What do you think is going on with this boy?

Question

He's 3-1/2 and has less than 10 words. He also learned a couple of signs in his early intervention program. He tries to talk but it's gibberish. He then gets frustrated and has terrible tantrums, screaming and crying.

Since he was an infant, he has rocked back and forth. So much so that he could "walk" his highchair across the floor. When sitting and watching a movie for instance, he'll rock back and forth on the couch, constantly. It has been said that he "explodes" into a room, constantly running, crashing into things, tackling himself onto the floor...

He does not engage in any pretend play. He doesn't line things up either. He does play appropriately with toy cars I suppose. He'll roll them along the ground then crash them, or throw them off the edge of a table so they crash. Most of his play is extremely physical, the trampoline, splash pool, park equipment. Very coordinated, he was running & climbing by 14 months.

Socially he doesn't join in with the other kids, but hangs back and follows along. He goes to a Montessori preschool. During free choice, he won't make a choice, but will go stand by the teacher until she directs him. At recess, he won't mix with the other kids, but will stand by the teacher.

Curious what people think

Answer 1

i am by far not a doctor. i am just a teenage girl. But i have lived with a younger brother who is autistic for my whole life. It sound so similar to him growing up. i knows few words, speaks mostly gibberish. and what he does love to play is physical. And seems to be ani social, doesn't interact with others well or at all. I don't think that he is autistic, because he was able to walk at a normal age, he could have asbergers. This means that he has a high functioning level of autism, and the one thing that they tend to struggle with the most is in social situations. and as for the constant rocking back and forth and the exploding into a room, autism children most of the time have a little bit of adhd.

Answer 2

From what you describe, it sounds like some sort of Autism Spectrum Disorder however, there are other disorders/disabilities that share characteristics of ASD.  Look into Sensory Integration Dysfunction and Apraxia.  

Some of the signs of SID are:

An acute awareness of background noises

Fascination with lights, fans, water

Hand flapping/repetitive movements

Spinning items, taking things apart

Walking on tip-toe

Little awareness of pain or temperature

Coordination problems

Unusually high or low activity level

Difficulty with transitions (doesn't "go with the flow")

Self-Injury or aggression

Extremes of activity level (either hyperactive or under active).

Fearful in space (on the swings, seesaw or heights).

Striking out at someone who accidentally brushes by them.

Avoidance of physical contact with people and with certain "textures," such as sand, paste and finger paints.

The child may react strongly to stimuli on face, hands and feet.

A child may have a very short attention span and become easily distracted.

A strong dislike of certain grooming activities, such as brushing the teeth, washing the face, having the hair brushed or cut.

An unusual sensitivity to sounds and smells.

A child may refuse to wear certain clothes or insist on wearing long sleeves/pants so that the skin is not exposed.

Frequently adjusts clothing, pushing up sleeves and/or pant legs.

Characteristics of Apraxia include:

Delayed onset of speech

Limited babbling as an infant

Restricted sound inventory

Loss of apparently previously spoken words

Receptive ability far exceeds expressive ability (your child understands at a much higher level than he or she is able to express)

Limited vocalization and sound play during infancy (parents often describe their child as a "quiet baby")

Limited number of consonant sounds

Possible difficulty in feeding during infancy

Vowel errors and distortions  

May have developed elaborate nonverbal or gestural communication

While repetition of sounds in isolation may be adequate, connected speech is more unintelligible than one would expect on the basis of single-word articulation test results. (Although the child may be able to produce sounds perfectly by themselves, he or she may make errors on these same sounds when combining them in longer units like words or phrases.)

Initial and final consonant deletion, cluster reduction, syllable omissions, substitutions and distortions (speech errors in children with apraxia of speech are often referred to as inconsistent or unpredictable)

Increase in errors with increase length of utterance, including problems producing multisyllabic words

Voicing errors (i.e.: Some sounds are produced very similarly except one may use the vocal cords--"voiced"--and one may not--"voiceless." For example, "P" and "B" are produced similarly. "P" is a voiceless consonant and "B" is a voiced consonant; "B" uses the vocal cords. Children with apraxia of speech can confuse or substitute these.)

Errors vary with the complexity of articulatory adjustment. (Articulatory adjustments means the extent to which the articulators--lips, tongue, etc.-- must shift between sounds in a word or phrase. A word like "baby" does not require much adjustment. A word like "dog" requires more adjustment.)

Groping, trial and error behavior, struggling to deliver speech. The child in this struggle may make sound prolongations, repetitions, or silent posturing. (For instance, the mouth appears to "grope" or be searching for positioning. Or the child may use short sounds or words repeatedly, using the time to try and find the motor position for the next sound or word he or she wants to make. An example: "I, well, well, well, can't do it." This is not the same as stuttering. Silent posturing means a child's mouth may move silently while he or she is searching for proper motor position.)

Slow rate and incorrect sequencing, called diadochokinesis. (For example: ask the child to say "pah, tah, kah" three times, or a word such as "buttercup". The child may get the sequence right the first time, but on subsequent attempts it will break down and the rate will be slowed.)

Prosodic disturbances. Prosody is the melody of speech and includes rate, stress, pauses, and intonation. (Children with apraxia of speech may speak too slow or too fast. They may not put stress on the correct syllables. Their voices may sound monotone.)

Oral apraxia sometimes, but not always, can accompany verbal apraxia. Oral apraxia is the impaired ability to, on command, perform nonspeech tasks like puffing out cheeks, l*****g lips, protruding tongue, puckering lips, etc.

Apraxia of speech may occur in isolation or in combination with other speech and language problems. The incidence of "pure" apraxia of speech is reportedly low. Most typically, children will exhibit a number of problems that contribute to their difficulty with speech.

Other "soft" neurological signs. Sometimes these children are described as awkward, uncoordinated, or clumsy. They may have difficulty organizing and coordinating fine motor skills too. Some parents report that their child may have sensory problems, poor body awareness, dislike toothbrushing, or seem sensitive to touch in their facial area.

Children with visual and hearing impairments also exhibit sensory integration issues as well as difficulties in communication.

I would recommend this child see a pediatrician, neurologist, and psychologist as well as receive comprehensive speech/language and occupational therapy evaluations.

Answer 3

there are major sensory integration issue going on-

it may be autism--

Answer 4

It sounds as if he has some sensory integration issues.  The fact that he is very physical and likes "deep impact" activities such as the trampoline, crashing into things, and tackling himself onto the floor indicates that he needs more physical/ motor stimulation than most kids.  The rocking behavior and the way that he plays with his cars also fits into this.  An occupational therapist could do an assessment and suggest activities that might be helpful.

As far as the speech/ language issue, it sounds as if he understands what is being said to him, judging by the fact that he will stand by the teacher "until she directs him."  But clearly his expressive speech is a major concern, which leads to some behavioral acting out when he becomes frustrated.  He may have apraxia, which makes it difficult for him to get his mouth, lips, and tongue make the movements that are needed to make the sounds of speech.  A speech therapist could do an assessment and make recommendations.  It would be a good idea to give him an alternate means of communication, such as a Picture Exchange Communication Systems (PECS.)  I generally like PECS better than sign, because most people don't sign, but  most people can read the pictures/ words in a PECS set-up.  Being able to communicate would reduce his tantrums.

The fact that he prefers the company of the teacher may just be a good adaptive strategy on his part.  The child already knows that he isn't able to communicate expressively very well, and the teacher has already demonstrated that she can help him even if he can't verbalize his needs (i.e., she directs him to an activity at choice time.)  He feels safe with her.  He may be a naturally shy child, or he may have learned that peer social interactions are not successful for him.  In any case, he has learned that being close to the teacher is the most comfortable place for him.

Obviously many of the things you have described are associated with autism.  Also obviously, none of us are qualified to make a diagnosis.  But there a couple of things that would make me lean toward sensory and speech issues, rather than autism:  1) The only self-stimulating behavior you mentioned was rocking, which also fits in with sensory integration disorder.  2) You don't mention any ritualistic behavior - he doesn't line things up or sort things into groups, or have the need to do everything in a particular way or order.  3) He follows along with the other students, rather than withdrawing to engage in a solitary interest.  He also spends his time hanging out with the teacher rather than isolating himself.  He has some social deficits, but they may well be related to his communication issues rather than to autism.

In any case, I hope this little guy is being assessed by qualified professionals who can make recommendations to assist him.

Answer 5

Sounds like early Asperger's.

Answer 6

take him to the doctor as much as i dont wish to say it it may be autism but only a dr can make that determination

Answer 7

I didn't read many of the answers, but my first thought was Autism.  There could also be other disorders that have to do with sensory integration, but everything you said is something you would hear from parents that have children with Autism.

I would suggest visiting your physician and getting a referral for a specialist.  

I have studied quite a bit on how to help children with Autism in Montessori classrooms, so if you need any help with that, please ask.  But get the diagnosis first.  It's impossible to diagnose something like that from an internet question.

Answer 8

He needs tested for an Autism Spectrum Disorder, could be Aspergers or PDD-NOS, the sooner he is diagnosed the better.

Answer 9

Sound like autism but 3 and a half is early to tell where on the spectrum.

Routine and patience will help him until he gets a diagnosis and extra help.

Answer 10

As the mother of a severly Autistic 2 year old, it definataly sounds like he may be on the Autism spectrum. He needs to go to a doc, or a child phsycologist for an autism evaluation. Early detection can be key in his progress.

Answer 11

Personally from some of the things you are discribing its the same thing that happen to my nephew.  he just got diaginosed with Autisum.

He gets very very fustrated with different things, and at people when they can not understand him. He really doesn`t speak much.  He can change his mood instantly. Good Luck!