social skills - group play and the 4.5 year old

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Are there any social skills interventions that help with group free play for the 4-5 year olds? My 4 year old boy really enjoys playing 1:1 with certain friends outside of school, and enjoys organized games (eg steal the bacon) at school. But most of the time he refuses to play with groups of kids during free play time. Apparently he even turns them down if they ask if he wants to play. No ASD diagnosis but I'm sure that ASD approaches would be relevant. I'm not sure how much of this is an introverted personality, and how much is a lack of skills. I know that a big part of it could be inherited temperment, since I remember hating to play in groups when I was a kid unless it was an actual game with rules!

If this is the question, spend the time and money on a assessment by a developmental pediatrician.

If he plays well one-on-one and participated in organized group games, what he chooses to do during free play wouldn't concern me unless he were unhappy. Since your kid doesn't seem upset or anxious, I would let him be about this.

I see a trend with moms in this area starting with OTs when they're concerned about their kids. OTS cannot diagnose motor planning issues or ADHD. Your kid on a typically developing trajectory--don't let an OT dictate a treatment plan in lieu of a formal assessment.

Who said the OT was dictating anything?? Geez. You assume a lot.

It was a warning not an assumption.

It was good and appropriate advice.

NP here - we started with OT at the recommendation of the developmental psychologist we contacted for an assessment (he did not do an assessment first). We've also been told repeatedly that our DC (5) is too young for a formal assessment. In all seriousness, how are moms with concerns who are new at this supposed to know where to start? What should I do first?

The developmental psychologist was probably referring to an educational evaluation. You can see a developmental pediatrician at any age.

We suspect ADHD and the psychologist was pretty clear that he thought DC was too young for any sort of an assessment because it was too early to separate out potential ADHD from age.

[Anonymous]

NP here - we started with OT at the recommendation of the developmental psychologist we contacted for an assessment (he did not do an assessment first). We've also been told repeatedly that our DC (5) is too young for a formal assessment. In all seriousness, how are moms with concerns who are new at this supposed to know where to start? What should I do first?

The developmental psychologist was probably referring to an educational evaluation. You can see a developmental pediatrician at any age.

We suspect ADHD and the psychologist was pretty clear that he thought DC was too young for any sort of an assessment because it was too early to separate out potential ADHD from age.

You are getting bad advice. Its not to young to get a formal assessment. You don't want to wait as its impacting your child's overall functioning. Many of us on this board start taking our kids to developmental ped's starting at 2-3-4. He is to young for a neuropsych. as that is generally a minimum of age 6. You don't want to wait if you suspect ADHD as he will start formal school/K and you want him to be successful. This psychologist may not be able to do the evaluation because of age, but others can. They are giving you bad advice. You are correct its hard to distinguish several different SN (as you can see from the debates here) but its good to have an evaluation as it gives you a place to start. You can always reevaluate at a later date as well. Many of us go yearly to the developmental ped, if not more often. We are required to go yearly or so from our insurance.

[Anonymous]

Anonymous wrote:

NP here - we started with OT at the recommendation of the developmental psychologist we contacted for an assessment (he did not do an assessment first). We've also been told repeatedly that our DC (5) is too young for a formal assessment. In all seriousness, how are moms with concerns who are new at this supposed to know where to start? What should I do first?

The developmental psychologist was probably referring to an educational evaluation. You can see a developmental pediatrician at any age.

We suspect ADHD and the psychologist was pretty clear that he thought DC was too young for any sort of an assessment because it was too early to separate out potential ADHD from age.

You are getting bad advice. Its not to young to get a formal assessment. You don't want to wait as its impacting your child's overall functioning. Many of us on this board start taking our kids to developmental ped's starting at 2-3-4. He is to young for a neuropsych. as that is generally a minimum of age 6. You don't want to wait if you suspect ADHD as he will start formal school/K and you want him to be successful. This psychologist may not be able to do the evaluation because of age, but others can. They are giving you bad advice. You are correct its hard to distinguish several different SN (as you can see from the debates here) but its good to have an evaluation as it gives you a place to start. You can always reevaluate at a later date as well. Many of us go yearly to the developmental ped, if not more often. We are required to go yearly or so from our insurance.

This is helpful. Can you recommend some developmental pediatricians? How do I find one?

[Anonymous]

+1. We got an adhd diagnosis at age 3. THe dev ped said it was "emphatically, unquestionably" adhd. We were having major problems in preschool which led to teh evaluation. Definitely not too early. At 6, the diagnosis hasn't changed, and i'm very glad we got answers as early as we did because we were able to start medicating (at 4) which was a life saver for him and us.

Get on the waitlist at KKI (Kennedy Krieger Institute) and childrens national hospital for a diagnosis. Both will give you a long wait time, but KKI tends to start calling with cancellations as early as 2 months later.

Shame on teh psychologist for telling you there was nothing to be done.

[Anonymous]

Back to OP's original question:

We are in teh district and looked for a social skills group for our son when he was age 4, and ultimately struck out. I called a zillion psychologists, OTs, etc inside the beltway, none of whom were currently offering groups for that age. There was one group our in, i think, Falls Church. But it was after work/school and we decided that would have been a stressful disaster for us to get to every week for 10 weeks.

To echo something another PP said, we spoke to a psychologist who said she tended not to do groups at that age because the adhd and asd kids are often functioning well enough in one-on-one settings and get thrown off in a bigger settings. But putting them in a group with 3 kids (a) doesn't provide the level of chaos they need in order to disrupt their social functioning (thus, no learning opportunities) and (b) at that age, they are mostly unable to take what they learn in a small group setting and apply outside of the context of the class. So i had a couple experts tell me not to bother at this age. To keep doing regular playdates and reassess at 6 or 7.

We did also ask our preschool director about it, and she looked into whether any other kids at the school might be a good fit to make a small social skills group and bring in a private psychologist every week, but she wasn't able to find anyone else.

[Anonymous]

Anonymous wrote:+1. We got an adhd diagnosis at age 3. THe dev ped said it was "emphatically, unquestionably" adhd. We were having major problems in preschool which led to teh evaluation. Definitely not too early. At 6, the diagnosis hasn't changed, and i'm very glad we got answers as early as we did because we were able to start medicating (at 4) which was a life saver for him and us.

Get on the waitlist at KKI (Kennedy Krieger Institute) and childrens national hospital for a diagnosis. Both will give you a long wait time, but KKI tends to start calling with cancellations as early as 2 months later.

Shame on teh psychologist for telling you there was nothing to be done.

so sick of people armchair diagnosing/critiquing on here. like PP I have been expressly told by numerous professionals that we can wait on a formal adhd assessment for our 4 year old for another year or two (or until his functioning in school becomes impacted). In the mean time we are addressing the deficits as they come, which for our particular case means OT for motor skills and emotional regulation. There actually is nothing magical about a developmental pediatrician and it is not practical for many families as a first step anyway because they are so hard to find and book in a timely manner. Yes in severe ADHD cases the situation might be different. But please ppl stop second guessing the MANY parents of preschoolers who are getting appropriate support for kids as their symptoms start to clarify.

[Anonymous]

Anonymous wrote:

Anonymous wrote:+1. We got an adhd diagnosis at age 3. THe dev ped said it was "emphatically, unquestionably" adhd. We were having major problems in preschool which led to teh evaluation. Definitely not too early. At 6, the diagnosis hasn't changed, and i'm very glad we got answers as early as we did because we were able to start medicating (at 4) which was a life saver for him and us.

Get on the waitlist at KKI (Kennedy Krieger Institute) and childrens national hospital for a diagnosis. Both will give you a long wait time, but KKI tends to start calling with cancellations as early as 2 months later.

Shame on teh psychologist for telling you there was nothing to be done.

so sick of people armchair diagnosing/critiquing on here. like PP I have been expressly told by numerous professionals that we can wait on a formal adhd assessment for our 4 year old for another year or two (or until his functioning in school becomes impacted). In the mean time we are addressing the deficits as they come, which for our particular case means OT for motor skills and emotional regulation. There actually is nothing magical about a developmental pediatrician and it is not practical for many families as a first step anyway because they are so hard to find and book in a timely manner. Yes in severe ADHD cases the situation might be different. But please ppl stop second guessing the MANY parents of preschoolers who are getting appropriate support for kids as their symptoms start to clarify.

No one is trying to diagnose your kid. I'm surprised that of the numerous professionals you saw that no one mentioned behavioral therapy conducted by a psychologist.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:+1. We got an adhd diagnosis at age 3. THe dev ped said it was "emphatically, unquestionably" adhd. We were having major problems in preschool which led to teh evaluation. Definitely not too early. At 6, the diagnosis hasn't changed, and i'm very glad we got answers as early as we did because we were able to start medicating (at 4) which was a life saver for him and us.

Get on the waitlist at KKI (Kennedy Krieger Institute) and childrens national hospital for a diagnosis. Both will give you a long wait time, but KKI tends to start calling with cancellations as early as 2 months later.

Shame on teh psychologist for telling you there was nothing to be done.

so sick of people armchair diagnosing/critiquing on here. like PP I have been expressly told by numerous professionals that we can wait on a formal adhd assessment for our 4 year old for another year or two (or until his functioning in school becomes impacted). In the mean time we are addressing the deficits as they come, which for our particular case means OT for motor skills and emotional regulation. There actually is nothing magical about a developmental pediatrician and it is not practical for many families as a first step anyway because they are so hard to find and book in a timely manner. Yes in severe ADHD cases the situation might be different. But please ppl stop second guessing the MANY parents of preschoolers who are getting appropriate support for kids as their symptoms start to clarify.

No one is trying to diagnose your kid. I'm surprised that of the numerous professionals you saw that no one mentioned behavioral therapy conducted by a psychologist.

Again, we are getting supports to address current challenges. Please stop patronizing. Of course we will consider behavioral therapy why the time comes.

[Anonymous]

Anonymous wrote:Back to OP's original question:

We are in teh district and looked for a social skills group for our son when he was age 4, and ultimately struck out. I called a zillion psychologists, OTs, etc inside the beltway, none of whom were currently offering groups for that age. There was one group our in, i think, Falls Church. But it was after work/school and we decided that would have been a stressful disaster for us to get to every week for 10 weeks.

To echo something another PP said, we spoke to a psychologist who said she tended not to do groups at that age because the adhd and asd kids are often functioning well enough in one-on-one settings and get thrown off in a bigger settings. But putting them in a group with 3 kids (a) doesn't provide the level of chaos they need in order to disrupt their social functioning (thus, no learning opportunities) and (b) at that age, they are mostly unable to take what they learn in a small group setting and apply outside of the context of the class. So i had a couple experts tell me not to bother at this age. To keep doing regular playdates and reassess at 6 or 7.

We did also ask our preschool director about it, and she looked into whether any other kids at the school might be a good fit to make a small social skills group and bring in a private psychologist every week, but she wasn't able to find anyone else.

Try Sue Abrams in Rockville. I'm pretty sure she has groups for the age or if he's close to 5 there is definitely a group as that's when my DS went to one of her groups.

[Anonymous]

If your kid doesn't want to play with other kids you should obviously get a good ASD eval. That's what everyone is tiptoeing around here. Call a Dev ped or don't,nobody is patronizing you. But ADHD that appears this early - our kids did too - usually goes along with other issues. And ASD is often misdiagnosed as ADHD. ADHD isn't a developmental disability per se. ASD is.

[Anonymous]

Anonymous wrote:If your kid doesn't want to play with other kids you should obviously get a good ASD eval. That's what everyone is tiptoeing around here. Call a Dev ped or don't,nobody is patronizing you. But ADHD that appears this early - our kids did too - usually goes along with other issues. And ASD is often misdiagnosed as ADHD. ADHD isn't a developmental disability per se. ASD is.

reading comprehension fail.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If your kid doesn't want to play with other kids you should obviously get a good ASD eval. That's what everyone is tiptoeing around here. Call a Dev ped or don't,nobody is patronizing you. But ADHD that appears this early - our kids did too - usually goes along with other issues. And ASD is often misdiagnosed as ADHD. ADHD isn't a developmental disability per se. ASD is.

reading comprehension fail.

Its just ASD Mom who diagnoses all kids with ASD. Hi ASD Mom, hope you are having a great day.

[Anonymous]

Anonymous wrote:

Anonymous wrote:+1. We got an adhd diagnosis at age 3. THe dev ped said it was "emphatically, unquestionably" adhd. We were having major problems in preschool which led to teh evaluation. Definitely not too early. At 6, the diagnosis hasn't changed, and i'm very glad we got answers as early as we did because we were able to start medicating (at 4) which was a life saver for him and us.

Get on the waitlist at KKI (Kennedy Krieger Institute) and childrens national hospital for a diagnosis. Both will give you a long wait time, but KKI tends to start calling with cancellations as early as 2 months later.

Shame on teh psychologist for telling you there was nothing to be done.

so sick of people armchair diagnosing/critiquing on here. like PP I have been expressly told by numerous professionals that we can wait on a formal adhd assessment for our 4 year old for another year or two (or until his functioning in school becomes impacted). In the mean time we are addressing the deficits as they come, which for our particular case means OT for motor skills and emotional regulation. There actually is nothing magical about a developmental pediatrician and it is not practical for many families as a first step anyway because they are so hard to find and book in a timely manner. Yes in severe ADHD cases the situation might be different. But please ppl stop second guessing the MANY parents of preschoolers who are getting appropriate support for kids as their symptoms start to clarify.

I'm the first PP and my response was to the previous PP (not OP, i think) that specifically said "we started with OT at the recommendation of the developmental psychologist we contacted for an assessment (he did not do an assessment first). We've also been told repeatedly that our DC (5) is too young for a formal assessment."

No one has done an ounce of arm chair diagnosing (or at least, hadn't when i posted the original PP above) about the person who made the above statement or about OP's kid. We all said "no, you got bad advice, of course you can seek a diagnosis as early as age 5". I have no idea what PP's kid has going on, and maybe they have nothing going on. But no one should use the excuse that "it's too early to diagnose".

If, as the PP above suggests, you've been told that the official diagnosis "can wait", then that is entirely different than "it's too early to diagnosis".

PS i think i'm muddling several PPs v OP in a lot of these comments.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If your kid doesn't want to play with other kids you should obviously get a good ASD eval. That's what everyone is tiptoeing around here. Call a Dev ped or don't,nobody is patronizing you. But ADHD that appears this early - our kids did too - usually goes along with other issues. And ASD is often misdiagnosed as ADHD. ADHD isn't a developmental disability per se. ASD is.

reading comprehension fail.

Its just ASD Mom who diagnoses all kids with ASD. Hi ASD Mom, hope you are having a great day.

My kid doesn't have ASD, so nice try I guess?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:+1. We got an adhd diagnosis at age 3. THe dev ped said it was "emphatically, unquestionably" adhd. We were having major problems in preschool which led to teh evaluation. Definitely not too early. At 6, the diagnosis hasn't changed, and i'm very glad we got answers as early as we did because we were able to start medicating (at 4) which was a life saver for him and us.

Get on the waitlist at KKI (Kennedy Krieger Institute) and childrens national hospital for a diagnosis. Both will give you a long wait time, but KKI tends to start calling with cancellations as early as 2 months later.

Shame on teh psychologist for telling you there was nothing to be done.

so sick of people armchair diagnosing/critiquing on here. like PP I have been expressly told by numerous professionals that we can wait on a formal adhd assessment for our 4 year old for another year or two (or until his functioning in school becomes impacted). In the mean time we are addressing the deficits as they come, which for our particular case means OT for motor skills and emotional regulation. There actually is nothing magical about a developmental pediatrician and it is not practical for many families as a first step anyway because they are so hard to find and book in a timely manner. Yes in severe ADHD cases the situation might be different. But please ppl stop second guessing the MANY parents of preschoolers who are getting appropriate support for kids as their symptoms start to clarify.

I'm the first PP and my response was to the previous PP (not OP, i think) that specifically said "we started with OT at the recommendation of the developmental psychologist we contacted for an assessment (he did not do an assessment first). We've also been told repeatedly that our DC (5) is too young for a formal assessment."

No one has done an ounce of arm chair diagnosing (or at least, hadn't when i posted the original PP above) about the person who made the above statement or about OP's kid. We all said "no, you got bad advice, of course you can seek a diagnosis as early as age 5". I have no idea what PP's kid has going on, and maybe they have nothing going on. But no one should use the excuse that "it's too early to diagnose".

If, as the PP above suggests, you've been told that the official diagnosis "can wait", then that is entirely different than "it's too early to diagnosis".

PS i think i'm muddling several PPs v OP in a lot of these comments.

Not all providers are qualified to do all tests and that may be the issue you are running into, which is why some of us suggested going to a generalist/developmental ped. to start. It is not too early for an ADHD diagnosis, if it is appropriate. You do not want to wait till K. to work on this as it can really interfere with school and make things very difficult. You are better off getting an evaluation now so you can provide it to the school for supports. Many of us have had to go to multiple providers to get accurate diagnosis and help.