Reply to 5-year-old behavior issues in Kindergarten

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]We would greatly appreciate any advice you have, as we are at a loss right now. We do not live in the DC area, but I have read and learned a lot about parenting from this forum.

Our DS started Kindergarten less than two months ago. He has a January birthday, so he is neither the youngest nor the oldest in his class. Overall, he seems to like school. He doesn't talk about school much, but occasionally he brings up school-related topics. When we ask specific questions about school, he usually answers us.

We just had a parent-teacher conference today, and the teacher pointed out several behavioral concerns. He does not really interact with other kids, even if other kids invite him to play. He daydreams and does not pay attention to the teacher. He talks to himself and sings when he's not supposed to. Academically, he's doing really well, even in his public school GT class.

The teacher suggested we seek a psychological evaluation (e.g., ADHD). We will reach out to his pediatrician about this. His teacher's observation is somewhat surprising but not totally out of the blue. DS has always been a bit socially behind; he is also sensitive and a perfectionist, so I know it will take him longer to adjust to Kindergarten. He is an introvert, but he also enjoys playing with other kids. He sometimes plays with stranger kids at the playground, so the teacher's observation that he does not play with his classmates really concerns us. I'm worried that he might be experiencing anxiety, so he uses self-talk as a soothing mechanism, and he kind of shuts himself down, which explains the lack of interaction with other kids.

His preschool teachers never raised similar concerns. DS has several close friends from preschool whom he still plays with. He is engaged in extracurricular classes. In addition to a psychological evaluation (which will be a long wait), are there steps we can take to help him? Could he be experiencing anxiety? Would occupational therapy or any other therapy help? I'd love to hear your thoughts or experiences. TIA.[/quote]

I am a teacher and parent of teen diagnosed with ADHD in elementary and Autism in middle school. The purpose of a neuropsych evaluation is to tease out what is going on whether it be anxiety, ADHD or autism (or a combination). Preschool teachers do not have the same education or experience as an elementary school teacher and so it isn’t surprising that they did not comment on your child’s behavior. Not only that, your child’s behavior may have fallen in the norm for preschool, but is now outside the norm for kindergarten. Teachers generally don’t recommend a neuropsych evaluation for borderline cases - she is very clearly seeing something she thinks needs further investigating. Your child may benefit from seeing a child therapist or psychologist. They can assess whether there is anxiety and provide their own thoughts at what may be going on.[/quote]

May I also ask what are some characteristics of kids who were not diagnosed with ASD when they were younger but were subsequently diagnosed in elementary or middle schools? Our child is sensitive (gag reflex), has allergies, and sometimes impulsive. But he thrived in preschool and wanted to be with friends (requests playdates, does not want to go somewhere but if his friend is going he agrees to go, etc). He is usually easy and adapts well to new settings. He has travelled to many places, met relatives, our friends, etc., and in all these settings he seems to enjoy and was well behaved. He does not enjoy a big crowd, for example, when we took him to magic show he would observe but not as excited as other kids. I am just not sure whether some of these characteristics are just his personality (which is a lot like me and my husband) or could also indicate that he could be on the spectrum. [/quote]

I am PP. As far as providers for neuropsychological evaluations there are many DCUM threads listing providers and “reviews.”  People like KKI (Kennedy Krieger), Children’s Hospital, Dr. Black at CAAT, and Stixrud.

I would be happy to tell you about our experience with a teen late diagnosed with ASD, but I don’t think it will be helpful to you. It’s very hard to generalize with issues like this. Your son is so young and there is a lot of overlap between the way ADHD, anxiety, and ASD can present. My child is very typical of a high functioning, late diagnosed girl. If you read about autism, girls present very differently than boys and are diagnosed later.

She was very verbal (her verbal IQ is actually in the 99% making her 2E) and imaginative. She always had a lot friends and play dates until middle school when the social demands changed. She was a colicky baby that needed to be held all the time. But since then she has been a dream child. So easy, even as a teen. Never had tantrums and is easy going. Her ADHD manifests as forgetful and inattentive, so no behavioral or academic problems. She has a high IQ and compensated until high school, until the demands became too much. Looking back, the only “tip offs” to her autism when she was young was: her toe walking (which her pediatrician— with an autistic son—did not flag as a concern or indication of autism), her dislike of fruit (she will not eat any fruit even though she loved it as a toddler), and her deep interest in animals. She used to take out the same couple of animal books over and over from the library in kindergarten.

In my uneducated opinion, I have always assumed that boys with autism are caught earlier because they have more obvious and stereotypical autism symptoms, which your son doesn’t seem to have. You say your son doesn’t like large crowds - that could be due to anxiety or sensory overload from ADHD or autism. Or it could just be his personality. It’s just very hard to tease these things out especially at a young age. Don’t stress over feeling like you need to have a diagnosis immediately. These things take time. The good news is that his academics aren’t impacted and he isn’t showing anxiety/distress at home. You will be able to work on the school piece.[/quote]

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