Reading/resource recs for attentive disorders/anxiety

[akafred]

The best book I have read for this kind of thing in general is "The Whole Brain Child". It's not EXACTLY for attention/anxiety issues, but by understanding better how the brain works, you can definitely see how it *doesn't* work quite right for kids with these deficits. I wish I had read it when DD was younger; I read it when she was 5.

[URMySunshine77]

Hey old friend. I've got more to write but just wanted to see really quickly if DS uses noise cancelling headphones when baby cries?

[spooko]

I can't speak to the rest, but I tend to be pretty sensory sensitive, especially with noises. On one level there's the actual overstimulation, but I really struggle with Misophonia. I haven't pursued treatment for it, but I do know that it can be treated with exposure therapy (kind of like you'd address a phobia). Maybe that's another avenue to try?

[spooko]

@aeroplaneoverthesea, I do wonder if it's more misophonia then. Typically there's a more mental component with that and in my (limited) research on it, there's an emotional side where those who irritate or are closer to us can have a greater impact than someone or something more removed. IDK!

[mrsbuttinski]

This sounds as if it is more than a garden variety sensory issue given that his response is directed at a sibling and not other crying babies or even the more common anxiety inducing random sounds that dog kids with an anxiety component to their SPD. These would be things like fire sirens, automatic toilet flushers/hand dryers, etc.

Did the dev pedi R/O ASD? Many of the behaviors you are describing are seen in an ASD presentation- late toileting training (developmental delay of an adaptive skill), sensory issues, aggression related to anxiety, social anxiety.

What behavior is the dev pedi referring to as "cognitive impulsity"?; that's not a commonly used term outside of ADHD and/or specific learning disability.

The best book, IMHO, for this kind of behavior is "The Explosive Child".

[akafred]

Apr 6, 2017 16:15:24 GMT -5 @aeroplaneoverthesea said:

Apr 6, 2017 15:37:48 GMT -5 mrsbuttinski said:

This sounds as if it is more than a garden variety sensory issue given that his response is directed at a sibling and not other crying babies or even the more common anxiety inducing random sounds that dog kids with an anxiety component to their SPD. These would be things like fire sirens, automatic toilet flushers/hand dryers, etc.

Did the dev pedi R/O ASD? Many of the behaviors you are describing are seen in an ASD presentation- late toileting training (developmental delay of an adaptive skill), sensory issues, aggression related to anxiety, social anxiety.

What behavior is the dev pedi referring to as "cognitive impulsity"?; that's not a commonly used term outside of ADHD and/or specific learning disability.

T he best book, IMHO, for this kind of behavior is "The Explosive Child".

We brought him to the developmental ped expecting an ASD diagnosis. I just thought he has a lot of little quirks, but I will say we're new at this all, and just trying to learn and adapt as quickly as possible. So maybe anxiety and attention issues fit too?

Things that we thought were odd at home included his laser focus/obsession with certain things. He started reading at 2, like reading everything. He could count to 1,000 by 3 and he's obsessed with numbers...I was like, okay this is not normal, right? He can name all the planets in order from the sun, and dwarf planets too...he just gets really into things. However he's also weirdly social. When we're at the psychologist office he talks to everyone in the waiting room. He tells imaginative stories and will talk about the things he loves to anyone who will listen. He loves attention, when we leave school everyday he shouts "class say bye to me!" And is absolutely tickled when they do. Transitions are rough, and he often wants to do what he wants to do. If we're out at a store he needs to be restrained in a cart or he's running all over the place. The developmental ped said he showed "no signs of ASD" and I believe thought the impulsivity came from him just selecting the first answer to questions to be done and move on.

It's like the dr said, "Aspergers isn't a dx anymore so he must not have it." That sounds like textbook stuff. And kids on spectrum can absolutely be "social", sometimes overly so. Sometimes they are "too" social, which also violates social norms, kwim? It's that challenge in recognizing and understanding those social norms, relative to age, that makes it a delay in that area. Two of the three little ASD friends I have current contact with are all up in your personal space and extremely friendly/social..."too" social. The other pretty much ignored people unless directed by his mom to address them.

[mrsbuttinski]

Ugh. But did this dev pedi do the actual assessments that could R/O ASD? Did they do ADOS? ADI? GADS?

Some random thoughts-

That pretty much sounds like my son only he had no issues with aggression. Probably because he didn't have a sibling to annoy him or interfere with his access to his preferred person, aka me. DS's "issues" didn't become a problem until well into kindie when he was 6. That said, he did "outgrow" some of his sensory issues and did mature out of a lot of his impulsivity. He also had years of positive discipline and CBT/CSIT.

I'm sure you can appreciate that your home school district may not be as proactive about identifying a child with a high functioning form as ASD since their IEP would be expensive to service; better to flatter mom out of services with a softer dx  and the notion the child's needs will be "outgrown" without school based interventions.

Aspergers has been subsumed by ASD in the current DSM-5. It still exists as a dx outside of the American Psychiatric Association Diagnostic manual; The International Classification of Diseases (ICD-10 for instance). DS's initial dx was Aspergers. His psychiatrist and psychologist both still consider him under that dx although he has been officially changes to ASD under the DSM-5. DS self identifies under Aspergers primarily though he does also have ADHD and GAD.

www.icd10data.com/ICD10CM/Codes/F01-F99/F80-F89/F84-/F84.5

Some kids with ASD can be social, though not necessarily in the most typical manner. Michelle Garcia Winner describes this as being "socially curious and curiously social". DS did really well socially in preschool even with peers although he always found chatting up older kids and adults more in his wheelhouse. Being social with indulgent adults doesn't count. 

DS used to race through work choosing the first answer when he was doing subjects that he didn't value or that didn't come easily to him. It was a way to "make it go away".

I would encourage you to read a copy of the OASIS Guide to Aspergers Syndrome or read about "Teddy" in Making Sense of Autism Spectrum Disorders. "Teddy" is about 85% based on DS.

[mrsbuttinski]

Apr 6, 2017 19:18:07 GMT -5 @aeroplaneoverthesea said:

Our developmental ped appointment felt very casual. It was almost 10 months ago, but from what I remember there was some block building formations, some directives, and a series of pictures where DS was asked to identify various emotions/activities and select the best fit. The specific tests you mentioned are not familiar to me, so I'm going to guess they weren't done. I'll definitely check out those books and call the office for a second opinion.


GADS, ADI, CARS are all interviews given the parents. A good clinician can make these feel almost like a conversation or taking a history. By design, they often feel as if the clinician is repeating a question because they are structured to reframe a query multiple times- you can come away feeling like "you just asked me that". ADOS, which is the gold standard, involves a couple of free play kind of scenarios including blowing bubbles and playing birthday party. Some clinicians will also ask teachers/caregivers to complete questionnaires ahead of the appointment. 


You should have gotten a comprehensive report about a month after with the scales used for evaluation and the results. 


I wouldn't R/O ASD because a kid can identify emotions. LMAO, DS's elementary SLP was always dazzled by DS's ability to do this better than many NT kids because he'd had so much rote instruction in the form of DH and I discussing the feelings of others even before he was officially dxd at 7. As a toddler one of his favorite books was one of photographs of young children exhibiting different emotions- it was almost as if he was cramming for some future test because he knew he didn't intuit the answers. DS has been telling me he "wasn't like those other kids" since he was a young 4.


The best evals in a preschool aged child tend to take several hours; they may even be broken up over 2 days. Ideally, the child sees a team of people- a dev pedi, perhaps a psychologist, OT, PT and SLP. 

[mrsbuttinski]

Also, did they do Conners Scales or anything to determine if there is ADHD going on? This would also be explored with his current teachers/caregivers.

This describes some of the tests used specifically for Aspergers even though it is no longer included in the DSM-5.

www.kennethrobersonphd.com/is-there-a-test-for-aspergers-syndrome/