how to hold the scissors to make the cut (fingers right where the blade tip could cut your fingers instead). Other examples include when he’s getting dressed in the morning, putting on pants on top of his pajama shorts and going the entire school day with both pairs on.

I asked him to turn off the porch light this morning as he was by the door and he just looked and said it was on. He seemed somewhat unsure of what to do. Common occurrences like this where he seems out of place for his age or ability or unsure of a situation that happens every day for years.

He will ask where to place his socks before a shower when the daily routine is to put dirty clothes in the hamper and socks in a sock bin beside the hampers.

Another recent example was at an indoor pool he seemed unable to get out of the side of the pool. He’s taken swimming lessons for a few years now and the instructor had to push his bottom up for him and explain how to push up with his arms.

I requested an IEP evaluation thru the school and they plan to do one this summer.

Doctors do not feel it’s adhd. They have said maybe a little social anxiety but much of this is a home setting with the same family members for over ten years now and every week day school setting with the same class and teachers.

I’m at a loss and worried that I’m running out of options. I bring this up to every pediatrician and they just essentially shrug it off as nothing of concern. It just feels like it’s something needing attending to, to me.

The unfamiliarity of common situations and inability to physically complete common tasks, what may that be exactly?

[Anonymous]

I don't know, but there are enough yellow flags to get a full evaluation, if it's affordable for you. I'd want to look at executive function, language processing, Developmental coordination disorder. I strongly recommend David Black at CAAT in Chevy Chase. The school evaluation will not be thorough enough.

[Anonymous]

Sounds like an OT evaluation would be helpful, as there may be some low tone or dyspraxia at play. Middle school is a big jump socially, so I wouldn't rule out a full neuropsych or at least a speech and language evaluation as some of these behaviors suggest a receptive language based issue.

[Anonymous]

Was he formerly familiar with these situations and able to physically complete these tasks? If you're seeing a decline in that regard, I'd suggest you have him checked by a neurologist out of an abundance of caution.

[Anonymous]

Like another poster recommended, I’d go for a full neuropsychiatric evaluation. That would turn up a learning disability, a developmental disability, or an issue like anxiety. While you had a limited evaluation at age six, it’s fine—and sometimes necessary—to repeat every three years.

[Anonymous]

Maybe also do a blood test for nutritional deficiencies.

[Anonymous]

His conditions may or may not be serious enough to get a diagnosis, but he might have low muscle tone and poor auditory processing. These things can be improved, if he wants to improve and you are willing to pay for therapy.

[Anonymous]

Op, I would be alarmed. I agree with others, you need to get more testing. Neuropsych, OT, at the least. If you haven’t mentioned the physical concerns to your ped, you should.

[Anonymous]

You’ll get better responses on the Special Needs forum, but it definitely sounds like you should get a neuropsych eval. The school eval will only flag academic deficits, and won’t look very deep. The school will also be reticent to provide more than a 504 plan if he’s not struggling academically (at least in this area).

[Anonymous]

Sounds like a processing issue and possibly motor planning. Ask doctor for a referral for a specialist.

[Anonymous]

If he were older it would obviously be dementia. Does he have low B12? Get medical exam and bloodwork along with the other exams.

[Anonymous]

Anonymous wrote:Was he formerly familiar with these situations and able to physically complete these tasks? If you're seeing a decline in that regard, I'd suggest you have him checked by a neurologist out of an abundance of caution.

This. Check out by a neurologist, and then if nothing, OT and neurospych. The pool example is particularly concerning. Did you mention that incident to your ped when your ped waived you off? Or was this incident too recent?

[Anonymous]

Trust your gut here Mama. What you describe calls for a full neuropsychological workup. The school and pediatrician will brush off your concerns, but you know your son best and what you describe calls for intervention ASAP.

[Anonymous]

Thank you PPs! I wouldn’t say he’s declining but I also wonder if having someone step in to help when he struggled with things has left him a bit unable to do it for himself too. I worry about that aspect of day to day, oftentimes when he was confused by something we would step in and help him essentially doing the “job” but giving him credit for it. In hindsight, the same was happening and still is happening at school. I recently called to see if he had packed his sandwich in his lunch box, his teacher went to check and rather than have him confirm, confirmed for him.

I wonder if he’s not been given enough independence to learn how but because he struggled with things, I believe we all assumed we were helping him not hindering him.

I have asked about social anxiety and been told it could be a possibility but given that it’s the same at home and school, I think that makes it more perplexing and leads me to wonder if it’s developmental perhaps?

Doctors have never had any notes regarding his tone or muscle - he’s been 98/99th percentile for weight and height since he was probably one years old.

Our insurance does not seem to cover the cost of the neuropsychiatric evaluation but I will continue to call around for these.

I’ve asked for a number of referrals for any types of specialists from two sets of different pediatric offices over the years and to no avail outside of that initial evaluation.

I’m not going to stop though, I thank each of you for taking the time to reply here! Thank you so much!

[Anonymous]

Op again. Adding, all bloodwork has been good. No deficiencies atleast across the panels done!