How to determine if a child has special needs?

[Anonymous]

Hi All, I want to ask your advice. I also want to say in advance that what I am dealing with pales in comparison to much of what I read here. I read the posts here and wonder how all the parents are coping so well. It is quite remarkable.

I am struggling with how you know when a child needs some level of intervention or help and I thought the folks here would be more equipped to answer than on the general parenting board.

Here is my situation. We have almost 4 year old boy/girl twins. They are healthy, bright, charming, well-socialized (though not yet in preschool), generally happy kids. My daughter makes us look like fantastic parents. She is highly verbal, was easily potty trained, adapts well to change/transitions, has minimal tantrums, and is generally an extremely easy kid (and was as a baby also.)

My son makes us feel like failures as parents. He is also smart, funny, etc... (and they're both great sleepers and eaters) but he is MUCH harder in terms of all behavior around emotional regulation - temper tantrums, screaming, hitting, scratching, etc... In the past couple of weeks we have had significantly increased battles around transitions, bedtime, some meals, etc... These battles and rages always happen when time we try (or have to) exert control over him. (I don't mean that he goes into a rage every single time we have to exert control, often he is quite compliant. But when he has a tantrum/rage it is always triggered by him feeling that he's not in control.) I use the word rage because he goes to a serious red zone sometimes - screaming at the top of his lungs, banging doors if he's closed in his room,hitting at us if we don't separate ourselves from him somehow, etc... And he can continue that for quite a while. He has also recently, just a couple of times, visibly regulated himself - taking himself off to sit alone until he was calmer, and then coming back and being sweet and gentle. I saw that and thought maybe we had turned a corner but then we had a week of daily rages that undermined the progress I thought he had made.

I can (and perhaps do) make lots of excuses for him - he's 3-4 and this kind of thing is developmentally normal, he has a twin sister who is dedicated to provoking him and is constantly needling him, both kids are in competition for parental attention (these behaviors are often worse when only one parent is home/available), there has been a fair amount of stress in our house this month (high stress guests, home repair nightmares, parental stress from life/work/etc...) and he tends to be quite emotionally sensitive, we changed nannies 6 weeks ago (though that transition seemed to go quite well and wasn't the result of any trauma or ill will), and so on...

My husband thinks he needs professional help. I think we're not doing a good enough job as parents. But we are at the point, after a particularly difficult week, where I'm really on the fence. I don't want to be so defensive or blind that we fail to get him (or us) professional help if it is appropriate. But I also don't want to overreact and make more of this than it needs to be - especially if the real issue is a lack of skill or information on our part.

I'm not sure it's possible to give advice on something like this when you don't know us and there is such limited information. But if any of you have any wisdom on how to work through these decisions, any expertise on the kinds of specific behaviors that are markers for needing intervention, or any strategies you would recommend we try, I would really welcome the advice.

Thanks so much. I really hesitated to post here because I am aware that many kids and families have much greater struggles, and I can only begin to imagine the pain and stress of that. I am in awe of the strength I see here routinely.

[Anonymous]

He may not be special needs but just need a few coping strategies. Which would mean you need a few so you can present them to him.

[Anonymous]

OP, I agree with your DH

You need to have him evaluated by a Developmental Pediatrician right away - so that you can start therapy right away IF that is what is recommended. Early intervention is the best thing you can do for these types of issues.

[Anonymous]

^^ Also 'help' for him would almost certainly include helping you and your DH find a behavioral approach that works for whole family. Getting some expect advice or help will give you more parenting tools and make you not a 'better parent' but perhaps a better parent yo the child you have.

[Anonymous]

I would just say that often kids act differently around parents/siblings than in a class setting. Have you tried a preschool for him yet?

I would encourage you to get him into a school setting so you know now, before kindergarten, how he is in a class setting. Can you control himself in class? How would he treat peers? How is the quality of his writing? All those things matter greatly at this age.

Then you would benefit from hearing from a teacher how s/he thinks your son is doing compared with kids his age.

[Anonymous]

Anonymous wrote:He may not be special needs but just need a few coping strategies. Which would mean you need a few so you can present them to him.

There's no harm in doing both. I would read the Kazdin Method to help you and DH learn more effective parenting classes. A behavioral therapist can also be helpful.

In terms of the tantrums, so some kids this may be a phase or an indication of something else. I would get yourself on a waitlist for a developmental pediatrician at KKI or Childrens.

If usually takes a few months, so in the meantime implementing behavioral techniques may improve behavior.

P.S. Don't compare kids. I'm sure it's especially tempting with twins, but it's truly irrelevant.

[Anonymous]

How long do his rages last? If they're 20 minutes or so, I don't see anything that is terribly troubling. If they last more than half an hour, I'd say you may need to seek professional assistance. Whichever way it is, you need to make sure you have effective discipline. the Kazdin book is good as is 123 Magic and Positive Discipline. We did a Positive Discipline course with Renee Hackney http://www.parentingplaygroups.com/parentworkshopdescriptions.htm even before we knew our kids had SN. It was extremely helpful and effective. Once you have some effective tools, it will help you (and any professional you consult with) determine where your kid actually lies on the tantrum/rage continuum.

[Anonymous]

OP here. Thank you all for your thoughtful and helpful feedback.

[Anonymous]

I think this is just the kind of struggles many of us have, honestly. It does sound like there are some potential issues, especially if he's closer to 4. We're they premature? I would call child find/area equivalent.