Was he ever evaluated by an OT? The reason I'm asking is that my 6 yr old with Asperger's seemingly met all milestones on time including motor milestones but when he was evaluated by his school, he qualified for OT and PT services, and he does have motor planning issues.

Just want to mention - I think the 5-6 year old age group experiences quite a bit of fear and anxiety. My DS (6) is definitely there. He follows me around the house now - would never have done that when he was younger. I remember being extremely self conscious at the age of 6. So it might be developmental. In the meantime, I suggest you let him know that everyone has fears - it's normal, but don't let it stop you trying the activities. Suggest ways you can help him (e,g. go on the ice with him for a bit). Discuss it in advance - what can you both do to help him make it happen? And don't forget to talk to him after he's done something he was scared of - I.e. see how it wasn't as bad as he expected ?

Anonymous wrote:OP here. We did have a full evaluation when DS was 4 because we do have a family history of Aspergers (my brother, for instance). He doesn't have any motor delays and has met all his milestones except for speech. He's very social and was never shy to approach a kid he didn't know on a playground.

So it can't be an OT issue? No motor planning, SPD issues, etc. The tantrums sounds like anxiety and problems with transitions. If it does not disappear (or gets worse), I would take him back to whoever evaluated him and ask them about it.

I find it interesting that you had him evaluated only b/c you have a family history of Asperger's mostly b/c we also have a family history but it never occurred to get our son evaluated until his school mentioned an evaluation would be a good idea.

OP here. We did have a full evaluation when DS was 4 because we do have a family history of Aspergers (my brother, for instance). He doesn't have any motor delays and has met all his milestones except for speech. He's very social and was never shy to approach a kid he didn't know on a playground.

Anonymous wrote:

Well, they do "all diagnose SPD". I'm one of THOSE posters and our OT diagnosed SPD for our kid with motor planning/coordination issues. He had also met all milestones on time and while he did have gross and fine motor issues they were mild. We went to a developmental pediatrician who diagnosed ASD/Asperger's. Had we stopped with the OT diagnosis, we never would have gotten a global evaluation and help for ALL his issues. My Aspie rarely/never throws tantrums like OP's kid. He was diagnosed at 4 and received OT and PT. He has pretty much caught up (enough to enjoy gym classes and play soccer) at 6 and no longer does PT.

Since OP also mentioned a speech delay, I suggest a global evaluation with a developmental pediatrician not just an OT eval. GL!

NP here. I don't know why you feel the need to bash OTs. It sounds like your DC was diagnosed correctly with motor planning/coordination issues (which is included under the SPD rubric). OTs provide valuable services. Developmental pediatricians do global evaluations but OTs/SLPs/PTs specialize in areas that dev peds don't. A developmental pediatrician can tell you if a child has expressive/receptive speech delays but isn't going to be able to pinpoint the specific areas of strengths/weaknesses that an SLP can. A SLP can also better tell whether a particular breakdown in speech is due to speech processing or if it's muscle related. With the limited amount of time you have with a dev ped, they can't do it and it's not what they specialize in.

I don't read anything into OP's post that would indicate a global evaluation is warranted at this time. Speech delays and a recent history of tantrums isn't enough to warrant a global evaluation.

Not bashing OTs at all. Our OT does a great job and has helped tremendously with fine motor issues. But SPD is not a medical diagnosis and SPD issues can be an indicator for medical issues. Not always but most of the time. Better to get it checked out. Since OP describes a child who has anxiety issues and a speech delay, a global evaluation may be more helpful than an OT eval.

Well, they do "all diagnose SPD". I'm one of THOSE posters and our OT diagnosed SPD for our kid with motor planning/coordination issues. He had also met all milestones on time and while he did have gross and fine motor issues they were mild. We went to a developmental pediatrician who diagnosed ASD/Asperger's. Had we stopped with the OT diagnosis, we never would have gotten a global evaluation and help for ALL his issues. My Aspie rarely/never throws tantrums like OP's kid. He was diagnosed at 4 and received OT and PT. He has pretty much caught up (enough to enjoy gym classes and play soccer) at 6 and no longer does PT.

Since OP also mentioned a speech delay, I suggest a global evaluation with a developmental pediatrician not just an OT eval. GL!

NP here. I don't know why you feel the need to bash OTs. It sounds like your DC was diagnosed correctly with motor planning/coordination issues (which is included under the SPD rubric). OTs provide valuable services. Developmental pediatricians do global evaluations but OTs/SLPs/PTs specialize in areas that dev peds don't. A developmental pediatrician can tell you if a child has expressive/receptive speech delays but isn't going to be able to pinpoint the specific areas of strengths/weaknesses that an SLP can. A SLP can also better tell whether a particular breakdown in speech is due to speech processing or if it's muscle related. With the limited amount of time you have with a dev ped, they can't do it and it's not what they specialize in.

I don't read anything into OP's post that would indicate a global evaluation is warranted at this time. Speech delays and a recent history of tantrums isn't enough to warrant a global evaluation.

Anonymous wrote:My DS was about the same age as yours (just before his 5th birthday) when he started exhibiting some similar behaviors. We couldn't figure it out because it was so very unlike him. It was getting the point that he was refusing to go to home birthday parties if he didn't know all the kids. He even got out of a bouncy house at one because there was one kid in there with him that he didn't know. He was refusing to try novel physical activities that he previously expressed interest in (and his younger siblings were doing). We were growing very concerned about it because it was getting worse over a 6 month period. I spoke to his pediatrician who suggested we meet with a child psychologist and also schedule an OT evaluation. We were able to see the psychologist first - it was just DH and I. After listening to our case history, he agreed said it sounded like DS had some general anxiety and asked us to first proceed with the OT evaluation. If OT didn't help, we were to come back to him.

Now, I know someone is going to come on here and start bashing OTs and say 'they all diagnose SPD' - which is what the OT did diagnose as well as low muscle tone. During the evaluation and subsequent OT sessions, it became clear to us that DS had some motor planning/coordination issues. He'd met all his physical milestones and was, up to that point, seemingly totally normal. But, up to that point, he'd not really be self aware nor did we notice that he was slightly lagging behind his peers. It was a lot harder for him to do new physical activities and he was becoming aware of it and it bothered him. After about 6 sessions of OT, his confidence really shot up and it wasn't as much of an issue. We continued OT for a while after that because of fine motor delays (we joined an NIH research study and learned a lot more about it from the NIH research team). After a while, we discontinued it. These SPD issues he's got are still there but manageable. However, his anxiety has waxed and waned over the years and has, at times, been problematic. So, for us, the issues he had when he was 5 were a combination of anxiety and motor planning/coordination. I suggest you read up on it and see if anything pertains to your DS. If so, you might consider an OT evaluation. It really gave our DS a lot of confidence. HTH.

Well, they do "all diagnose SPD". I'm one of THOSE posters and our OT diagnosed SPD for our kid with motor planning/coordination issues. He had also met all milestones on time and while he did have gross and fine motor issues they were mild. We went to a developmental pediatrician who diagnosed ASD/Asperger's. Had we stopped with the OT diagnosis, we never would have gotten a global evaluation and help for ALL his issues. My Aspie rarely/never throws tantrums like OP's kid. He was diagnosed at 4 and received OT and PT. He has pretty much caught up (enough to enjoy gym classes and play soccer) at 6 and no longer does PT.

Since OP also mentioned a speech delay, I suggest a global evaluation with a developmental pediatrician not just an OT eval. GL!

My DS was about the same age as yours (just before his 5th birthday) when he started exhibiting some similar behaviors. We couldn't figure it out because it was so very unlike him. It was getting the point that he was refusing to go to home birthday parties if he didn't know all the kids. He even got out of a bouncy house at one because there was one kid in there with him that he didn't know. He was refusing to try novel physical activities that he previously expressed interest in (and his younger siblings were doing). We were growing very concerned about it because it was getting worse over a 6 month period. I spoke to his pediatrician who suggested we meet with a child psychologist and also schedule an OT evaluation. We were able to see the psychologist first - it was just DH and I. After listening to our case history, he agreed said it sounded like DS had some general anxiety and asked us to first proceed with the OT evaluation. If OT didn't help, we were to come back to him.

Now, I know someone is going to come on here and start bashing OTs and say 'they all diagnose SPD' - which is what the OT did diagnose as well as low muscle tone. During the evaluation and subsequent OT sessions, it became clear to us that DS had some motor planning/coordination issues. He'd met all his physical milestones and was, up to that point, seemingly totally normal. But, up to that point, he'd not really be self aware nor did we notice that he was slightly lagging behind his peers. It was a lot harder for him to do new physical activities and he was becoming aware of it and it bothered him. After about 6 sessions of OT, his confidence really shot up and it wasn't as much of an issue. We continued OT for a while after that because of fine motor delays (we joined an NIH research study and learned a lot more about it from the NIH research team). After a while, we discontinued it. These SPD issues he's got are still there but manageable. However, his anxiety has waxed and waned over the years and has, at times, been problematic. So, for us, the issues he had when he was 5 were a combination of anxiety and motor planning/coordination. I suggest you read up on it and see if anything pertains to your DS. If so, you might consider an OT evaluation. It really gave our DS a lot of confidence. HTH.

Anonymous wrote:I'm truly jealous that he went 5 years without having a tantrum!! Maybe it's a developmental growth spurt and he's out of sorts?

OP here. God, I hope not. He's already too tall for a five year old and wears size 6-7 clothes.

I'm truly jealous that he went 5 years without having a tantrum!! Maybe it's a developmental growth spurt and he's out of sorts?

It may be a very short-lived thing. My son has other issues, but adjustments to new people/places has never really been one of them. This summer, we had an AWFUL experience with one particular camp--ballistic tantrums every morning. This is a very well regarded camp, and I knew other kids there, so it wasn't that the counselors were a horror or anything. All I can figure is that it's just where he was that week, or maybe there was one thing that set him off on the wrong foot. I would give it a couple weeks before you get too concerned --- don't give him a lot of positive feedbacks about the tantrums, and it may just resolve.

OP here. No extra stressful situations. Same preschool, no new siblings or pets. He did have a vacation though during winter break.

Agree with PP. My child also went from super easy going baby to defiant/avoiding preschooler who would meltdown when overwhelmed. He was eventually diagnosed with generalized anxiety, which has only become more obvious over the years. I definitely didn't see it coming, though in retrospect, I do see signs. Not saying that your child has a diagnosis of anxiety or anything like that, only that these are very typical signs of stress.

I would want to know if there is something going on in the child's life that is stressful. A move, a new sibling, a problem at school, a friend moving away. What is stressful?

How do you handle these situations?

My five year old never threw tantrums. And I mean never. With the exception of his speech delay, he is a very typical five year old. He loves sports, cars, is pretty fearless. But lately he has started to throw tantrums whenever he tries a new activity. For example, he begged us to sign him up for ice skating lessons. We get to class and he is clinging to me and he's crying non-stop. When the coach tried to approach him, he climbed underneath a bench!

Yesterday we went to his friend's birthday party. He was pretty excited to him. THe moment all the kids started climbing and jumping on bouncers, he again climbed underneath the bench and refused to come out. He went to eat a cake kicking and screaming. This has been going on for almost a month now.

Is this some sort of transition time for him or is this a more serious concern?